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What are Esophageal Spasms?

What is the esophagus? The esophagus is a tube which runs from the back of the throat and to the opening of the stomach. This tube is the main transporter of food and liquids to our stomachs.

An Esophageal Spasm is a condition whereby the muscle in the esophagus develops a cramp causing pain and discomfort in the chest area.

Esophageal spasms are irregular and vary from strong to mild contractions of the esophagus. 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.


What causes Esophageal Spasms?

The exact cause of esophageal spasms is unknown. Research shows that this condition can result from a disruption in the nerve activity which coordinates the swallowing action and movement of food down the esophagus e.g.

  • In many cases people that eat very hot or very cold food may trigger an episode.
  • GERD (Gastro esophageal reflux disorder) is a disorder of the body’s nerves or motor neurons. GERD can also cause erosion of the esophagus in severe cases.
  • Compression of the vagus nerve that runs from the body to the brain.


What are the symptoms of Esophageal Spasms?

  • Central chest pain that spread outward to the bodies extremities (i.e. legs, arms or neck regions)
  • The swallowing of solids or liquids becomes difficult (also causes pain)
  • Hawking up of foods and liquids or regurgitation
  • Pain under or around the breast bone area
  • A constant feeling as if there is something stuck in your throat
  • GERD (gastro esophageal reflux disorder) or heartburn


Risk factors

Esophageal Spasms are more commonly found in women. Women are more prone to suffer with esophageal spasms due to fluctuating hormones, obesity/being overweight, and pregnancy and these all decrease the pressure on the muscles and block reflux.
Other factors include:

  • Smoking
  • Abuse of alcohol 

Certain foods can be related with acid reflux such as:

  • Citrus Fruits (grape fruits, mandarins, lemons, oranges, tangelos, lime)
  • Garlic and onions
  • Drinks that contains caffeine
  • Eating large meals
  • Fatty foods (chips, burgers, chocolates, spicy foods, tomatoes, chili sauce, etc)
  • Alcohol


Treatment for Esophageal Spasms

  • Treatment of esophageal spasms in the short term is mainly used to relax and calm the esophageal muscles
  • Long-term treatment may involve managing any contributing health condition such as ones diet and lifestyle as well as taking accompanying medications such as:
    • H-2-receptor blockers – these are over the counter drugs (cimetidine, and ranitidine). These medications help to reduce the production and levels of acid in the stomach. They are not as fast acting as antacids, but do offer long term relief.
    •  Antacids – (Maalox and Tums), counterbalance stomach acid and can provide fast relief).
  •  Altering your eating habits and avoiding any foods which can cause acid reflux.
  • Avoid hot, cold or spicy foods, large meals and foods with a high acid content   (such as fruit juice, chocolate and tomatoes).
  • Surgical treatment –
    • Esophagectomy is a condition whereby the entire esophagus is removed thereby eliminating contractions.
    • Myotomy surgery involves a process whereby contractions are made weaker (surgery is not a common option)


Medication that is been used for Esophageal Spasms

  • Calcium channel blockers- reduce the severity of the contractions in patients with nutcracker esophagus.
    • Nutcracker esophagus– is a disorder which affects the movement or peristalsis contractions of the esophagus in a co-coordinated manner. This makes swallowing solids or liquids difficult slightly difficult.
  • Nitrates – decrease vasospasm in the brainstem
    • Vasospasm is the constriction of blood vessels, resulting in a decrease in blood flow.
  • Diffuse esophageal spasms can cause intense chest pains. This is because the spasms occur in an uncoordinated pattern which makes it difficult to swallow not only solids but also liquids. Low-dose antidepressants are recommended to reduce symptoms (by decreasing chest pains).

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