Esophageal spasm

Definition

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

Alternative Names

Diffuse esophageal spasm; Spasm of the esophagus

Causes, incidence, and risk factors

The cause of esophageal spasm is unknown. Very hot or very cold foods may trigger an episode in some people.

Symptoms

• Difficulty swallowing or pain with swallowing
• Pain in the chest or upper abdomen

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

Signs and tests

• Esophagogastroduodenoscopy (EGD)
• Esophageal manometry
• Esophagogram (barium swallow x-ray)

Treatment

Nitroglycerin given under the tongue (sublingual) may be effective in an acute episode of esophageal spasm. Long-acting nitroglycerin and calcium channel blockers are also used to treat esophageal spasms.

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

Rarely, severe cases may need dilation (widening) of the esophagus or surgery to control symptoms. However, it is not clear whether these procedures will help.

Support Groups

Expectations (prognosis)

An esophageal spasm may come and go (intermittent) or last for a long time (chronic). Medicine can help relieve symptoms.

Complications

The condition may not respond to treatment.

Calling your health care provider

Call for an appointment with your health care provider if you have symptoms of esophageal spasm that don't go away.

Prevention

Avoid very hot or very cold foods if you get esophageal spasms.

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References

Kahrilas PJ, Pandolfino JE. Esophageal neuromuscular function and motility disorders. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier;2010:chap 42.