Esophageal Spasm Symptoms, Causes and Treatment

 Do you sometimes have trouble swallowing? You might have esophageal spasms. Esophageal spasms are contractions in the esophagus that can cause difficulty swallowing, chest pain, or both. The esophagus is the tube that connects your mouth to your stomach, and esophageal spasms occur when this tube contracts involuntarily. In most cases, esophageal spasms only happen occasionally and are not a serious problem. However, sometimes they can be more frequent and prevent food from traveling to the stomach.

Types of esophageal spasms

There are two main different types of esophageal spasms, and the symptoms can vary depending on the type. 

The most common type is called diffuse (or distal) esophageal spasm (DES), and it usually causes difficulty swallowing. DES occurs when the muscles in the esophagus contract erratically, making it difficult for food to pass and cause regurgitation or swallowed food and drink to come back up the esophagus. It may also feel like an object or food is stuck in the throat.

The second type is called nutcracker esophagus and it usually causes chest pain. Nutcracker esophagus occurs when the muscles in the esophagus contract too hard and for too long. This can be painful when swallowing and can cause severe chest pain that is often mistaken for a heart attack. If you have sudden chest pains or other signs of a heart attack, call 911 immediately and seek immediate medical attention.

Causes of esophageal spasms

There are no known risk factors for esophageal spasms and there is often no known cause for esophageal spasms. However, they are related to a disorder of the nerves that control the muscles in the esophagus that move food through the digestive system. 

Here are a few things that can trigger spasms. These triggers can include:

- Eating hot or cold food

- Drinking carbonated beverages

- Having acid reflux

- Being anxious or stressed

There are also a few medical conditions that can cause esophageal spasms, such as:

• GERD: gastroesophageal reflux disease
• Achalasia: a condition where the esophagus muscles don't relax properly
• Scleroderma: a condition that hardens connective tissues
• High blood pressure

Diagnosis and Treatment for esophageal spasms

The treatment for esophageal spasms will vary depending on the severity and frequency of the spasms. A gastroenterologist, a physician specializing in the digestive system, can help you with deciding the best treatment. 

The gastroenterologist may recommend tests to help determine the best course of treatment. The tests may include:

• Upper Endoscopy: a thin, flexible tube with a camera is inserted down the esophagus and stomach to get a closer look
• Esophageal Manometry: measures the pressure and muscle activity in the esophagus
• Barium swallow and X-rays: After drinking a chalky liquid that coats and fills the inside lining of your digestive tract, the x-ray shows your doctor how well the liquid moves from your esophagus to the stomach and upper intestine.

If esophageal spasms are infrequent and not severe, they usually don't require any treatment. However, if they are more frequent or cause difficulty swallowing, there are a few options your gastroenterologist may recommend.

Home Remedies:

• Relaxation techniques: This can include things like yoga, meditation, and deep breathing exercises.
• Changes in diet: Avoiding trigger foods and drinks, eating smaller meals, and chewing food slowly can help to prevent esophageal spasms.
• Use Peppermint: Peppermint oil may relax the esophagus muscles. Put a few drops of peppermint oil in drinking water or suck on a peppermint lozenge. This may relieve some minor symptoms.

Medical Treatments

• Medications: If esophageal spasms are severe, your gastroenterologist may prescribe medications to help relax the esophageal muscles.
• Botulinum toxin (Botox®) injections: These injections relax the nerve endings but may require several injections over time and results may only be temporary.
• Surgery: This is an option for severe cases. A myotomy procedure permanently paralyzes the muscle which stops abnormal contractions. However, the esophageal muscle will no longer work and your digestive system will rely on gravity to push food and liquid through the esophagus.

If you think you might be experiencing esophageal spasms, it's important to see a doctor to rule out any other possible causes of your symptoms. Once esophageal spasms have been diagnosed, there are home and medical treatments that can help to relieve your symptoms and prevent them from happening again. Schedule your appointment to get treated.