Diffuse esophageal spasm (contraction painful)
Throat | Gastroenterology | Diffuse esophageal spasm (contraction painful) (Disease)
A person with esophageal spasms has abnormal contractions of the muscles in the esophagus. Normally, the esophageal muscles contract in an organized way to propel food down the esophagus. Spasms of the esophageal muscles can prevent food from entering the stomach.
Symptoms of esophageal spasm include difficulty swallowing and the sensation that something is stuck in the throat. Other symptoms include chest pain, upper abdominal pain, heartburn, vomiting, and weight loss.
Diffuse esophageal spasm is an uncoordinated series of muscle contractions that prevent food from normally traveling from the esophagus to the stomach. These spasms can be very painful. Very hot or cold foods can cause the symptoms. Chest pain is a common symptom of esophageal spasm, and can be mistaken for cardiac angina. The cause of this disorder is unknown.
Causes and Risk factors
Causes of diffuse esophageal spasm are not well understood. It is clear, however, that many cases are caused by uncontrolled gastroesophageal reflux. Therefore, an empiric trial of acid suppression medication is often the first line therapy. It has also been reported that very cold or hot beverages can trigger an esophageal spasm, and avoidance therapy benefits some people.
Diagnosis and Treatment
Treatment of esophageal spasm may include medications to control spasm, esophageal dilation procedures, and surgery. Several drugs, including nitroglycerin and calcium channel blockers are used to treat this condition. Acid suppression therapy, such as proton pump inhibitors, are often the first line therapy. Botulinum toxin, which inhibits acetylcholine release from nerve endings, injected above the lower esophageal sphincter may also be used in the treatment of DES. Small studies have suggested benefit from endoscopic balloon dilation in certain patients. ...