Esophageal spasm, one way or another, is quite common, another thing is that this condition is not always pronounced.
The intensity of its manifestations is different, because a person can attribute minor discomfort to a lot of extraneous factors, without even knowing what is really happening.
To understand well what constitutes a spasm of the esophagus, one should turn to anatomy and decide on concepts.
Spasm refers to involuntary and painful muscle contraction.
Esophageal spasm is, therefore, a special case. Meanwhile, esophageal spasm is often accompanied by severe pain and discomfort.
From the point of view of anatomy, the esophagus is an elastic tube that serves to carry food into the stomach. The esophagus itself is by no means uniform in structure: it has several bends along its entire length and therefore varies in thickness along its entire length. In the initial section (near the pharynx) and at the end (directly in front of the stomach) there are special muscle structures - sphincters. They have the appearance of muscle rings and perform a barrier function. When swallowing food, the smooth muscles of the walls of the esophagus contract, leading to their smoothing and widening of the lumen of the organ.
The musculature of the esophagus, therefore, is responsible for the movement of the walls of the esophagus and contributes to the normal movement of food into the stomach. Under normal conditions, a person does not feel the movements of the walls of the esophagus. However, if an esophageal spasm occurs, muscle contractions become inadequate: the lumen of the organ narrows, the food cannot normally pass through the esophagus and painful sensations arise.
Esophageal spasm: symptoms
The spasm of the esophagus is not always felt acutely. For this reason, many may not notice this transient violation. In some cases, the patient may observe one or more characteristic symptoms.
Especially susceptible to pathological contractions are esophageal sphincters. Somewhat less often the walls of the esophagus experience spasm. Both sphincters and walls are richly innervated (the esophagus is penetrated by nerve endings), which is explained by the functions of the esophagus.
The most common manifestation of this condition is pain of varying intensity and nature. Patients describe it as piercing or burning, or bursting and crushing. The localization of pain is determined in the neck (about 2-3 fingers below the chin) or chest (at the level of the heart). Pain in a heart attack or an attack of angina pectoris is similar. With these pathologies, esophageal spasm is often confused by the patients themselves. In most cases, the suspicions are unfounded.
Pain syndrome for spasm lasts from 10 to 60 minutes. Throughout this time, pain intensity may persist.
Pain syndrome is very variable:
• Pain can radiate to the scapula, back, lower jaw, ears, and even hands.
• Discomfort can be aggravated by turning the head, changing body position, or physical activity.
In addition, symptoms include:
• Sensation of a coma in the throat, pressure in the chest area.
• Inability to swallow (both solid food and liquids). The so-called dysphagia.
Not always pain and dysphagia develop in parallel. One can exist without the other.
As already mentioned, spasm of the esophagus is a common phenomenon. This condition may be accompanied by discomfort, severe pain. However, you should not panic: after a certain period of time (usually up to half an hour), the symptoms disappear. During this period, it is important to refrain from further eating, so as not to irritate the already irritated esophagus.
Esophageal spasm: causes
The causes of spasm of the esophagus are various. According to statistics, most often spasm is observed in people with a mobile type of nervous system (such individuals are prone to depression, easily excitable and, as a rule, impressionable). Therefore, young women are most prone to esophageal spasm. In addition, the risk group includes:
• Persons suffering from chronic diseases of the cervical spine.
• Persons prone to chewing food insufficiently thoroughly.
• Patients who have had upper respiratory infections.
• People suffering from gastrointestinal diseases (especially GERD - gastroesophageal reflux disease).
Based on this, all the causes of the development of spasm can be divided into several groups:
• Mechanical reasons. Not associated with concomitant pathologies. Most often, an esophageal spasm develops when you try to swallow an oversized piece, when using highly carbonated or excessively chilled drinks.
• Infectious causes. After a recent infectious disease, the risk of esophageal spasm is higher. The secret in which bacteria (mucus, sputum) multiply abundantly is swallowed. Some pathogens settle on the wall of the esophagus, destroying its mucous membrane. In response, a reflex contraction of the organ occurs (usually such a spasm is less intense, but longer).
• Gastrointestinal diseases. Esophageal spasm is observed in gastritis with high acidity and a number of other diseases.
