What is Esophageal Spasm
Esophageal spasm is a sudden tightening (contraction) of the part of the body that moves food from the mouth to the stomach (esophagus). Normally, smooth, wave-like muscle contractions move food and liquids down the esophagus.
Esophageal spasms are abnormal muscle contractions that can cause chest pain and trouble swallowing (dysphagia). Spasms may also cause swallowed foods or liquids to come back up into the throat (regurgitation).
There are two types of esophageal spasms. You may have one or both types:
- Diffuse esophageal spasms. These are irregular, uncoordinated spasms. This type tends to cause more dysphagia.
- Nutcracker esophagus. This is a type of spasm in which the muscles move normally, but the contraction is very strong. This type tends to be more painful.
Severe esophageal spasms can make it hard to eat and do everyday activities. They often occur with severe heartburn (reflux esophagitis). The symptoms can come and go and may be triggered or worsened depending on your diet or other medical issues.
What are the causes?
The cause of esophageal spasms is not known.
What increases the risk?
The following factors may make you more likely to develop esophageal spasms:
- Being female.
- Age. The risk may increase as you get older.
- Depression or anxiety.
- Having GERD (gastroesophageal reflux disease).
What are the signs or symptoms?
Symptoms may vary from day to day. They may be mild or severe. They may last for minutes or hours. Common symptoms include:
- Chest pain. This may feel like a heart attack.
- Back pain.
- Dysphagia.
- Heartburn.
- A feeling that something is stuck in the throat (globus).
- Regurgitation of foods or liquids.
For some people, certain things may trigger symptoms, such as:
- Certain foods and drinks. These may include very hot or very cold foods or drinks.
- Eating very quickly.
How is this diagnosed?
This condition may be diagnosed based on your symptoms and a physical exam. You may have tests, such as:
- Endoscopy. This involves using a flexible tube that has a camera on the end of it (endoscope) to look down your throat and examine your esophagus.
- Barium swallow. This involves drinking a substance that will show up well on X-rays (barium) and then having X-rays to see how the substance moves through your esophagus.
- Esophageal manometry. This involves passing a small, thin tube through your nose and down into your throat. The tube contains pressure sensors that measure muscle contractions in the esophagus while you swallow.
How is this treated?
Mild esophageal spasms may not need treatment. You may be able to manage the spasms by avoiding triggers. For more frequent or severe spasms, treatment may include:
- Medicine
to:
- Relax the esophageal muscles.
- Relieve muscle spasms (calcium channel blockers and nitrates).
- Relieve pain by blocking nerve endings in the esophagus. This is done with an injection of a toxin (botulinum).
- Relieve heartburn (proton pump inhibitors).
- Antidepressant medicines. These are sometimes used to ease symptoms.
- Surgery to reduce esophageal muscle contractions (myotomy), in very severe cases.
Follow these instructions at home:
Eating and drinking
- Keep track of foods, drinks, and habits that trigger spasms or heartburn. Avoid these triggers as much as you can.
- Eat meals slowly. Chew food completely before swallowing.
- Avoid swallowing foods and drinks when they are very hot or very cold.
General instructions
- Take over-the-counter and prescription medicines only as told by your health care provider.
- Find ways to manage stress, such as regular exercise or meditation.
- If you struggle with depression or anxiety, talk with your health care provider about treatment options.
- Keep all follow-up visits as told by your health care provider. This is important.
Contact a health care provider if:
- Your symptoms get worse or do not get better with medicine.
- You are losing weight because of dysphagia.
- Your esophageal spasms affect your quality of life, such as your ability to eat.
Get help right away if:
- You have severe chest pain.
- You have chest pain that is different from your usual chest pain.
- You have trouble breathing.
- You choke.
Summary
- An esophageal spasm is a sudden tightening (contraction) of the part of the body that moves food from the mouth to the stomach (esophagus). These abnormal muscle contractions can cause chest pain and trouble swallowing (dysphagia).
- The cause of esophageal spasms is not known.
- Treatment may not be needed for mild spasms. For frequent or more severe spasms, treatment may include medicine, or, for very severe spasms, surgery.
- Keep track of foods, drinks, and habits that trigger spasms or heartburn. Avoid these triggers as much as you can.
