Abnormal muscle spasms in the esophagus are called esophageal spasms. The esophagus is the tube that connects your mouth and stomach. On either end of the esophagus are sphincter muscles that flex and contract as part of the digestive process. Within the tube are valves that work to move food from the mouth to the stomach. Esophageal spasms can be painful and prevent food from passing from mouth to stomach.
In this article, you'll learn more about what is an esophageal spasm and what symptoms are associated with esophageal spasm, along with possible causes of esophageal spasm and treatment options.
Symptoms of Esophageal Spasm
The symptoms associated with esophageal spasms can come and go and range in severity. Some people may experience no symptoms, while others experience mild symptoms. Mild symptoms can come on suddenly after drinking or eating, or they may come on suddenly with no apparent cause. Mild symptoms can come and go for minutes or over an hour.
Some symptoms are severe and may require immediate medical attention from a healthcare provider.
When to Seek Emergency Services for Chest Pain
While minor chest pain is a symptom of esophageal spasms, in some cases the pain can become so severe it feels like a panic attack or heart attack. Call your healthcare provider or seek immediate medical support if you have sudden, severe chest pain.
Symptoms of esophageal spasms include:
- Acid reflux or heartburn causing chest pain or a burning sensation
- Swallowing difficulties, including trouble swallowing liquids and food (dysphagia)
- Chest pain
- Feeling like something is stuck in your throat
- Food or drink coming up the esophagus into the mouth (regurgitation)
Types of Esophageal Spasms
The two types of esophageal spasms are diffuse spasms and nutcracker esophagus:
Diffuse (or Distal) Esophageal Spasms: This type of esophageal spasm occurs occasionally and causes food or drink to come back up.
Nutcracker Esophagus: This condition affects how the esophagus works. With nutcracker, or jackhammer, esophagus (hypertensive peristalsis), the muscle contractions are powerful and strong enough to cause pain. The pain is worse when swallowing, and it can feel like squeezing in your chest. It doesn't typically cause regurgitation.
Nutcracker Esophagus (Hypertensive Peristalsis)?
Symptoms of esophageal spasm, including acid reflux or regurgitation and feeling like something is stuck in the throat, can lead to feeling like you need to clear your throat.
These associated symptoms can lead to:
- Voice hoarseness
- Sore throat
- Increased discomfort in the esophageal area
There are several potential causes of esophageal spasms, but the exact cause is still unknown. Suspected causes of esophageal spasms include:
- Nerve dysfunction
- Muscle weakness or injury
- Acid reflux
- Chronic acid reflux, that is, chronic heartburn due to gastroesophageal reflux disease (GERD)
- Consuming very cold or very hot food or drinks
What Is GERD?
GERD is defined as chronic acid reflux caused by lower esophageal muscle weakness. Muscle weakness can be a structural difference or caused by repeat irritation. GERD can cause difficulty swallowing and passing food from the mouth to the stomach. It is a likely cause of esophageal spasms. If you experience any unexplained weight loss or any signs of digestive bleeding—such as blood coming up when coughing or vomiting or if there is blood in your stool, seek immediate medical care.
10 Things to Stop Doing If You Have GERD
How to Treat an Esophageal Spasm
Treatment for esophageal spasms depends on the cause (if known) and severity of symptoms. Treatment is aimed at reducing symptoms by relaxing the esophageal muscles.
If you do not have any symptoms of esophageal spasms, treatment may not be necessary. If you do have symptoms, your healthcare provider may discuss the following treatment options, starting with dietary modifications followed by medications and then surgery in more severe cases.
Lifestyle modifications include reducing triggers for esophageal spasms. One example is quitting smoking (if you smoke) because the smoke irritates and eventually weakens the esophageal lining and sphincter muscles.
Your healthcare provider may also suggest reaching a healthy body weight to relieve pressure on your lower esophagus and upper abdomen, as well as avoiding dietary triggers for acid reflux, such as spicy foods, which irritate the esophageal lining.
How Obesity Is Treated
Your healthcare provider may recommend medication that relaxes the muscles used for swallowing. Calcium channel blockers may also be prescribed.
Certain antidepressants, such as tricyclic antidepressants and selection serotonin reuptake inhibitors (SSRIs) are considered a mainstay of treatment for esophageal issues. These medications are prescribed because they effectively target nerves to relieve pain associated with spasms. There is not a lot of clinical research conducted on the use of antidepressants for this specific type nerve pain, though.
The Use of Antidepressants for Managing Chronic Pain
Botulinum Toxin (Botox) Injections
If lifestyle modifications and medications have not worked to treat esophageal spasms, you may wish to consider Botox injections. The botulinum toxin injections work by temporarily paralyzing the smooth lower esophagus muscles, reducing pressure on the lower esophageal sphincter and providing relief from chronic spasming.
Research also shows while Botox injections work for reducing esophagus spasms, this treatment may also induce or trigger symptoms of GERD.
Botox (OnabotulinumtoxinA) - Intramuscular, Intradetrusor, or Intradermal
In severe cases in which other options have not provided adequate relief from esophageal spasms, your healthcare provider may suggest surgical treatment. Surgery for esophageal spasm is called myotomy. It requires an incision in the lower esophagus muscle, which permanently stops it from being able to spasm. In these cases, gravity will be the force to carry food and drink from your mouth to your stomach.
Effectiveness of Surgery
One study on spasm symptom frequency and surgical intervention from France shows esophageal surgery for spasms is a highly effective method of treatment. Researchers found in a follow-up of 20 patients who underwent surgery for esophagus spasm treatment, all clinical outcomes were significantly improved compared with results from preoperative surveys or symptoms recorded before surgical intervention. The researchers note that one study limitation is it reports on frequency rather than intensity of symptoms.
GERD (Heartburn) Surgery: Everything You Need to Know
Esophageal spasms are abnormal spasms that occur in the tube connecting the mouth and stomach. Symptoms can come and go and range in severity. They include difficulty swallowing, chest pain, and feeling like something is squeezing your chest or that you have something stuck in your throat.
Severe chest pain, especially if lasting more than a few minutes, is cause for calling your healthcare provider or seeking immediate medical attention. When warranted, esophageal spasms can be treated if necessary with lifestyle modifications, medications, Botox injections, or, in severe cases, surgery.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Consumer Reports. When chest pain is an emergency and when it's not.
Loma Linda University. Esophageal spasms.
Johns Hopkins Medicine. Swallowing disorders: Introduction.
National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK). Symptoms & Causes of GER & GERD.
Johns Hopkins Medicine. Smoking and the digestive tract.
National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK). Treatment for GER and GERD.
Clinical Gastroenterology and Hepatology. Antidepressants for functional esophagus disorders.
Kumar D, Zifan A, Mittal RK. Botox injection into the lower esophageal sphincter induces hiatal paralysis and gastroesophageal reflux.Am J Physiol Gastrointest Liver Physiol. 2020;318(1):G77-G83. doi:10.1152/ajpgi.00238.2019
Leconte M, Douard R, Gaudric M, Dumontier I, Chaussade S, Dousset B. Functional results after extended myotomy for diffuse oesophageal spasm.Br J Surg. 2007;94(9):1113-1118. doi:10.1002/bjs.5761
By Michelle Pugle
Michelle Pugle, BA, MA, is an expert health writer with nearly a decade of contributing accurate and accessible health news and information to authority websites and print magazines. Her work focuses on lifestyle management, chronic illness, and mental health. Michelle is the author of Ana, Mia & Me: A Memoir From an Anorexic Teen Mind.
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