• Psychosomatic causes. For psychosomatic reasons, most of the esophageal cramps occur. Repeating the above, it should be noted that the esophagus is abundantly innervated, because it subtly responds to the most minor changes from the nervous system. Strong feelings, depression, stress cause disturbances in the work of the sympathetic nerve and the X pair of cranial nerves (which are precisely responsible for the contraction and relaxation of the muscles of the esophagus). In this case, indeed, all diseases from the nerves.
• Diseases of the spine (neck). Diseases of the spine (primarily the neck, to a lesser extent the thoracic spine) are the cause of the infringement of the nerve roots. The normal innervation of the esophagus is disrupted and, as a result, a spasm develops.
Esophageal Spasm: Diagnosis
From the point of view of diagnosis, this condition is obvious. It is enough to clarify the presence of characteristic symptoms and exclude more severe gastrointestinal diseases, as well as diseases under which the esophageal spasm can mask (heart attack, angina pectoris, coronary heart disease).
It is not difficult to independently determine the spasm of the esophagus. Often patients have a question, is it worth to consult a doctor with this pathology? It is important to pay attention to a number of factors:
• Pain and discomfort occurred after eating a meal undergoing stress.
• There are no concomitant symptoms (such as severe shortness of breath, confusion).
• The pains are monotonous and disappear after 30-60 minutes.
If the picture is similar, there is no reason for concern. You can do it yourself. In all other cases, it is recommended to consult a doctor, but rather, doctors (first of all, to a therapist, then to an otolaryngologist and gastroenterologist).
Diagnosis methods for spasm of the esophagus are aimed at the exclusion of other diseases and include:
• Survey (the doctor asks clarifying questions in order to understand what he is dealing with and determine the further diagnostic strategy).
• Endoscopic examinations (Gastroesophagoscopy, the purpose of which is to examine the mucous membrane of the stomach and esophagus). These studies are associated with minimal discomfort for the patient, but are recognized as the most informative.
• X-ray of the esophagus with a contrast agent (the patient drinks a special contrast agent, after which standard radiography is performed). This method is more informative than conventional radiography, because it allows you to evaluate the anatomical state of the esophagus.
• Determination of the release of gastric juice into the esophagus (daily pH meter).
Esophageal spasm: treatment
To start treatment, you need to establish the initial cause of the pathology. If the spasm is of a singular nature, or it is associated with mechanical causes - special treatment is not required. It is enough to provide first aid. In all other cases, medication is indicated.
What drugs are used for this:
• Antispasmodics (contribute to the relaxation of smooth muscles): No-shpa, Duspatalin, Drotaverin, etc. The price varies from 30 to 300 rubles. Help get rid of pain and discomfort.
• Calcium channel blockers. They reduce muscle contractility. Among the drugs: Diltiazem, Verapamil and others. These drugs cause a lot of side effects, because their use is permissible strictly according to the indications and under the supervision of a doctor.
If the cause of esophageal spasm lies in psychosomatic reasons, it is worth using sedatives:
• Valerian extract, Novo-Passit, etc.
When it is established that a spasm of the esophagus occurs as a reaction to throwing the gastric juice into the esophagus, antacids are prescribed. They neutralize acid:
• Rutatsid, Gastal, Almagel, etc.
In the vast majority of cases, specialized treatment is not required. It is enough to remove the main symptoms. How to help yourself?
• First of all, you need to completely calm down. Nervous tension will only aggravate the situation.
• If pain and discomfort occur during eating, you can try to drink a small amount of still water (the temperature should be room temperature).
• In a number of cases, proper breathing helps: you need to take a breath, count to four, exhale and count to four again. Continue this for 1-2 minutes.
• You can take a sedative, drink tea from chamomile.
• If the above methods do not help, you can chew gum with an intense mint flavor or dissolve a mint candy.
Medical methods (including atropine injections, etc.) should be used with caution. Atropine often develops an allergy.
Fortunately, 99% of cramps can be relieved by these methods. It is important to remember that spasm of the esophagus is an unpleasant phenomenon, extremely painful, but generally harmless.
Thus, esophageal spasm is not as rare as it might seem at first glance. Most often, it is due to insufficient chewing of food or is a response to stress and increased anxiety. Only the doctor can determine the initial cause of the spasm. The treatment is mainly symptomatic. As a rule, independent actions are enough. In any case, do not panic. Esophageal spasm is not life threatening.
