Esophageal spasm

Esophageal spasm or oesophageal spasm is a disorder of esophageal motility. The esophagus is an organ in vertebrates which consists of a fibromuscular tube through which food passes, aided by peristalsis contractions, from the upper esophageal sphincter to the stomach through waves of co-ordinated muscle contraction, or peristalsis.

There are two types of esophageal spasm:

• Diffuse esophageal spasm (DES), where there is unco-ordinated esophageal contractions where several sections of the esophagus can contract at once.
• Nutcracker esophagus (NE) also known as hypertensive peristalsis, where the contractions are co-ordinated but with an excessive amplitude.

Both conditions can be linked with Gastroesophageal reflux disease.

When the co-ordinated muscle contraction are irregular or uncoordinated, this condition may be called diffuse esophageal spasm. These spasms can prevent food from reaching the stomach where food gets stuck in the esophagus. At other times the co-ordinated muscle contraction is very powerful, which is called nutcracker esophagus. These contractions move food through the esophagus but can cause severe pain.

Symptoms

Esophageal spasm is rare. Often, symptoms that may suggest esophageal spasm are the result of another condition such as gastroesophageal reflux disease (GERD) or achalasia. The symptoms can also include dysphagia, regurgitation, noncardiac chest pain, heartburn, globus pharyngis (which is a feeling that something is stuck in the throat) or a dry cough.

Causes

It is not clear exactly what causes esophageal spasms. Sometimes esophageal spasms start when someone eats hot or cold foods or drinks. However, they can also occur with eating or drinking. The increased release of acetylcholine may also be a factor, but the triggering event is not known.