Description

Esophageal spasms are painful contractions within the muscular tube that connects the mouth and the stomach, called the esophagus. Esophageal spasms can feel like sudden, chest pain that lasts from a few minutes up to hours. Some people may be confused with heart pain, also called angina.

Esophageal spasms typically occur only now and then, and may not need treatment. But sometimes the spasms happen a lot and can prevent food and liquids from traveling through the esophagus. If esophageal spasms affect the ability to eat or drink, treatments are available.

Symptoms

The symptoms of esophageal spasms include:

  • Squeezing pain in the chest. The pain is often intense and may be confused with heart pain or heartburn.
  • Difficulty in swallowing solids and liquids, sometimes related to the ingestion of specific substances. Red wine or extremely hot or cold liquids are the most common culprits.
  • The feeling that an object is stuck in the throat.
  • The return of food and fluids back up into the esophagus, also called regurgitation.

When to see a doctor

The contraction of chest pain that occurs with esophageal spasms can also be caused by a heart attack. If you have a squeezing pain in the chest, seek medical attention immediately.

Causes

It is not clear what causes esophageal spasms. However, they seem to be related to the abnormal functioning of the nerves that control the muscles used in swallowing.

A healthy esophagus moves food to the stomach through a series of coordinated muscle contractions. Esophageal spasms make it difficult for the muscles in the walls of the lower part of the esophagus to coordinate. This makes it more difficult for the muscles to move the food to the stomach.

There are two types of spasms of esophagus, distal esophageal spasm and hypercontractile esophagus, also known as the esophagus into the nutcracker.

Risk factors

Risk factors for esophageal spasms include:

  • Sex. Women are more likely to have esophageal spasms men.
  • Age. Esophageal spasms tend to occur around 60 years of age.

Diagnosis

To diagnose esophageal spasms, a health professional may recommend:

  • The upper gastrointestinal endoscopy. An upper endoscopy uses a tiny camera on the end of a flexible tube to visually examine your upper digestive system. Endoscopy can also be used to collect a sample of tissue to be examined for other diseases of the esophagus. This tissue sample known as a biopsy.
  • X-rays of the upper part of the digestive system, also called an esophagram. X-rays are taken after you drink a chalky liquid that coats and fills the inside lining of the digestive tract. The coating allows a specialist to see a silhouette of your esophagus, stomach and the upper intestine. Some people may experience diarrhea for 1 to 2 days after this test.
  • The esophageal manometry. This test measures the rhythmic muscle contractions in your esophagus when swallowing; the coordination and force exerted by the muscles of the esophagus; and how well the lower esophageal sphincter relaxes or opens during a swallow.

Treatment

The treatment depends on the frequency of esophageal spasms happen and how bad they are.

If the spasms only happens now and then, a health care professional may first recommend avoiding extremely hot or cold food to see if that alleviates the symptoms.

If the spasms make it difficult to eat or drink, your doctor may recommend that you:

  • Management of the underlying conditions. Esophageal spasms are sometimes associated with conditions such as heartburn or gastroesophageal reflux disease (GERD). A health professional may recommend a proton pump inhibitor for the treatment of GERD. Sometimes, antidepressants, such as imipramine, may be prescribed. This medication can help to reduce the sensation of pain in the esophagus.
  • Medications to relax the muscles of swallowing. The peppermint oil, onabotulinumtoxinA (Botox) injections into the esophagus, or calcium channel blockers such as diltiazem (Cardizem, Tiazac, others), it can make cramps less severe.
  • Surgery (myotomy). If the medicine is not working, a health professional may recommend a procedure that involves cutting the muscle at the lower end of the esophagus. This procedure, called a myotomy, can help to weaken the contractions esophageal. Long-term studies of this approach are not available, so that the myotomy in general, it is not recommended to spasms of the esophagus. However, it may be considered if other treatments do not work.
  • Peroral endoscopic myotomy (POEM). The POEM procedure is minimally invasive. This new technique involves the placement of an endoscope through the mouth and throat. This allows a surgeon will make a cut in the inner lining of the esophagus. Then, as in the myotomy, the surgeon cuts the muscle at the lower end of the esophagus. As standard myotomy, POEM is usually considered only if other treatments do not work.

Lifestyle and home remedies

To help you deal with occasional spasms of esophagus, try:

  • To avoid the triggers. Make a list of foods and drinks that cause your esophageal spasms.
  • Choose foods that are hot or cool. Let the food and drink very hot or very cold it sit for a bit before eating or drinking them.
  • Suck on a mint. Peppermint oil is a smooth muscle relaxant and can help to relieve spasms of the esophagus. Place the mint lozenge under the tongue.

Preparing for your appointment

You may be referred to a health professional who specializes in the digestive system, also called a gastroenterologist.

What you can do

  • Be aware of any pre-appointment restrictions, such as fasting before your appointment.
  • Write down your symptoms, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Write down any triggers of the symptoms, such as specific foods.
  • Make a list of all your medications, vitamins and supplements.
  • Write down your key medical information, including other conditions.
  • Write down key personal information, including any recent changes or stressors in your life.
  • Write questions during your appointment.
  • Ask a relative or friend to accompany you, to help you remember what was discussed during the appointment.

Questions to ask your doctor

  • What is the most likely cause of my symptoms?
  • What tests do I need? Is there any special preparation for them?
  • Is my condition likely temporary or long-term?
  • What treatments are available?
  • What types of foods are likely to make my symptoms worse?
  • I have other health problems. How can I best manage these conditions?

In addition to the questions you have prepared, do not hesitate to ask other questions.

What to expect from your doctor

It is likely to be asked a couple of questions. Be prepared to answer them you can let go the more points you want to spend more time. You may ask:

  • When did you begin experiencing symptoms? How serious are they?
  • The symptoms been continuous or occasional?
  • What, if anything, seems to improve or worsen your symptoms?
  • It makes the effort to carry in the chest pain?
  • Is your chest pain associated with the arm or jaw pain, shortness of breath, or nausea?
  • Are your symptoms related to food? Are triggered by any particular food or type of food?
  • You experience the symptoms of heartburn after eating, such as a burning sensation in the chest or a sour taste in the mouth?
  • Do you ever wake up during the night with heartburn, chest pain, or an acid taste in the mouth?
  • Do you have difficulty swallowing food, or had to change your diet to avoid the difficulty swallowing?
The symptoms and treatment of spasms of Esophagus