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Esophageal spasm


Definition:

Esophageal spasms are abnormal contractions of the muscles in the esophagus (the tube that carries food from the mouth to the stomach). These spasms do not move food effectively to the stomach.

Alternative Names:

Diffuse esophageal spasm; Spasm of the esophagus

Causes, incidence, and risk factors:

The cause of esophageal spasm is unknown. Very hot or very cold foods may trigger an episode in some people.

Symptoms:

It can be hard to tell a spasm from angina pectoris, a symptom of heart disease. The pain may spread to the neck, jaw, arms, or back

Signs and tests:
Treatment:

Nitroglycerin given under the tongue (sublingual) may help a sudden episode of esophageal spasm. Long-acting nitroglycerin and calcium channel blockers are also used for the problem. .

Long-term (chronic) cases are sometimes treated with low-dose antidepressants such as trazodone or nortriptyline to reduce symptoms.

Rarely, severe cases may need dilation (widening) of the esophagus or surgery. to control symptoms

Expectations (prognosis):

An esophageal spasm may come and go (intermittent) or last for a long time (chronic). Medicine can help relieve symptoms.

Complications:

The condition may not respond to treatment.

Calling your health care provider:

Call your health care provider if you have symptoms of esophageal spasm that don't go away.

Prevention:

Avoid very hot or very cold foods if you get esophageal spasms.

References:

Kahrilas PJ, Pandolfino JE. Esophageal neuromuscular function and motility disorders. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier;2010:chap 42.


Review Date: 10/8/2012
Reviewed By: George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, and Stephanie Slon.

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