Esophageal Spasm: Symptoms, Causes, Treatment (2023)

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.

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)

Causes

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

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

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.

Medications

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.

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.

Surgery

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.

Summary

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.