Esophageal Spasm

Esophageal spasm is pain and difficulty in swallowing due to abnormal clenching of the muscles in the esophagus.

Symptoms of Esophageal Spasm

The symptoms of esophageal spasm are:

  • Dull or intense pain under the breast bone
  • The pain may then radiate to the jaw and arm
  • Difficulty swallowing
  • Involuntary regurgitation of food

Esophageal spasm can occur by itself or right after a severe gastroesophageal reflux.

Esophageal Spasm Diagnosis

Because the symptoms of esophageal spasm are similar to that of a heart attack, your doctor would first perform test to rule out a heart attack.

Diagnosing esophageal spasm is difficult, because outside of the spasm attack, the esophagus looks perfectly normal.

Tests for esophageal spasm include:

  • Biopsy
    Tissue sample or biopsy of the lower esophagus usually reveals tissue damage due to stomach acid (gastroesophageal reflux).

  • pH probe
    This measures the acidity of the area and is used to rule out gastroesophageal reflux as the cause.

  • Esophageal manometry
    This test measures muscle contractions in the esophagus

Prevention of Esophageal Spasm

Instances of the spasm can be avoided by:

  • Swallowing only well-chewed food in small pieces
  • Avoiding hot food or hot and cold drinks
  • Avoiding relapse of gastroesophageal reflux, if present
  • Reducing stress.

Treatments for Esophageal Spasm

The treatments for this condition include:

  • Nitrates
    Nitroglycerin and isosorbide dinitrate used for treating heart attack can alleviate the spasm and chest pain.

  • Anticholinergic drugs
    These are medications that relax the smooth muscle, such as hyoscyamine sulfate, dicyclomine, or propantheline bromide.

  • Calcium channel antagonists
    These medicines are commonly used to treat high blood pressure.

  • Gastroesophageal reflux medications

  • Psychiatric drugs for panic attack and depression

  • Pneumatic dilator
    A balloon is inserted into the esophagus and then inflated to dilate the esophagus.

  • Bougie
    A bougie (“boojie”) is a weighted, tapered rubber device which is used to flatten the esophageal tissue and widen the opening.

  • Esophagomyotomy
    A surgical cut along the length of the esophagus is done to prevent complete contraction of the muscle in the esophagus.

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