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Esophageal spasm

Diffuse esophageal spasm; Spasm of the esophagus; Distal esophageal spasm

 

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.

Causes

 

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

 

Symptoms

 

Symptoms may include:

  • Problems 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

 

Tests you may need to look for the condition include:

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

 

Treatment

 

Nitroglycerin given under the tongue (sublingual) may help a sudden episode of esophageal spasm. Long-acting nitroglycerin and calcium channel blockers are also used for the problem.

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

 

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 your health care provider if you have symptoms of esophageal spasm that don't go away. The symptoms may actually be due to heart problems. Your provider can help decide if you need heart tests.

 

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: Elsevier Saunders; 2010:chap 42.

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        Tests for Esophageal spasm

         
         

        Review Date: 11/20/2014

        Reviewed By: Jenifer K. Lehrer, MD, Department of Gastroenterology, Frankford-Torresdale Hospital, Aria Health System, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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