What are Esophageal Spasms?
The esophagus is the tube that carries food from the mouth into the stomach. An esophageal spasm is when the esophagus has uncoordinated, irregular, and sometimes very powerful contractions.
Typically the contractions of the esophagus are coordinated, meant to move the food through the esophagus into the stomach.
Two Types of Esophageal Spasms
Diffuse: this type of esophageal spasm is one that is an irregular and uncoordinated squeezing of the esophagus’ muscles. This can keep food from going into the stomach, meaning it is stuck in the esophagus.
Nutcracker: this type of esophageal spasm squeezes in a coordinated way, in the same manner that moves food into the stomach normally.
However, this squeezing is strong. Though they do move food through and into the stomach, they can cause some severe pain. You can experience both types of esophageal spasms. However, esophageal spasms are quite uncommon.
Typically, the symptoms that could suggest you have esophageal spasms are due to other conditions such as GERD, or gastroesophageal reflux disease, or achalasia- which is a disorder with the nervous system that keeps the muscles in the lower esophageal sphincter and the esophagus from properly working. Panic attacks and anxiety can result in very similar symptoms.
What Makes Esophageal Spasms Occur?
The actual reasons that esophageal spasms occur is not known. Many medical professionals say that it comes as a result of nerve activity disruption in coordinating the swallowing reflex of the esophagus. In some individuals, extremely hot or extremely cold foods could trigger an esophageal spasm.
Can Nicotine Cause Esophageal Spasms?
It has not been stated that nicotine causes or contributes to esophageal spasms, but it can have some effects on the gastrointestinal tract.
However, if you are experiencing esophageal spasms, it is recommended that, if you are currently using tobacco products, that you cease using them- or at least not use them as much.
Symptoms of an Esophageal Spasm
Most of the time, if you’re having an esophageal spasm, you may experience chest pain, spreading out to your back, arms, jaw, and/or neck. Some say that the pain is very similar to that of a heart attack.
If you’re experiencing chest pain, you should definitely be evaluated by your physician as soon as you can in order to rule out cardiac problems.
Other symptoms of an esophageal spasm include having problems or being unable to swallow liquids or foods, pain when swallowing, feeling like the food is stuck in the center of your chest, and heartburn (characterized by a burning sensation in the chest).
Diagnosing Esophageal Spasms
Your doctor will be able to determine the cause of your esophageal spasms simply by looking at your medical history and asking you a few questions.
These will include what foods/liquids trigger your symptoms, how you feel when the food gets stuck, what other symptoms or conditions you might have and whether or not you are currently on medication for them.
The process for diagnosing can also include tests such as a barium swallow or esophagus tests (for example, esophageal manometry).
A barium swallow will be completed using x-rays and esophageal manometry will include using a small tube that has been attached to transducers, which measure pressure.
Some other tests that could be done to find out if your chest pain is due to GERD, abnormal backflow- known as reflux- of stomach acid, food, and other digestive chemicals from the stomach into your esophagus.
Treatment for Esophageal Spasms
Treatment of esophageal spasms include treating other conditions that make them worse, including GERD. Typically, GERD is successfully treated with changes in your diet and lifestyle, as well as medications to reduce the amount of acid present in the stomach.
Following are some tips to try if you want to control/manage your esophageal spasms:
- Making some alterations in your eating habits
- Eat several small meals instead of 2-3 larger ones
- After eating, give yourself 2-3 hours before lying down- don’t have late night snacks
- Chocolate, alcohol, and mint can flare up symptoms of GERD- they actually relax the valve between the esophagus and the stomach
- Spicy foods and foods that have lots of acid, as well as coffee can aggravate the symptoms of GERD in some. If you notice that you have esophageal spasms after consuming certain foods, you might want to consider eliminating it from your diet to see if your symptoms do improve.
- If you smoke or use smokeless tobacco, stop- it could be contributing to your symptoms
- If you do have symptoms of GERD at night, you should raise the head of your bed about 6 to 8 inches by placing the frame on blocks or getting a foam wedge and placing it under the head of your mattress. Simply adding extra pillows will not work
- Don’t wear clothing that is tight around your middle section
- If you need to, lose weight- even just five to ten pounds can make a big difference
If these simple changes in lifestyle aren’t enough to help soothe the symptoms of GERD, your physician may suggest that you try taking some medications that will reduce stomach acid. OTC medications that your physician may suggest are:
- Antacids (Tums, Maalox, or Mylanta)
- Stronger medications meant to reduce acid such as Pepcid (famotidine), Prilosec (omeprazole), and ranitidine (Zantac)
The esophageal spasms themselves can be directly treated with medications such as calcium channel blockers and nitrates, meant to relax the muscles of the esophagus.
However, these medications are not always effective. Your physician could also recommend specific types of antidepressants. Even though you may not be experiencing depression, the medications can still help to soothe the pain.
If the esophageal spasms are caused by anxiety, you can treat those symptoms with controlled breathing exercises and relaxation techniques.
Finally, as a last resort, surgery can be used to treat esophageal spasms. The surgeon will cut the muscles on the lower esophagus. Typically, this procedure is only done when all other therapies have proven to not be effective.