An esophageal spasms is a painful contraction in the esophagus muscles (the tube connecting the mouth and stomach). If it occurs occasionally, there is no need for treatment, but sometimes it is frequent and can hinder the passage of food and liquid through the esophagus. Specific treatments can be helpful if the spasm interferes with food and drink intake. It feels like severe chest pain that can last a few minutes to hours. Some patients may mistakenly consider it an angina attack when you swallow food, the muscle of the esophagus flex and relax (contract). When the esophagus works correctly, these contractions generate waves and help the food material travel down the stomach. This series of contractions is called peristalsis. During an esophageal spasm, these contractions do not work correctly, and the passage of food and liquid is interrupted.
Types of esophageal spasms:
There are two leading types of esophageal spasms;
- Distal: Uncoordinated muscle contraction in the esophagus’s lower part. The spasm causes your already swallowed food or liquid back up to the esophagus. It is called regurgitation.
- Nutcracker/ Jackhammer: The muscle contractions are solid or forceful. It is painful, especially when you swallow food or liquid. This pain can be severe and feels like chest squeezing.
Symptoms of esophageal spasms:
The main symptoms are;
- Difficulty swallowing
- Chest pain (even feels like a heart attack)
- Heartburn
- Feeling like something has stuck in your throat
- Backward flow of food or liquid up to the throat (regurgitation)
Causes of esophageal spasms:
The cause of esophageal spasms is still unknown. Some experts narrate this problem is associated with the nerve connection fault, which controls the function of the esophagus muscle. The acid in the esophagus can lead to this problem. Excessive acid accumulation in the esophagus can result from long heart burns. You can notice these symptoms while eating or drinking hot or icy food. The spasm can happen anytime, even when you are not eating or drinking.
Other factors that increase the risk may include:
- Stress and depression
- Some types of foods and drinks
- Some treatments or surgeries like cancer treatments, neck surgery, and chest radiation therapy
- Having a high blood pressure
Diagnosis of esophageal spasm
The following diagnostic techniques are used to monitor the fault;
- Esophagus manometry: The rhythmic muscle contraction measured when you swallow.
- X-ray of the upper digestive system (esophagram): An X-ray is performed after drinking a chalky liquid that fills the internal lining of your digestive tract.
- Upper endoscopy: A thin, flexible tube equipped with a light and camera is inserted down your throat to visualize the inner side of the esophagus and stomach. It is also used to study different esophageal diseases.
Treatment of esophageal spasms
Treatment of this disorder depends on the severity of your condition. If it is occasional, the doctor recommends you avoid consuming hot and cold food or liquid. If it is frequent and interferes with your food consumption routine, then these parameters are adopted;
- Underlying condition: This condition is sometimes mixed with heartburn or gastroesophageal reflux disease (GERD). Your recommended treatment is a proton pump inhibitor or an antidepressant-like Tofranil. This drug helps to minimize the sensation of pain in the esophagus.
- Drugs to relax the esophageal muscles: Peppermint oil or Botox injection, or calcium channel blockers like Cardizem, and Tiazac, can reduce the severity of pain.
- Surgery: This procedure is called myotomy. The lower end of the esophageal muscle is cut to reduce the contractions. This treatment is only recommended when all other systems are not responding.
- Peroral endoscopic myotomy: In this procedure, an endoscope is inoculated in your mouth down the throat and makes an incision in the inner lining of your esophagus. The lower end of the esophageal muscle is mainly cut, but this treatment is only applicable when other therapies are not responding.
References:
- https://www.medicalnewstoday.com/articles/321656#identification
- https://www.webmd.com/digestive-disorders/what-is-esophageal-spasm
- https://my.clevelandclinic.org/health/diseases/15575-esophageal-spasms
- https://www.mayoclinic.org/diseases-conditions/esophageal-spasms/diagnosis-treatment/drc-20372255
