How are esophageal spasms and strictures diagnosed?

If symptoms such as difficulty swallowing or a burning sensation in the throat or chest are present, your doctor may perform various tests to determine the cause. These tests may include:

  • Barium swallow - which requires a patient to swallow a solution containing barium. X-rays are taken while the barium moves down the esophagus. If a stricture is present, the barium may become stuck or slows down.
  • Endoscopy - if the doctor suspects that a structural abnormality is present. A narrow tube called an endoscope is inserted into the esophagus. The endoscope has a light and tiny camera at one end so the doctor can observe the inside of the esophagus.
  • Esophageal manometry - if no structural abnormality is detected. It is performed to measure pressure waves inside the esophagus. The presence of unusually large numbers of simultaneous contractions in the lower esophagus is the major indicator of spasms.
  • Esophageal motility test - measures muscular strength and coordination. The test is performed by inserting a small tube through the nose into the esophagus. The tube contains pressure-sensitive transducers, which remain in the esophagus after the tube is withdrawn. The patient swallows a small amount of water (about a teaspoon) at regular intervals to allow the transducers to measure the contractions during peristalsis. The test can also detect whether there is an abnormality in the valve at the lower end of the esophagus (lower esophageal sphincter).

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