Acid Reflux/GERD

What is a Jackhammer Esophagus?

What is an Esophagus?

Esophagus or the food pipe or the gullet is an organ of digestive system found in vertebrates. It is a pipe like structure that connects mouth to the stomach. It a passage that allows the chewed food to reach the stomach for proper digestion.

What is Jackhammer Esophagus?

Esophageal spasm is mainly of two types diffuse esophageal spasm or occasional contraction and hypertensive peristalsis or nutcracker esophagus.

Jackhammer esophagus is also known as hypercontractile peristalsis. It is a motility disorder of esophagus characterized by esophageal spasm. The disease is named so because the esophageal spasm is very strong and long lasting.

The diffuse esophageal spasm may be accompanied by expulsion of food or liquids while the painful nutcracker esophagus may not cause food or liquid expulsion.

Esophageal spasm is a rare condition that occurs in old aged people of 60 to 80 years of age. It is also associated with gastroesophageal reflux disease (GERD). The annual incidence of esophagus spasm is about 1 in 100,000 population.

Jackhammer esophagus is a new and rare disease of esophagus. Very little is known about the disease. It is defined in terms of high resolution manometry (HRM).

The Chicago Classification of esophageal motility come with an appropriate definition of jackhammer esophagus.

It defines jackhammer esophagus manometrically by distal contractile integral greater than 8000 mm/Hg/cm/s at very high amplitude and velocity.

According to a study conducted on 34 patients suffering with jackhammer esophagus disease most of the patients also suffered from dysphagia and chest pain.

Researchers at Loyola University Health System in 2015 identified a new rare swallowing disorder known as achalasia that can happen to people at any age. Achalasia is a rare disease with no cause and cure known.

What are the Causes of Jackhammer Esophagus?

Since this disease is recently gained importance in the research area not much is known about the disease. Some researchers link jackhammer esophagus disease as an abnormality of the nerve controlling the esophagus.

While others relate it to increased amount of acetylcholine. Yet another finds it to be associated with GERD.

Other causes of jackhammer esophagus disease are listed below:

  1. A person with psychiatric illness who has been treated with tricyclic antidepressants may suffer with the disease. But it is not that both diseases are linked to each other.
  2. Caucasians are at risk that other ethnic backgrounds.
  3. Gender also play an important role in this disease. Women are more likely to be affected than men.
  4. Adults are at more risk of having this disease than children.
  5. High blood pressure
  6. Anxiety and depression
  7. Consuming very hot or very cold food and drinks
  8. Drinking red wine

What is a Jackhammer Esophagus

What are the Symptoms Associated with Jackhammer Esophagus?

The symptoms can range from mild to severe. Many times the symptoms of this disease goes undiagnosed or misunderstood with other diseases such as acid reflux, GERD, achalasia and eosinophilic esophagus.

The symptoms associated with jackhammer esophagus disease are as follows:

  1. Chest pain
  2. Lump in the throat feeling
  3. Heartburn
  4. Difficulty in swallowing food and liquids
  5. Expulsion or regurgitation

Chest pain due to jackhammer disease may be as severe as having a heart attack.

How Jackhammer Esophagus Disease is Diagnosed?

Diagnosing this disease is not that easy because it is often misdiagnosed with other related diseases. The doctor may ask for patient’s history, health report, symptoms experienced and then conduct related tests. There are two specific tests for jackhammer esophagus

  1. Barium swallow
  2. Esophageal manometry

Other tests may be carried out to confirm jackhammer esophagus.

How to Treat Jackhammer Esophagus?

The patient may or may not need any medical assistance depending on the severity of the disease or symptoms associated with it. Mortality is very rare in this disease.

Treatments of jackhammer esophagus include the following:

1- Dietary management: Managing diet is very important in reducing pain. The patient should avoid eating late at night.

Carbonate food that lead to heartburn should be avoided. The patient should be able to distinguish between good food and bad food so that he/she can manage the disease.

2- Medications: Medication includes antidepressants, proton pump inhibitors, smooth muscle relaxer, nitrates to reduce chest pain, calcium channel blockers and botulinum toxin.

3- Esophageal pH Monitoring: If there is acid reflux, this test is conducted.

4- X ray: It gives the image of the esophagus.

5- Esophageal Dilation: It is required if the patient has trouble in swallowing the food.

6- Surgery: If nothing works, surgery can be the only option. Myotomy is the surgery to treat esophageal spasm. This is not always recommended.

7- Per Oral Endoscopy Myotomy (POEM): It involves fixing the problems of esophageal spasm. The operation takes place through the mouth using a gastroscope. It is a new technique that leaves no surgical scars and no pain. This is the minimal invasive procedure.

Are There Some Home remedies to Treat Jackhammer Esophagus Disease?

There are certain home remedies that can be helpful in treating jackhammer esophagus. Some of these are listed below:

  1. Food and beverages should be chosen carefully.
  2. Anxiety and stress should be controlled to avoid any trigger.
  3. Placing a peppermint lozenge under the tongue helps to soothe the muscles. Peppermint oil is beneficial in esophageal spasm. It relaxes the muscles.
  4. Very hot and very cold food and beverages should be avoided.

Lifestyle change to a healthy eating habits and regular physical activities are beneficial in any case. Some of the changes in the lifestyle and eating habit can help in managing jackhammer esophagus disease. In case of any disease it is very important to educate the patient everything about the disease and associated symptoms.

The esophageal spasm diseases are very rare and their actual cause is still not known. Research is still going on in this field to find the reason behind the disease and treatment of the disease. New researches will give new knowledge about the disease and more and more people will be aware of the disease.

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