Digestion

How do Esophageal Spasms Bother us?

Esophageal spasms

are conditions which are associated with uncoordinated and irregular contractions of the muscles of the esophagus (the tube connecting the mouth and the stomach). These spasms hinder the movement of chewed food to the stomach.

This condition has very serious consequences as it is often confused with heart attack or angina. These spasms could cause palpitations along with a sharp pain in the chest similar to that in a heart attack. Often, the first thing the physician would do to treat such symptoms would be to conduct diagnostic tests and rule out heart attack.

Types of Esophageal Spasms

These spasms are of two types:

Diffuse spasm of the esophagus

– This condition is also referred to as the CorkScrew Esophagus as the esophagus often resembles a corkscrew structure when affected.
The patient would have intermittent spasms and belching. The patient will regurgitate (draw back the chewed food) very frequently whatever was eaten from a meal not long ago. Other symptoms would be difficulty in swallowing and chest pain.

Nutcracker Esophagus

– It has more severe symptoms than the former. The spasms are regular and coordinated , but they are extremely severe and associated with a lot of pain. The problem of regurgitation of food is less frequent.

Symptoms of Spams of Esophagus:

  • A shooting chest pain that could radiate to the arms, back, neck, shoulders or jaw.
  • Difficulty in swallowing food.
  • Pain in swallowing food.
  • Severe to moderate acid reflux.
  • Severe to moderate belching.
  • Sour and acid after taste in the mouth.
  • A burning sensation in the chest and esophagus.
  • Excessive regurgitation of food.

Causes

  • Chronic Gastroesophageal Reflux Disease (GERD) results in this condition.
  • Motility (structural deformity) problems of the sphincter muscle at the base of the esophagus, which prevents swallowed food from making its way back to the esophagus.
  • Nervous breakdowns, anxiety, stress or panic attacks.
  • It is reported that very cold and hot beverages trigger this condition.

Treatment of Esophageal Spasms

  • Nitroglycerin and Isosorbide dinitrate typically administered under the tongue can give immediate relief from the spasm and chest pain.
  • Calcium channel blockers used to treat high blood pressure also help alleviate this condition.
  • An inflated Pneumatic Dilator (balloon) is inserted in the esophagus to dilate the esophagus.
  • Muscle relaxers like Hyoscyamine sulfate, dicyclomine or propantheline bromide also are used to treat this.
  • Acid reflux medications would provide relief too.
  • It is often advisable to treat causes like stress, anxiety and depression clinically.
  • Using a Bougie (a weighted rubber device) is another invasive technique of widening the esophageal tube.
  • In extreme cases however, a Esophagomyotomy (fixing the muscles of the esophagus surgically) becomes necessary.

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