Causes and risk factors
The exact cause of oesophageal spasm is unknown. Sudden painful, irregular and uncoordinated contraction of the muscles of oesophagus lead to the condition. It prevents normal peristaltic movement of the GI tract. Very hot or very cold foods may trigger an episode in some people. Experts believe that problem with the nerve that co-ordinates the oesophageal contraction can lead to oesophageal spasm. Types of oesophageal spasm are – Diffuse oesophageal spasm [DES] – spasm associated with regurgitation of food and liquid and Nutcracker oesophageal spasm – painfully strong contraction without regurgitation of the food and liquid.
Clinical presentation
Patient with oesophageal spasm presents with regurgitation of the food and drink especially in case of diffuse oesophageal spasm. Patient complains of sensation of something stuck in the throat [globus]. The symptoms are intermittent and variable. Associated symptoms include heart burn, squeezing and intense chest pain, which may radiate to arm, neck, back or jaw mimicking angina pain, difficulty in swallowing [Dysphagia]. Accompanying symptoms may include anxiety, depression in patients.
Investigation
Medical history by the patient and Clinical examination by the doctor helps in diagnosis. Barium swallow is recommended. Oesophageal manometry is done. Oesophagogastroduodenoscopy is advised. Oesophageal pH monitoring is advised.
Treatment
Treatment involves medicines such as analgesics. Muscle relaxants, anti anxiety medicines, may be required. Underlying disease condition such as GERD, heartburn should be treated along with. Further treatment consists of surgery that includes dilatation or myotomy, if patient doesn’t respond to any of the above treatments.
Other Modes of treatment
The other modes of treatment can also be effective in treating oesophageal spasm .
Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating oesophageal spasm.
