What is esophageal spasm?

Esophageal spasm is a sudden, painful tightening of your lower esophagus. Your esophagus is the tube that food and liquids pass through from your mouth to your stomach.

What causes esophageal spasm?

The cause of esophageal spasm is not clear. It may be caused by problems with the nerves that control how your esophagus moves when you swallow . Esophageal spasm may be common among family members. Foods that are too hot or too cold may increase how often your esophagus spasms. Spasms may also happen on their own.

What are the signs and symptoms of esophageal spasm?

You may have any of the following:

• Trouble when you swallow: Food may get stuck in your esophagus.
• Chest pain: You may have chest pain or discomfort that starts behind your sternum (breastbone). The pain may spread to your arms, jaw, or back. It may be mild or severe. It may also worsen when you eat.
• Heartburn: This is a burning feeling in your chest or throat caused by stomach acid that rises into your throat. This may leave a bitter taste in your mouth, and it may be worse after meals or when you lie down.

How is esophageal spasm diagnosed?

You may receive the following tests:

• Manometry: Your healthcare provider will gently insert a tube into your throat and down into your stomach. The tube has sensors on it that measure the pressure in your esophagus. This pressure shows the strength of the spasms when you swallow. The test also shows how well food and fluids move down your esophagus when you swallow.
• Endoscopy: Your healthcare provider will gently place a scope (long tube with a small camera on the end) into your throat to check for problems with the shape of your esophagus. Your healthcare provider may also check the thickness of your esophagus. Samples of your esophagus tissue may be taken and sent to a lab for tests.
• X-ray with barium swallow: An x-ray of your abdomen is a picture of your stomach and esophagus. You will drink a thick liquid called barium to help your esophagus and stomach show up better on the x-ray. Follow the instructions from your healthcare provider before and after the x-ray test.

How is esophageal spasm treated?

With treatment, your spasms, pain, and trouble swallowing may improve. Ask your healthcare provider for more information about these and other treatments for esophageal spasms:

• Medicine:
  • Pain medicine: This medicine helps take away or decrease pain caused by the spasms.
  • Smooth muscle relaxants: This medicine may help your muscles and esophagus relax so it is easier for you to swallow. It may also decrease your pain and trouble swallowing.
  • Proton pump inhibitors: This medicine may help reduce stomach acid and prevent heartburn.
  • Botulinum toxin injections: This medicine is given as shots into your esophagus to relax the muscles. Your healthcare provider may use a scope as a guide for the injections.
• Surgery: You may need surgery if other treatments do not improve your symptoms.
  • Dilatation: Dilators to widen your esophagus are gently inserted through a scope into your esophagus.
  • Myotomy: Muscles in your esophagus are cut to widen the area and allow food and liquids to move into the stomach more easily.

Treatment options

The following list of medications are in some way related to or used in the treatment of this condition.

• isosorbide mononitrate
• Dilatrate-SR
• Isordil Titradose
• Isochron
• IsoDitrate

View more treatment options

What other treatments may my healthcare provider suggest?

Ask for more information about the following:

• Biofeedback: Biofeedback is a type of therapy that helps you control how your body reacts to stress or pain. Your healthcare provider will use electrodes (wires) on different parts of your body, such as your chest, to monitor your body responses. This may help you learn ways to reduce your pain or spasms.
• Relaxation therapy may help decrease physical and emotional stress. Stress may cause pain, lead to illness, and slow healing. Deep breathing, muscle relaxation, and music are some forms of relaxation therapy.

When should I contact my healthcare provider?

• Your symptoms do not improve even with treatment.
• You have severe pain when you swallow.
• You lose weight without trying.
• You have questions about your condition or care.

When should I seek immediate care or call 911?

• You are drooling or have trouble swallowing .
• You are choking, gagging, or vomiting.
• You have pain when you swallow.
• You have new or worse chest pain and shortness of breath.

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