Acid Reflux/GERD

Diffuse Esophageal Spasm – What Is It?

Diffuse esophageal spasms are a spasm within the esophagus. The esophagus is what connects your mouth to your stomach and is what swallows and starts moving your food towards your stomach.

The esophagus is a muscular tube separated into three separate sections. When you swallow, they will all contract at the same time to move food downwards.

However, a diffuse esophageal spasm causes your esophagus to contract in an uncoordinated way, making your food stay in your esophagus rather than continuing downwards to your stomach.

As you may be already to tell already, this can result in a myriad of various issues and, of course, treatments and symptoms.

This article will be covering many of these problems and explain how your esophagus works much more clearly than I have already done so far.

How The Esophagus Works

The esophagus is a somewhat complex part of your anatomy. I say this because it is made of two layers of muscle – inner circular and outer longitudinal layers – and it is divided into three separate zones, although they all work together and use much of the same anatomical structures. No worries about how complex this will get; I’ll keep it very simple to avoid confusion.

The upper zone of your esophagus is what starts the contractions in your throat that push your food or drink down. It is made up of striated muscle, which means you can control this part of your esophagus!

It has the upper esophageal sphincter in it, which means that it can detect when there is food or drink making its way down your throat and then it will help coordinate the progression of it downwards.

The middle zone has both striated and smooth muscles, which means you only have partial control over this zone.

Here, the inner circular and outer longitudinal muscles work together to continue moving the food down your throat.

The lower zone is not a zone you have any control over and it has the lower esophageal sphincter in it.

This sphincter is typically contracted to prevent any reflux – which is very good for us to not experience – and will relax to allow the food to pass.

As you can see, it is a very specific and coordinated act to simply have your food pass through your esophagus.

You already probably thought of the consequences of not being able to swallow well at the same time, but now you can see exactly how wrong it can go.

Each muscle must work one immediately after the other to continue pushing it through or else it will get stuck somewhere because there is no longer a push behind it.

what is Diffuse Esophageal Spasm

Possible Types of Spasms

There are two major types of esophageal spasm. We’ll be focusing on diffuse esophageal spasm, but there is also hypertensive peristalsis. They are very similar, but act a little differently from one another.

Diffuse esophageal spasm, as we have already noted, happens when contractions in your throat aren’t any harder than normal but they are uncoordinated or don’t happen simultaneously.

Meanwhile, hypertensive peristalsis – also known by the wonderful name of nutcracker esophagus – occurs when the contractions are coordinated but there is a high amplitude.

An extreme form of this is called hypercontractile esophagus, or jackhammer esophagus. This is when the contractions are of very high amplitude, involve most of your throat, and occurs for a prolonged period.

In both of these cases, this would be swallowing very hard, like if you had a lot of food or drink to swallow. This is typically measured by using manometric or radiologic tools, as it would be hard to observe either spasm otherwise.

Symptoms

There are several symptoms that can be experienced with these types of spasms as it affects your throat and chest region. The symptoms include things like:

  • Chest pain; usually starts or worsens with hot foods or liquids
  • Difficulty swallowing, often leading to the feeling of food stuck in the center of your chest
  • Heartburn
  • Regurgitation

The severity of pain or how aware you are of it depends on how severe your condition is. Because of these symptoms, it is very common for diffuse esophageal spasms to be underdiagnosed.

Two of the main symptoms – chest pain and heartburn – can be written off as indigestion, a heart attack or another heart related issue in some cases.

These symptoms can also lead to you being unable to eat if the spasms are too severe. This is when you need to see a doctor for treatment quickly.

However, even if your set of symptoms isn’t too severe, if it begins having a noticeable impact on how you eat or drink things, you should talk to a doctor and see what you can do in your particular case.

Causes

There are several different causes and potential factors of diffuse esophageal spasms. One of these is disruption or damage to the nerves which coordinate the muscle movement in the esophagus.

This can lead to achalasia in some cases, where it prevents the esophagus from pushing food into your stomach. This could be caused by an abnormal immune response in some people.

Achalasia symptoms has many of the same symptoms as an esophageal spasm in addition to weight loss. This can be treated with a very minimally invasive surgery or therapy.

The increased release of acetylcholine, the chemical nerve cells release to other cells – could potentially be a factor as well, although right now there doesn’t seem to be any reason why this would start happening.

Gastric reflux or a primary nerve disorder have also been theorized for being a factor as to why these spams happen. For now, they are still theories.

Having difficulties swallowing any liquid or food tends to suggest a neuromuscular disorder while difficulties swallowing food tends to come from a structural issue within your esophagus.

And, surprisingly, difficulties swallowing can be made worse by consuming very hot or very cold products, hearing lots of loud noises, or being stressed.

Risk Factors

I mentioned earlier how risky these spasms can be. However, while there are already risks for having difficulties swallowing, many of the risk factors I’m listing emerge from the potential issues with treatments. Many of these problems are based on the type or therapy and treatment used.

For just a quick look at potential risks, there is a risk of:

  • Getting a hole in your esophagus when it has been dilated; this could lead to surgery to have the hole closed again
  • Damage to a stomach nerve may occur in certain treatments
  • Infection (as with every surgical procedure)
  • Pneumonia

Keep in mind that these have only a chance of happening, and only with particular treatments. Your doctor should discuss the possibilities of each treatment so you can decide if it is something you want to do or not.

Treatments

There are a few different treatment options available to you, some of which are a bit unexpected.

The first one I’ll mention is Botox. That’s right, you can get Botox injected to help out with your spasms.

This helps because it will be injected into the muscle that is causing the problem and it will prevent the nerves from releasing the chemical that will make the muscle contract. This may need to be done again over time to ensure it stays that way.

Sometimes, muscle relaxants help those experiencing diffuse esophageal spasms because it will stop the muscles from contracting at the wrong times.

It’s been said that a little bit of peppermint oil mixed with water that you drink helps make the muscles in your throat contract normally again. However, this may not work for many people or be recommended by your doctor.

If none of the other treatment options work – which there are definitely more that your doctor is likely to offer you – then surgery is likely going to be the next option.

Due to how severe this condition is and how it can impact your health, it is better to get it taken care of and fixed as quickly as possible.

Conclusion

Now you have learned a lot more information about diffuse esophageal spasms. Hopefully this information will help you later down the line, particularly if you or someone around you begins experiencing similar symptoms or notes that they have difficulty swallowing their food.

While it may not be very severe in most cases, if you think it is a condition you may have, you should contact your doctor about it and see if you can get a test done – if they agree that you may have it, that is.

This is important to do because it can help you avoid particular types of food and drink that make it difficult for you to swallow or enjoy your food.

There’s nothing worse than going to a nice restaurant with your family and friends only to not be able to eat and you end up being in pain over it.

Make sure to list your symptoms and monitor what you eat more often if you think this is the problem. It could just be you need to eat smaller bites or that you are having indigestion issues.

In any case, you now have more knowledge than before and can be pretty prepared for any issues with esophageal spasms that may come your way.

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