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Oesophageal Spasms

Oesophageal Spasms are the sudden and abnormal squeezing of the oesophagus, which carries food from the mouth to the stomach. This condition can express itself with a variety of symptoms and can sometimes be misdiagnosed as other conditions with a similar presentation. Some people mistake this condition for a heart attack.

Symptoms

The symptoms of this condition can sometimes be confused for other problems like a heart attack because they are similar. Some people get woken up by their oesophageal spasms because they are so painful. The symptoms of oesophageal spasms are:

  • Feeling like there is something that is stuck in the throat
  • Regurgitation of drink or food
  • Heartburn
  • Feelings of pain in the chest
  • Being unable to sleep due to the spasms

Causes & Risk Factors

The causes of oesophageal spasms are not well known. It has been discovered that they are a kind of motility disorder. These disorders cause problems with the movement of food through the gastrointestinal (GI) tract. This is linked to nerve signals from the brain that are not being delivered correctly to the oesophagus.

There are two kinds of oesophageal spasms:

  • Distal oesophageal spasms (DES)

These spasms happen alongside regurgitation, which means that food and liquids come back up into the mouth with the spasms.

  • Nutcracker or jackhammer oesophagus

In this form of oesophageal spasms, a twisted or corkscrew-shaped oesophagus creates powerful spasms. This kind of oesophageal spasm is not usually linked with regurgitation.

The risk factors for oesophageal spasms are:

  • Being aged 60-80
  • Having GERD (gastroesophageal reflux disease)
  • Drinking red wine
  • Drinking very hot or very cold drinks
  • Dealing with anxiety or depression

Diagnosis

The problem with the diagnosis of this condition is that the symptoms often appear a lot like a heart attack. Many doctors will first run tests to make sure that there is not a heart attack going on. Once coronary artery disease or angina have been ruled out, other tests can be done to look for oesophageal spasms.

An upper endoscopy might be called for, which uses a camera on the end of a flexible tube to allow visualisation of the oesophagus or the stomach. A barium swallow test can also allow for X-rays to show the movement of food through the GI tract. Manometry is the only test that can directly diagnose the spasms in the oesophagus. This procedure uses sensors on a thin tube in the oesophagus to capture a record of the spasms as they happen.

Treatment & Prevention

Treatment of this condition can be difficult. Medications can help to relax the smooth muscles of the oesophagus, and in some cases, treatment with antidepressants can help with these painful spasms. Botulinum injections can relax the muscles in the oesophagus for a period of a few months at a time.

Surgery can also be done to cut the thick muscles in the lower part of the oesophagus. This is usually only recommended in cases where the spasms are quite severe, and the condition does not respond to other treatments.

Prevention of this condition can be impossible since the root cause of the problem is not well-understood. Once you have been diagnosed with oesophageal spasms, you will want to avoid known triggers and be careful about the temperature of your food and drink as you consume it. Controlling stress in your life can also help to mitigate symptoms of this condition.

 
 
 

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