Esophageal Spasms

Esophageal Spasms


Esophageal spasms are painful contractions of the esophagus. It can feel like spontaneous chest pains that last anywhere from 5 mins to a couple of hours. They occur rarely and usually don’t require any treatment. But if the spasms occur often, they may require medical attention.

Signs and symptoms

Esophageal spasms can be mistaken for heart pain. It usually presents as difficulty swallowing, regurgitation or the feeling of an obstruction in the esophagus. The spasms may be triggered by hot or cold foods and liquids.

Causes and risk factors

Medical science is unsure what causes these spasms but they appear to be neurological. There are 2 types of esophageal spasms based on the muscle movement involved – Distal Esophageal spasms (DES) involving uncoordinated “up-and-down” spasms, or Jack-hammer esophageal spasm which involves a corkscrew movement resulting in more intense spasms. Esophageal spasms are more likely in geriatric patients with GERD, high blood pressure and anxiety or depression.


Esophageal spasms could cause chest pains and reduce the quality of life. In the case of pre-existing injury or perforation in the esophagus, the spasms could cause further tearing of the tissue.


The doctor will first rule out a cardiac condition by performing an EKG. Then, an esophageal manometry test and barium swallow test are needed to check the function of the esophageal muscles. An endoscopy may be required. The doctor may also see the need to monitor the pH of the esophagus to check for acid reflux.

Treatment and Surgical Interventions

To treat the esophageal spasm, it is essential to identify the cause. If certain foods or certain temperatures are triggers, these must be eliminated from the diet. Quitting smoking, maintaining a healthy weight and eating smaller, more frequent meals could help. Botox injections could help patients by relaxing theesophageal muscles. Surgery is recommended very rarely. A Peroral Endoscopic Myotomy (POEM) is performed to surgically remove a portion of the esophagus to reduce contraction.


Identifying and eliminating the triggers can help prevent recurrent bursts of esophageal spasms. Controlling underlying conditions that cause the spasms, such as depression or GERD, will also help.


Endoscopy Guidelines

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