An esophageal spasm is a rare disorder characterized by abnormal muscle contractions in the esophagus.
The esophagus is the narrow muscular organ that connects the mouth to the stomach and through which foods and liquids pass after being swallowed. After food is chewed and swallowed, the lump of food moves downward through the esophagus. If the esophagus is functioning normally, peristalsis, or a wave of coordinated contractions, takes place.
However, people with distal esophageal spasm may experience simultaneous contractions in long sections of the esophagus instead of a coordinated wave of contractions. The contractions may be irregular, uncoordinated, or unusually powerful, keeping food or liquids from moving normally down the esophagus.
People who have esophageal spasms may experience:
There are two main types of spasms:
An esophageal stricture occurs when the esophagus becomes abnormally narrow. Benign (non-cancerous) strictures may occur due to buildup of fibrous tissue and collagen deposits due to ulcers or chronic inflammation of the esophagus.
There are two major types of strictures: simple and complex.
People with esophageal strictures also have difficulty swallowing solid foods, but generally do not have problems with swallowing liquids.
No one is sure exactly what causes esophageal spasms. The nerves that regulate peristalsis, the series of muscle contractions in the esophagus, might not work properly. Sometimes spasms are triggered when a person eats hot or cold foods and beverages. However, spasms can also occur in the absence of eating or drinking.
The most common type of esophageal stricture is a peptic stricture resulting from gastroesophageal reflux disease (GERD). Unless it is treated, GERD can cause scarring and narrowing of the lower esophagus. However, now that more effective medications, such as proton pump inhibitors, have been developed to treat GERD, strictures in the lower esophagus resulting from acid reflux are less common.
Strictures may also result from:
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:
There are a variety of methods available for treating simple benign (non-cancerous) esophageal strictures.
Dilation is used to widen the esophageal passageway to relieve dysphagia (difficulty swallowing). The technique uses dilators (long plastic or rubber cylinders of different sizes) to stretch the opening. Dilators with gradually increasing diameters are inserted through the mouth, sometimes over a guide wire.
Balloons may be passed through an endoscope and inflated to stretch the opening. Medication to reduce gastric acid production may be given before the procedure if the stricture is caused by GERD.
Complex strictures are often seen after radiation therapy to treat cancer of the head, neck or chest, or in cases where caustic substances were ingested. In cases for patients with malignant cancer, temporary metal stents (expandable tubes) may be used instead of balloon dilation to keep the esophagus open.
Various treatment options for spasms of the lower (distal) esophagus may include:
In most cases, patients can be treated successfully and the disorder will not lead to other serious conditions.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition. This document was last reviewed on: 12/27/2017