Esophageal Spasm

Topic Overview

What is esophageal spasm?

Esophageal spasms are irregular, uncoordinated, and sometimes powerful contractions of the esophagus, the tube that carries food from the mouth to the stomach. Normally, contractions of the esophagus are coordinated, moving the food through the esophagus and into the stomach. Esophageal spasms can prevent food from reaching the stomach, leaving it stuck in the esophagus.

Esophageal spasms are uncommon. Often, symptoms that may suggest an esophageal spasm are the result of another condition such as gastroesophageal reflux disease (GERD) or achalasia, a problem with the nervous system in which the muscles of the esophagus and the lower esophageal sphincter (LES) don't work properly. Anxiety or panic attacks can also cause similar symptoms.

What causes esophageal spasm?

The cause of esophageal spasm is unknown. Many doctors believe it results from a disruption of the nerve activity that coordinates the swallowing action of the esophagus. In some people, very hot or very cold foods may trigger an episode.

What are the symptoms?

Most people with this condition have chest pain that may spread outward to the arms, back, neck, or jaw. This pain can feel similar to a heart attack. If you have chest pain, you should be evaluated by a doctor as soon as possible to rule out or treat cardiac disease.

Other symptoms include difficulty or inability to swallow food or liquid, pain with swallowing, the feeling that food is caught in the center of the chest, and a burning sensation in the chest (heartburn).

How is esophageal spasm diagnosed?

Your doctor can often determine the cause of esophageal spasm from your medical history by asking you a series of questions. These include questions about what foods or liquids trigger symptoms, where it feels like food gets stuck, other symptoms or conditions you may have, and whether you are taking medicines for them.

The diagnosis can be confirmed with tests, including a barium swallow or endoscopy. These tests use X-rays or a small, lighted viewing instrument to examine the inside of the esophagus. Your doctor may also do esophagus testing, a set of tests used to check the condition and function of the esophagus. Tests measure acid levels in the esophagus as well as the strength and pattern of muscle contractions in the esophagus.

Other tests may be done to determine whether chest pain may be caused by gastroesophageal reflux disease (GERD), the abnormal backflow (reflux) of food, stomach acid, and other digestive juices from the stomach into the esophagus.

How is it treated?

Treatment for esophageal spasm includes treating other conditions that may make esophageal spasms worse, such as gastroesophageal reflux disease (GERD). GERD is usually treated with changes to diet and lifestyle and medicines to reduce the amount of acid in the stomach. Spasms themselves may be treated directly with medicines such as nitrates and calcium channel blockers to relax the muscles of the esophagus, although these medicines are not always effective. Your doctor may also recommend certain types of antidepressant medicines. Even though you may not be depressed, they can help with the pain.

Treating anxiety with relaxation and controlled breathing exercises may also help to reduce symptoms.1

In rare cases, surgery is used to treat esophageal spasm. The surgeon cuts the muscles along the lower esophagus. This procedure is usually performed only in serious cases that do not respond to other therapies.

Other Places To Get Help

Organizations

American College of Gastroenterology
P.O. Box 342260
Bethesda, MD  20827-2260
Phone: (301) 263-9000
Web Address: www.acg.gi.org
 

The American College of Gastroenterology is an organization of digestive disease specialists. The Web site contains information about common gastrointestinal problems.


National Digestive Diseases Information Clearinghouse (NDDIC)
2 Information Way
Bethesda, MD  20892-3570
Phone: 1-800-891-5389
Fax: (703) 738-4929
E-mail: nddic@info.niddk.nih.gov
Web Address: www.digestive.niddk.nih.gov
 

This clearinghouse is a service of the U.S. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the U.S. National Institutes of Health. The clearinghouse answers questions; develops, reviews, and sends out publications; and coordinates information resources about digestive diseases. Publications produced by the clearinghouse are reviewed carefully for scientific accuracy, content, and readability.


References

Citations

  1. Fass R, Dickman R (2006). Noncardiac chest pain. In MM Wolfe et al., eds., Therapy of Digestive Disorders, 2nd ed., pp. 969–984. Philadelphia: Saunders Elsevier.

Other Works Consulted

  • Kongara K, Soffer E (2003). Esophageal motility disorders and noncardiac chest pain. In SL Friedman et al., eds., Current Diagnosis and Treatment in Gastroenterology, 2nd ed., pp. 283–298. New York: McGraw-Hill.

Credits

Author Monica Rhodes
Editor Kathleen M. Ariss, MS
Associate Editor Pat Truman, MATC
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer Jerome B. Simon, MD, FRCPC, FACP - Gastroenterology
Last Updated March 31, 2008

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