Esophageal spasms

An esophageal spasm is the abnormal muscle contractions of the long muscular tube called esophagus which connects your mouth to the stomach. Usually, in a healthy person, the contraction of the muscle coordinated with the peristaltic movement esophagus facilitates the passage of food from the mouth to the stomach. But, with esophageal spasm, the muscle contractions can be irregular, uncoordinated or sometimes powerful that restrict the passage of food normally into the stomach.

The esophageal spasms may occur very rarely and may not require any treatment. However, a frequent or repeated esophageal spasm causing blockage of food and liquids from entering into the stomach may require appropriate treatment to reduce the further complications.

Symptoms

The esophageal spasm symptoms include the following:

  • Chest pain that radiates to arms, back, neck, or jaw
  • Inability to swallow the food or liquid
  • Pain while swallowing
  • Burning sensation in the chest
  • Backward flow of consumed food or liquid (regurgitation)

Medical advice

Usually, no treatment is required for esophageal spasm. But, if the spasms are frequent and cause severe squeezing pain in the chest, then you must immediately seek the medical care.

Risk factors

The incidence of esophageal spasm is very less. People aged between 60 and 80 years are at increased risk of developing esophageal spasms.

It is often associated with gastroesophageal reflux disease. The other factors that increase the risk of esophageal spasms include:

  • Hypertension
  • Anxiety or depression
  • Intake of red wine or consumption of very hot or very cold drinks or foods

Self-management

A change in diet and lifestyle might help you to reduce the progression or prevents the esophageal spasms. Consider the following measures:

  • Avoid chocolate, mint, and alcohol as they worsen your condition.
  • Avoid the intake of spicy foods, acidic foods such as tomatoes and oranges, and coffee.
  • Avoid smoking.
  • Maintain a healthy weight.
  • Avoid stressful situations as stress may increase the severity of esophageal spasms.
  • Use of peppermint lozenge would benefit you by acting as a muscle relaxant.

Your doctor might recommend the treatment based on the severity, frequency, and underlying cause of the condition. The esophageal spasms treatment includes the following:

Medications:To manage the underlying conditions such as GERD, your doctor might prescribe proton pump inhibitor such as lansoprazole. Sometimes antidepressants such as trazodone or imipramine are suggested to reduce pain. Sildenafil, botox injections or calcium channel blockers such as diltiazem helps to reduce the severity of contractions. Surgery:The surgical procedure used to treat esophageal spasm is called myotomy. The procedure involves removal of muscle from the lower part of your esophagus to control the contractions. Another surgical treatment involves peroral endoscopic myotomy (POEM), where an endoscope is used along with myotomy. The surgical procedure is considered only when you don’t respond to any of the treatments.

Often, your doctor can identify the cause of esophageal spasms by taking a medical history and performing a thorough physical examination. To confirm the diagnosis, your doctor might suggest any of the following tests.

  • Endoscopy :Endoscopy is a noninvasive procedure used to examine your esophagus.
  • Barium swallow :During the test, you will be asked to swallow a solution that contains barium and then X-rays are taken while you’re swallowing it.
  • Esophageal manometry :The test is used to measure the muscle contractions of your esophagus.
  • Esophageal pH monitoring :The test is used to determine the acid reflux.

The exact cause of esophageal spasms is still unknown. But, many research studies suggest that they occur due to abnormal neuronal activity that facilitates the swallowing action of the esophagus. Sometimes, the triggering factors such as consumption of drinks, hot or cold beverages, or hot or cold foods may cause esophageal spasms.

Often, the esophageal spasms occur as a result of certain conditions such as gastroesophageal reflux disease (GERD), achalasia, and anxiety or panic attacks.

Types of esophageal spasms

There are two major types of esophageal spasms that include:

  • Diffuse or distal esophageal spasms:The diffuse esophageal spasms are characterized by irregular and uncoordinated squeezing of the esophageal muscles. This causes the food to remain in the esophagus and obstructs the food passage from the mouth to the stomach. In severe cases, it may lead to esophageal motility disorders such as GERD, achalasia, and dysphagia.
  • Nutcracker esophagus:The nutcracker esophageal spasms involve a coordinated squeezing of esophageal muscles. These contractions are very strong and cause severe pain.