Alternative Names diffuse oesophageal spasm, DES, spasm of the oesophagus
Definition Oesophageal spasm is an uncoordinated contraction of the muscles of the oesophagus. The esophagus is the muscular tube that carries food from the mouth to the stomach.
What is going on in the body? Normally, the oesophagus muscles contract and relax in order, from top to bottom. This moves the food from the mouth to the stomach. In oesophageal spasm, all the muscles contract at once. This causes pain and fails to move the food along. As a result, the person may have trouble swallowing. Sometimes the condition is triggered by eating hot or cold foods.
What are the signs and symptoms of the condition? Symptoms of oesophageal spasm may include:
What are the causes and risks of the condition? Women are more likely than men to have oesophageal spasm. The cause of the spasms is not known. Someone who gets spasm after eating hot or cold food may have a hypersensitive oesophagus.
What can be done to prevent the condition? If a person's oesophageal spasm is triggered by hot or cold foods, he or she should avoid them.
How is the condition diagnosed? Oesophageal spasm can be diagnosed by a test called manometry. In this test, a special tube is inserted down the oesophagus. The tube measures the muscle activity of the oesophagus. Abnormal contractions mixed with normal movement suppports the diagnosis.
A person with a hypersensitive oesophagus may be diagnosed by inflating a long balloon in the person's oesophagus. If this causes the same symptoms, preventive methods may work.
What are the long-term effects of the condition? Oesophageal spasm does not usually lead to more serious problems. The pain, however, can be disabling. Sometimes a person is afraid to eat and becomes malnourished or loses weight.
What are the risks to others? Oesophageal spasm is not contagious and poses no risk to others.
What are the treatments for the condition? Treatment for oesophageal spasm may include:
dilation, a procedure in which instruments of increasing size are inserted through the oesophagus
nitrate medications, such as nitroglycerin. These medications are the same as those used for chest pain caused by heart problems.
calcium channel blockers, including nifedipine and verapamil
An individual with a hypersensitive oesophagus sometimes improves with low doses of medications normally used for depression, such as imipramine or trazodone.
What are the side effects of the treatments? Nitrates can cause headaches and low blood pressure. Calcium channel blockers can cause nausea, constipation, and other side effects. Antidepressants can cause side effects that depend on the medication used.
What happens after treatment for the condition? No treatment for oesophageal spasm is effective for everyone. Often several approaches will be tried before one works. In many cases, the symptoms will improve, but not go away completely.
How is the condition monitored? The person's symptoms are usually the best guide to how well the treatment for oesophageal spasm works. Any new or worsening symptoms should be reported to the doctor.
Author: William M. Boggs, MD Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
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