Esophageal spasm
| Esophageal spasm | |
|---|---|
| Synonyms | Diffuse esophageal spasm, DES |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Chest pain, dysphagia |
| Complications | Aspiration pneumonia, weight loss |
| Onset | Typically middle age |
| Duration | Intermittent |
| Types | N/A |
| Causes | Unknown, possibly nerve or muscle abnormalities |
| Risks | Anxiety, GERD |
| Diagnosis | Esophageal manometry, barium swallow, endoscopy |
| Differential diagnosis | Achalasia, gastroesophageal reflux disease, angina |
| Prevention | N/A |
| Treatment | Calcium channel blockers, nitrates, botulinum toxin, surgery |
| Medication | Diltiazem, nifedipine |
| Prognosis | N/A |
| Frequency | Rare |
| Deaths | N/A |
Esophageal spasm is a condition characterized by abnormal muscle contractions in the esophagus, the long tube that connects the mouth to the stomach. These spasms can prevent food from reaching the stomach, causing it to come back up into the throat.
Symptoms
The most common symptoms of esophageal spasm include:
- Chest pain that may spread outward to the arms, back, neck, or jaw
- Heartburn
- Difficulty swallowing, known as dysphagia
- Regurgitation of food or liquids
- Sensation of an object stuck in the throat, known as globus sensation
Causes
The exact cause of esophageal spasm is unknown. However, it may occur due to abnormal nerve activity in the esophagus. Certain factors may increase the risk of developing esophageal spasm, such as:
- Gastroesophageal reflux disease (GERD)
- Anxiety or depression
- Consuming very hot or cold foods or drinks
- Certain medications, including those used to treat high blood pressure
Diagnosis
Esophageal spasm can be diagnosed through a variety of tests, including:
- Barium swallow: This test involves swallowing a liquid that coats the esophagus and stomach, making them easier to see on an X-ray.
- Esophageal manometry: This test measures the rhythmic muscle contractions in your esophagus when you swallow.
- Endoscopy: This procedure involves inserting a thin, flexible tube with a light and camera down your throat to examine your esophagus.
Treatment
Treatment for esophageal spasm may include:
- Medications to relax the muscles in the esophagus
- Botulinum toxin (Botox) injections into the esophagus
- Surgery to cut the muscle at the lower end of the esophagus
- Psychotherapy for those whose spasms are related to anxiety or depression
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Contributors: Prab R. Tumpati, MD