About Esophageal Spasms
Esophageal spasms can happen when the nerves controlling the esophagus muscles don’t work properly, causing the muscles to contract in an abnormal and uncoordinated way.
While the exact causes of esophageal spasms are not fully understood, there are several factors that may contribute to their development:
- Age: People between the ages of 60 and 80 are more likely to experience esophageal spasms.
- Gastroesophageal reflux disease (GERD): This condition, especially if it leads to scarring or narrowing of the esophagus, can increase the risk of esophageal spasms.
- Anxiety and depression: Times of anxiety or depression may make a person more susceptible to esophageal spasms.
- Trigger foods or drinks: Consuming certain foods or drinks, such as red wine or very hot or cold items, can act as triggers for esophageal spasms.
It's important to note that these risk factors do not guarantee the development of esophageal spasms, but they may increase the likelihood. If you are concerned about your risk or experiencing symptoms, it's best to consult with a healthcare professional for an accurate diagnosis and appropriate management.
People may experience mild to severe symptoms with esophageal spasms. Symptoms typically resolve on their own after a few minutes; however, they may last longer in some people. Common symptoms of esophageal spasms include:
- Severe chest pain, which may be similar to the chest pain of a heart attack. If chest pain feels different than prior episodes of esophageal spasm, lasts more than a few minutes, or is severe or worsening, call 911 or be taken to the emergency room for evaluation.
- Feeling as though an object is stuck in the throat or chest
- Difficulty swallowing
- Heartburn
- Regurgitation of food or drink
Other symptoms include:
- Chronic cough
- Unexplained weight loss
- Vomiting
- Hoarse voice
Other conditions may cause some of these symptoms. It's important to seek medical attention if you experience these symptoms to rule out any severe or life-threatening conditions.
To diagnose esophageal spasms, doctors commonly perform the following examinations, tests, and procedures:
- Detailed symptom assessment: Your doctor will ask about your symptoms, what triggers them, and what makes them better to help assess the condition.
- EKG or stress test: These cardiac tests help rule out more serious conditions like angina (chest pain).
- Esophageal manometry: This test measures muscle contractions in the esophagus while you swallow water.
- Barium swallow: You drink a contrast liquid, which helps provide a better view of your esophagus during an X-ray.
- Endoscopy: A thin, flexible tube with a camera is inserted down your throat to visualize the inside of your esophagus and help identify unusual changes.
- Esophageal pH monitoring: This test measures the pH balance in your esophagus and checks for acid reflux and regurgitation.
Remember, these are general guidelines. It's important to consult with your healthcare professional for personalized advice.
The goals of treatment for esophageal spasms are to manage and prevent symptoms, as well as to address any underlying conditions that may be contributing to the spasms. Some people with no symptoms or mild symptoms may not need treatment. Here are the different treatment options and how they work:
Medication types:
- Proton pump inhibitors (PPIs) or H2 blockers: These medications can help reduce throat spasms by treating gastroesophageal reflux disease (GERD), which is a common underlying cause of esophageal spasms.
- Antidepressants: The medications may help with the faulty nerve problems that cause esophageal spasms and alleviate pain. In addition, they can help manage underlying depression if present and contributing to spasms.
- Calcium channel blockers: These medications help relax the esophageal muscles, potentially reducing spasms or making them less severe.
Therapies:
- Stress management techniques: These techniques, such as relaxation exercises or therapy, can help manage underlying stress that may contribute to esophageal spasms.
Therapeutic procedures:
- Botulinum toxin (Botox) injections: They can be used to relax the esophageal muscles and reduce spasms.
- Myotomy: A surgical procedure where the muscles at the lower end of the esophagus are cut to weaken the spasms. Myotomy may be considered for severe cases if other treatment options are ineffective.
- Peroral endoscopic myotomy (POEM): A minimally invasive surgery where an incision is made in the esophagus to weaken the spasms. POEM may be considered for severe cases if other treatment options are ineffective.
Health behavior changes:
- Identifying trigger foods and drinks: Keeping a food diary can help identify specific foods and drinks that trigger symptoms. Avoiding these triggers can prevent future spasms.
- Eating smaller, more frequent meals: This can help prevent excessive pressure on the esophagus, reducing the likelihood of spasms.
- Increasing fiber intake: Consuming more fiber may help improve overall digestive health and reduce spasms.
Other treatments:
- Natural remedies: Standardized deglycyrrhizinated licorice (DGL) extract and peppermint oil are natural remedies that may help reduce esophageal spasms. DGL extract can be taken before and after meals to reduce spasms, while peppermint oil can be used in a solution or lozenge form.
Remember, it's important to consult with your healthcare professional before trying any medication or treatment, including natural remedies. This is especially important if you have other conditions or are taking other medications. They can provide personalized advice based on your individual situation.
Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Other side effects can occur. Check with your health care professional or read the information provided with your medication for additional side effect information.