What are esophageal spasms?

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.

What is the esophagus?

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.

How does the esophagus work?

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.

Is there more than one type of esophageal spasm?

Esophageal spasms can affect muscles in your esophagus differently. The two main types are:

  • Diffuse (or distal) esophageal spasm: Uncoordinated muscle contractions happen mostly in the lower part of the esophagus. This type of esophageal spasm often causes already swallowed food or liquid to come back up your esophagus (called regurgitation).
  • Nutcracker esophagus: This similar condition also affects how the esophagus muscles work. In nutcracker (or jackhammer) esophagus, muscle contractions are too strong or forceful. This can cause pain, especially when you swallow. The pain can be severe and may feel like squeezing in your chest.

How common are esophageal spasms?

Esophageal spasms are rare. Medical experts estimate that diffuse esophageal spasm affects one in 100,000 people.

What causes esophageal spasms?

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.

What are the symptoms of esophageal spasms?

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.

What do esophageal spasms feel like?

If you have esophageal spasms, you may have:

  • Chest pain that may feel like heartburn (burning sensation in the chest) or, less commonly, a heart attack.
  • Trouble swallowing foods or liquids (dysphagia).
  • Pain near the breastbone when you swallow or at other times.
  • Sensation that something is stuck in your throat.
  • Food or liquid comes back up after you swallow it (regurgitation).

Last reviewed by a Cleveland Clinic medical professional on 11/03/2020.

References

  • Goel S, Nookala V. Diffuse Esophageal Spasm. [Updated 2020 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan. Accessed 10/27/2020.
  • Merck Manuals. Manometry. Accessed 10/27/2020.
  • Merck Manuals. Esophageal Spasm. Accessed 10/27/2020.

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