What is esophageal spasm?
Esophageal spasms are
irregular, uncoordinated, and sometimes powerful contractions of the
esophagus, the tube that carries food from the mouth
to the stomach. Normally, contractions of the esophagus are coordinated, moving
the food through the
esophagus and into the stomach.
There are two main types of esophageal spasm:
- Diffuse esophageal spasm. This type of spasm is an irregular, uncoordinated squeezing of the muscles of the esophagus. This can prevent food from reaching the stomach, leaving it stuck in the esophagus.
- Nutcracker esophagus. This type of spasm squeezes the esophagus in a coordinated way, the same way food is moved down the esophagus normally. But the squeezing is very strong. These contractions move food through the esophagus but can cause severe pain.
You can have both types of esophageal spasm.
Esophageal spasms are uncommon. Often, symptoms that
may suggest an esophageal spasm are the result of another condition such as
gastroesophageal reflux disease (GERD) or achalasia, a
problem with the nervous system in which the muscles of the esophagus and the
lower esophageal sphincter (LES) don't work properly.
Anxiety or panic attacks can also cause similar symptoms.
What causes esophageal spasm?
The cause of
esophageal spasm is unknown. Many doctors believe it results from a disruption
of the nerve activity that coordinates the swallowing action of the esophagus.
In some people, very hot or very cold foods may trigger an episode.
What are the symptoms?
Most people with this
condition have chest pain that may spread outward to the arms, back, neck, or
jaw. This pain can feel similar to a
heart attack. If you have chest pain, you should be
evaluated by a doctor as soon as possible to rule out or treat cardiac disease.
Other symptoms include difficulty or inability to swallow food or
liquid, pain with swallowing, the feeling that food is caught in the center of
the chest, and a burning sensation in the chest (heartburn).
How is esophageal spasm diagnosed?
Your doctor can
often find out the cause of esophageal spasm from your medical history by
asking you a series of questions. These include questions about what foods or
liquids trigger symptoms, where it feels like food gets stuck, other symptoms
or conditions you may have, and whether you are taking medicines for
The diagnosis can be confirmed with tests, including esophagus tests (such as esophageal manometry) or a
barium swallow. Esophageal manometry uses a small tube attached to instruments (transducers) that measure pressure. A barium swallow is done using X-rays.
Other tests may be done to
find out whether chest pain may be caused by gastroesophageal reflux disease
(GERD), the abnormal backflow (reflux) of food, stomach acid, and other
digestive juices from the stomach into the esophagus.
How is it treated?