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
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
Exams 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.
Outlook (Prognosis)
An esophageal spasm may come and go (intermittent) or last for a long time (chronic). Medicine can help relieve symptoms.
Possible Complications
The condition may not respond to treatment.
When to Contact a Medical Professional
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.
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.
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
