Overview
Esophageal spasms are painful contractions within the muscular tube connecting your mouth and stomach, known as the esophagus. These spasms can cause intense, sudden chest pain that may be mistaken for heart pain (angina) and difficulty swallowing solids and liquids. Esophageal spasms typically occur occasionally and may not require treatment, but if they interfere with eating and drinking, treatments are available. The exact cause of esophageal spasms is not clear, but they seem to be related to abnormal functioning of the nerves controlling the muscles used during swallowing.
Understanding the disease
Symptoms
Symptoms of esophageal spasms include squeezing pain in the chest, difficulty swallowing solids and liquids, especially when swallowing specific substances like red wine or extremely hot or cold liquids, the feeling that an object is stuck in the throat, and the return of food and liquids back up the esophagus, also known as regurgitation. If you experience squeezing chest pain, seek immediate medical care as it may also be caused by a heart attack.
Risk Factors
Rhe risk factors for eosinophilic esophagitis, such as climate, season, sex, family history, and allergies, might indirectly contribute to the development of esophageal spasms. To better understand the specific risk factors for esophageal spasms, consult a medical professional.
Development
The document discusses two types of esophageal spasms: distal esophageal spasm and hypercontractile esophagus, also known as jackhammer esophagus. The exact cause of esophageal spasms is not known, but they appear to be related to atypical functioning of nerves that control the muscles used during swallowing. In distal esophageal spasm, the muscles in the walls of the lower esophagus have difficulty coordinating, making it difficult to move food to the stomach. In hypercontractile esophagus, the muscles in the walls of the esophagus contract too forcefully and too frequently, also interfering with the movement of food to the stomach. Dysphagia, or difficulty swallowing, can be caused by various factors, including achalasia, diffuse spasm, and esophageal stricture.
Assessment and Diagnosis
Triage
You should see a doctor if esophageal spasms are suspected, especially if the symptoms are severe enough to make eating difficult or if you are losing weight. Additionally, if the symptoms are accompanied by flu-like symptoms such as fever, headache, and muscle aches, or if you suspect food is stuck in your esophagus, seek immediate medical care. Other reasons to consult a doctor include experiencing chest pain that lasts more than a few minutes, having a history of heart disease and experiencing chest pain during an esophageal spasm, experiencing pain in the mouth or throat when eating, and experiencing shortness of breath or chest pain shortly after eating. In cases of severe or persistent symptoms, it's important to seek medical attention.
Diagnosis
Your healthcare provider may recommend the following tests to diagnose esophageal spasms:
- Esophageal manometry: This test measures the rhythmic muscle contractions in your esophagus when you swallow, the coordination and force exerted by the esophagus muscles, and how well your lower esophageal sphincter relaxes or opens during a swallow.
- X-rays of your upper digestive system, also called an esophagram: X-rays are taken after you drink a chalky liquid that coats and fills the inside lining of your digestive tract. The coating allows your provider to see a silhouette of your esophagus, stomach, and upper intestine.
- Upper endoscopy: Your provider inserts a thin, flexible tube equipped with a light and camera down your throat to examine the inside of your esophagus and stomach. This instrument is called an endoscope. Endoscopy also can be used to collect a sample of tissue to be tested for other esophageal diseases. This tissue sample is known as a biopsy. It is important to follow your healthcare provider's recommendations and discuss any questions or concerns you may have about the diagnosis process.
Management and Treatment
Complications
Potential complications of esophageal spasms include scarring or narrowing of the esophagus (stricture), tearing of the esophageal lining due to retching or passing instruments through an inflamed esophagus during endoscopy, and Barrett's esophagus. Barrett's esophagus is a condition in which the cells lining the esophagus are damaged from acid reflux, increasing the risk of esophageal cancer. If left untreated, esophageal spasms can lead to these complications.
Treatment
Treatments for esophageal spasms depend on the severity and frequency of the symptoms. If the spasms occur only occasionally and do not interfere with the ability to eat or drink, no specific treatment may be necessary. However, if the spasms are frequent and cause difficulty swallowing, the following treatments may be considered:
- Medications: Certain medications, such as muscle relaxants and anti-acids, may help alleviate the symptoms of esophageal spasms. Antidepressants and anti-seizure medications may also be prescribed for certain cases.
- Lifestyle changes: Avoiding triggers, such as red wine, hot or cold liquids, and certain foods, can help minimize the occurrence of esophageal spasms. Eating smaller, more frequent meals and avoiding late-night meals may also be helpful.
- Dilation: In some cases, a procedure called esophageal dilation may be performed to widen the esophagus. A balloon or other device is inserted into the esophagus and inflated to stretch the muscle.
- Surgery: In severe cases, surgery may be necessary to correct the underlying issue causing the esophageal spasms. This might involve removing tumors or repairing a stricture. It is important to consult a healthcare professional for a proper diagnosis and appropriate treatment plan, as the causes and treatments of esophageal spasms can vary.
Preparing for medical consultation
To prepare for an appointment for esophageal spasms, you should:
- 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 you scheduled the appointment.
- Write down any triggers to your symptoms, such as specific foods.
- Make a list of all your medications, vitamins, and supplements.
- Bring a relative or friend along for support and to help you remember the information discussed during the appointment.
- Prepare a list of questions to ask your healthcare provider, such as treatment options, diet and lifestyle changes, and how to manage other health conditions. By doing this, you can make the most of your appointment time and ensure you have the information you need to manage your esophageal spasms effectively.