Esophageal Spasm

Provided by: Healthwise
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Topic Overview

What is esophageal spasm?

Esophageal spasms are irregular, uncoordinated, and sometimes powerful contractions of the esophagus, the tube that carries food from the mouth to the stomach. Normally, contractions of the esophagus are coordinated, moving the food through the esophagus and into the stomach. Esophageal spasms can prevent food from reaching the stomach, leaving it stuck in the esophagus.

Esophageal spasms are uncommon. Often symptoms that may suggest an esophageal spasm are the result of another condition such as gastroesophageal reflux disease (GERD) or achalasia, a problem with the nervous system in which the lower esophageal sphincter (LES) doesn't work properly. Anxiety or panic attacks can also cause similar symptoms.

What causes esophageal spasm?

The cause of esophageal spasm is unknown. Many doctors believe it results from a disruption of the nerve activity that coordinates the swallowing action of the esophagus. In some people, very hot or very cold foods may trigger an episode.

What are the symptoms?

Most people with this condition have chest pain that may spread outward to the arms, back, neck, or jaw. This pain can feel similar to a heart attack. If you have chest pain, you should be evaluated by a health professional as soon as possible to rule out or treat cardiac disease.

Other symptoms include difficulty or inability to swallow food or liquid, pain with swallowing, the feeling that food is caught in the center of the chest, and a burning sensation in the chest (heartburn).

How is esophageal spasm diagnosed?

Your doctor can often determine the cause of esophageal spasm from your medical history by asking you a series of questions. These include questions about what foods or liquids trigger symptoms, where it feels like food gets stuck, other symptoms or conditions you may have, and whether you are taking medications for them.

The diagnosis can be confirmed with tests, including a barium swallow or endoscopy. These tests use X-rays or a small, lighted viewing instrument to examine the inside of the esophagus. Your health professional may also do esophagus testing, a set of tests used to evaluate the condition and function of the esophagus. Tests measure acid levels in the esophagus as well as the strength and pattern of muscle contractions in the esophagus.

Other tests may be done to determine whether chest pain may be caused by gastroesophageal reflux disease (GERD), the abnormal backflow (reflux) of food, stomach acid, and other digestive juices from the stomach into the esophagus.

How is it treated?

Treatment for esophageal spasm includes treating other conditions that may make esophageal spasms worse, such as gastroesophageal reflux disease (GERD). GERD is usually treated with changes to diet and lifestyle and medications to reduce the amount of acid in the stomach. Spasms themselves may be treated directly with medications such as nitrates and calcium channel blockers to relax the muscles of the esophagus, although they are not always effective.

Treating anxiety with relaxation and controlled breathing exercises may also help to reduce symptoms.1

In rare cases surgery is used to treat esophageal spasm. The surgeon cuts the muscles along the lower esophagus. This procedure is usually performed only in serious cases that do not respond to other therapies.

Other Places To Get Help

Organizations

American College of Gastroenterology
P.O. Box 342260
Bethesda, MD 20827-2260
Phone: (301) 263-9000
Web Address: www.acg.gi.org

The American College of Gastroenterology is an organization of digestive disease specialists. The Web site contains information about common gastrointestinal problems.


National Digestive Diseases Information Clearinghouse (NDDIC)
2 Information Way
Bethesda, MD 20892-3570
Phone: 1-800-891-5389
Fax: (703) 738-4929
E-mail: nddic@info.niddk.nih.gov
Web Address: http://digestive.niddk.nih.gov/ddiseases/a-z.asp

This clearinghouse is a service of the U.S. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the U.S. National Institutes of Health. The clearinghouse answers questions; develops, reviews, and sends out publications; and coordinates information resources about digestive diseases. Publications produced by the clearinghouse are reviewed carefully for scientific accuracy, content, and readability. The clearinghouse does not provide medical advice.


References

Citations

  1. Richter JE (2000). Approach to the patient with noncardiac chest pain. In MM Wolfe et al., eds., Therapy of Digestive Disorders: A Companion to Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 1st ed., pp. 27–36. Philadelphia: W.B. Saunders.

Credits

Author Christopher Hess
Associate Editor Terrina Vail
Primary Medical Reviewer Patrice Burgess, MD
- Family Medicine
Specialist Medical Reviewer Peter J. Kahrilas, MD
- Gastroenterology
Last Updated April 18, 2006
Last Updated: 04/18/2006

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This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information. For more information, click here. Privacy Policy. How this information was developed.

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