Diffuse Esophageal Spasm (Painful Contraction)
Description
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.
Symptoms
Chest pain, breathing problems, chest pain that increased with swallowing, vomiting.
Tests
A history and physical exam will be performed. An esophagram and/or esophageal manometry is done to confirm the diagnosis.
Treatment
Nitroglycerin given under the tongue (sublingual) may be effective in episodes of acute pain. Long-acting nitroglycerin and calcium channel blockers are also used to treat esophageal spasms. Chronic cases are sometimes treated with low-dose antidepressants such as nortriptyline to reduce symptoms. For severe cases surgery is sometimes necessary.
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