Diffuse esophageal spasm

Definition

Esophageal spasms are irregular 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

Causes

The cause of esophageal spasm is unknown. Very hot or very cold foods may trigger an episode in some people. It can be hard to tell a spasm from angina. The pain may spread to the neck, jaw, arms, or back.

Symptoms

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

Exams and Tests

An esophagogram shows irregular contractions of the esophagus. Esophageal manometry shows esophageal spasms.

Treatment

Sublingual (beneath the tongue) nitroglycerin may be effective in an acute episode. Long-acting nitroglycerin and calcium channel blockers are also used to treat esophageal spasms. Chronic cases are sometimes treated with low-dose antidepressants such as nortriptyline to reduce symptoms.

Rarely, severe cases require surgery.

Outlook (Prognosis)

An esophageal spasm may be a condition that comes and goes (intermittent) or lasts 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 persistent esophageal spasm symptoms.

Prevention

Avoid very hot or very cold foods if you are prone to esophageal spasms.

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