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Tied in Knots: Esophageal Spasm Explained

If you woke up in the middle of the night to searing pain in your chest, particularly if you are over the age of 60, your first instinct might be to dial 911 thinking you are having a heart attack. This would be the right reaction, given the severity of heart disease.

It turns out there are other conditions that could cause a sudden sharp pain or burning sensation in the chest though, and one of them is more of a threat to your dinner than your life. You may never have heard of a relatively rare condition called esophageal spasm until it happens to you, but if you experience one of these spasms, you are not likely to forget it.

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Featured

 Nutcracker Esophagus: This Rare Condition Can Feel Like A Heart Attack

This vivid name describes what happens when the muscles in your food pipe (esophagus) go into overdrive. Normally, these muscles contract with a regular coordinated rhythm, moving food smoothly from the mouth to the stomach. It’s so coordinated, you barely notice it.

 The Types, Signs, and Treatment of Esophageal Spasms

Sharp, sudden burning sensations in your chest should always be taken seriously. However, it is also important to know that there are conditions that can create this pain that don’t impact the heart. While heartburn, GERD, and other gastrointestinal issues can cause pain and discomfort in your chest, another less common condition, esophageal spasms, can lead to other problems beyond a sharp, burning sensation.

Articles of Interest

An Overview of Esophageal Spasm - Symptoms, Diagnosis, Treatment, and Remedies

In some cases, the esophageal muscles start contracting on their own in an uncoordinated way without any food stimulus, causing esophageal spasms. These contractions, unlike peristalsis, are extremely painful and may last for minutes, making it extremely uncomfortable for people to go about their day in a normal way. The condition also interrupts normal swallowing patterns, making it difficult for food to reach the stomach.

Corkscrew Esophagus

Barium swallow video...

Corkscrew oesophagus – A rare cause of dysphagia

Diffuse oesophageal spasm (DES) is a rare oesophageal motility disorder associated with dysphagia. It is characterised by multiple spontaneous and uncoordinated oesophageal contractions and can occur at any age, although it is predominantly seen in patients over 50 years of age. DES typically causes substernal chest pain with dysphagia for both liquids and solids, but symptoms may occur in different locations and range in severity and duration.

Diffuse Esophageal Spasm

The typical clinical features that a patient with diffuse esophageal spasm presents with are: 1. The most prominent and imminent feature for DES is the presentation of dysphagia that can occur with both solids and liquids. 2. Globus hystericus in which the patient presents with a sensation of an object getting trapped on the back of the throat. 3. Chest pain which is noncardiac in nature, retrosternal in presentation, and with the possibility of radiating to the back. It accounts for less than 10% of cases of noncardiac chest pain. In some instances, it can even present with a much more severe presentation than characteristic anginal features.

Manometrically jackhammer esophagus with fluoroscopically/endoscopically distal esophageal spasm...

Jackhammer esophagus is a rare esophageal motility disorder that can result in dysphagia, chest pain, and gastro-esophageal reflux symptoms. High-resolution manometry is the gold standard for diagnosis, while corkscrew esophagus on upper gastrointestinal endoscopy is an uncommon manifestation.