Esophageal spasm

Esophageal spasms are abnormal contractions of the muscles in the esophagus, the tube that carries food from the mouth to the stomach. These spasms may not move food effectively to the stomach.

Spasms

Muscle cramps are when a muscle gets tight (contracts) without you trying to tighten it, and it does not relax. Cramps may involve all or part of on...

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Causes

The cause of esophageal spasm is unknown. Very hot or very cold foods may trigger spasms in some people. Muscle or nerve problems in the esophagus may cause the spasm.

Symptoms

Symptoms may include:

• Problems swallowing or pain with swallowing

  Problems swallowing

  Painful swallowing is any pain or discomfort while swallowing. You may feel it high in the neck or lower down behind the breastbone. Most often, th...

  

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• Pain in the chest or upper abdomen

  Pain in the chest

  Chest pain is discomfort or pain that you feel anywhere along the front of your body between your neck and upper abdomen.

  

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It can be hard to tell a spasm from angina pectoris, a symptom of heart disease. The pain may spread to the neck, jaw, arms, or back

Angina

Angina is a type of chest discomfort or pain due to poor blood flow through the blood vessels (coronary vessels) of the heart muscle (myocardium). T...

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Exams and Tests

Tests you may need to look for the condition include:

• Esophagogastroduodenoscopy (EGD)

  Esophagogastroduodenoscopy

  Esophagogastroduodenoscopy (EGD) is a test to examine the lining of the esophagus, stomach, and first part of the small intestine (the duodenum)....

  

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• Esophageal manometry

  Esophageal manometry

  Esophageal manometry is a test to measure how well the esophagus is working.

  

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• Esophagogram (barium swallow x-ray)
• Heart evaluation if there is concern that the spasm sensation stems from heart disease
  

Treatment

Nitroglycerin given under the tongue (sublingual) may help a sudden episode of esophageal spasm. Long-acting nitroglycerin and calcium channel blockers are also used for the problem.

Long-term (chronic) cases are sometimes treated with low-dose antidepressants such as trazodone or nortriptyline to reduce symptoms.

Occasionally, spasm may improve with medicines that block acid production.

Botulinum toxin injections may be done into the esophagus for some conditions that may cause esophageal spasm, such as achalasia, and for distal esophageal spasm.

Rarely, certain cases may need dilation (widening) of the esophagus by endoscopic myotomy (cutting the affected muscles in the esophagus). Surgery may be needed to control symptoms in the case of spastic achalasia.

Outlook (Prognosis)

An esophageal spasm may come and go (intermittent) or last for a long time (chronic). Medicine can help relieve symptoms in many cases. However, other treatments may be needed, especially in the case of achalasia.

Chronic)

Chronic refers to something that continues over an extended period of time. A chronic condition is usually long-lasting and does not easily or quick...

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Possible Complications

The condition may not respond to treatment.

When to Contact a Medical Professional

Contact your health care provider if you have symptoms of esophageal spasm that don't go away. The symptoms may actually be due to heart problems. Your provider can help decide if you need heart tests.

Prevention

Avoid very hot or very cold foods if you get esophageal spasms. If the spasm also causes trouble swallowing, avoiding difficult foods such as meat, dry breads, and rice may help.

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