Spasm of the esophagus

Alternative names
Diffuse esophageal spasm; Esophageal spasm

Definition
Esophageal spasms involve irregular contractions of the muscles in the esophagus, which is the tube that carries food from the mouth to the stomach. These spasms do not propel food effectively to the stomach.

Causes, incidence, and risk factors

The cause of esophageal spasm is unknown. Very hot or very cold foods may trigger an episode in some people. The pain may be indistinguishable from angina and may radiate to the neck, jaw, arms, or back.

Symptoms

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

Signs 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 nortryptiline, to reduce symptoms.

Rarely, severe cases require surgery.

Expectations (prognosis)

An esophageal spasm may be an intermittent or chronic condition. Relief of symptoms is usually achieved with medication.

Complications

The condition may not respond to treatment.

Calling your health care provider

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.

Johns Hopkins patient information

Last revised: December 5, 2012
by Potos A. Aagen, M.D.

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