Esophageal Spasms

Causes and Risk Factors of Diffuse Esophageal Spasm
A specific cause is seldom found, but there may be associated reflux esophagitis (inflammation of the esophagus associated with movement of the contents of the stomach up into the esophagus).

Diagnosis of Diffuse Esophageal Spasm
The abnormalities as determined by radiography or esophageal manometry (measurement of pressure) may be either symptomatic or asymptomatic.

Treatment of Diffuse Esophageal Spasm
Esophageal spasms are difficult to treat. Anticholinergics, nitroglycerin, and long-acting nitrates have limited success. Calcium channel blockers given orally (e.g., verapamil or nifedipine) may be useful in selected patients. Potent analgesics are often needed but may be habit-forming. Sublingual nitroglycerin can be effective for the acute episode, and long-acting nitroglycerin (isorbide) – or both – are often effective.

In severe cases that are unresponsive to medical management, a long-term esophageal myotomy (surgical dissection of muscles) along the full length of the esophagus may be needed and may prove helpful.