Esophageal spasms are problems with muscles in your esophagus, the tube that takes food and drink to your stomach after you swallow. Spasms may cause minor to severe symptoms, including difficulty swallowing and chest pain. Medication or other therapies often help. Surgery is rare. If you have severe chest pain, seek medical care right away.
Esophageal spasms are abnormal muscle contractions in the esophagus (the tube that connects your throat to your stomach). These spasms make it harder for food to reach your stomach. They can be painful.
The esophagus is a muscular tube that makes up part of your digestive system. It takes food or drink to your stomach after you swallow.
The muscles that make up the esophagus work together in intricate ways. Sphincters (muscular valves) at both ends of the esophagus open and close to let food and drinks pass from your mouth to your stomach. These valves also stop food or liquid from coming back up your esophagus (such as from the stomach) for no reason.
After you swallow, esophagus muscles contract (flex and relax). When the esophagus works as it should, this wave of coordinated contractions moves food or liquid down to your stomach. This series of contractions is called peristalsis.
If you have esophageal spasms, these contractions don’t work correctly. Unusually powerful or ineffective muscle contractions in the esophagus can make it difficult for food or liquid to move through your esophagus.
Esophageal spasms can affect muscles in your esophagus differently. The two main types are:
Esophageal spasms are rare. Medical experts estimate that diffuse esophageal spasm affects one in 100,000 people.
The precise cause of esophageal spasms is unknown. Some in the medical community believe the problem results from faulty nerves that are responsible for how the esophagus muscles work. Too much acid in the esophagus could also lead to the problem. Excess acid can be due to having heartburn for a long time.
Some people notice esophageal spasm symptoms after eating hot or very cold food or drink. But spasms can happen anytime, even when you’re not eating or drinking.
Esophageal spasms can cause mild to severe symptoms. Some people experience no symptoms.
In some cases, esophageal spasms can cause chest pain that feels like you’re having a heart attack. Call your provider or seek immediate medical care if you experience worsening, unexplained chest pain for more than five minutes.
The symptoms of esophageal spasms usually come and go. You may notice symptoms at certain times, such as after eating or drinking something very hot or cold. Or symptoms may come on suddenly, out of nowhere. Symptoms may last for a few minutes or more than one hour.
If you have esophageal spasms, you may have:
Esophageal spasms can be tricky to diagnose. Your healthcare provider will first physically examine you to evaluate your symptoms. If you have chest pain, your provider may order tests, such as electrocardiogram (EKG), to rule out heart disease.
Other tests that help diagnose esophageal spasms include:
Esophageal spasm treatments focus on relaxing the esophageal muscles to relieve your symptoms. If esophageal spasms don’t cause symptoms, you may not need treatment.
Unfortunately, because researchers have not uncovered what causes esophageal spasms, you can’t prevent the condition from happening altogether. Still, identifying what triggers your symptoms (such as certain foods or drinks) may help you keep symptoms from starting or getting worse.
Esophageal spasms can be disruptive. They sometimes cause pain or trouble swallowing. But the condition isn’t considered a serious threat to your health. Esophageal spasms are not known to cause esophageal cancer.
Heartburn-like pain and trouble swallowing are often signs of a routine problem (such as GERD, or chronic acid reflux). Less commonly, these symptoms may signal a more serious condition (such as cancer). Always check in with your provider if you experience similar symptoms for longer than two weeks.
The prognosis of esophageal spasms varies, based on the severity of your symptoms. Many people experience few or minor symptoms from esophageal spasms.
Treatments can often improve esophageal spasm symptoms considerably. Reach out to your provider if you have trouble swallowing or persistent heartburn.
Esophageal spasms can sometimes cause symptoms that look very similar to a heart attack. A heart attack can be life-threatening if not treated right away. Call 911 or seek immediate medical care if you experience:
A note from Cleveland Clinic
Left untreated, moderate to severe cases of esophageal spasms can negatively affect your quality of life. Symptoms may make eating difficult, which can lead to nutrition imbalances over time. Chronic pain may lead you to withdraw from activities you enjoy or take an emotional toll. If heartburn, trouble swallowing or other esophageal spasm symptoms limit how much you get out of life, ask your provider about treatment options. Always seek immediate medical care when you have unexplained chest pain.
Last reviewed by a Cleveland Clinic medical professional on 11/03/2020.
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