Esophageal Spasm: What is it? Causes, Symptoms, Diagnosis, Treatment and Prevention

It occurs when the esophagus contracts abnormally and can be very painful and uncomfortable.

When it occurs, the movement of food and beverages into the stomach is interrupted and less efficient.

The esophagus goes from the mouth to the stomach and is part of an individual’s digestive system. Move food from the throat to the stomach by contracting coordinated. It is about 10 inches long and has muscular walls lined with mucous membranes.

Esophageal spasms are usually rare, but they can frequently occur in some people and interfere with the ability to eat and drink normally.

When this is the case, treatment is usually required.

Causes of esophageal spasm

It is not clear exactly what causes esophageal spasms.

They can be connected to a malfunction of the nerves that control the muscles inside the esophagus.


Some conditions and factors that can produce esophageal spasms include:

  • Certain foods and beverages, including red wine and foods too hot or too cold.
  • Gastroesophageal reflux disease, particularly if it leads to scarring or narrowing of the esophagus.
  • Some treatments for cancer, such as surgery of the esophagus or radiation of the chest, neck, or head.
  • Anxiety and depression.


Symptoms of esophageal spasm include:

  • Pain in the chest is so intense that it is mistaken for a heart attack.
  • A feeling that something is trapped in the throat or chest.
  • Difficulty swallowing
  • Heartburn.
  • Regurgitation of food and stomach acids in the mouth.

Immediate medical attention should be sought in case of esophageal spasms.

Given the severity of esophageal spasms and the similarity of their symptoms with angina, it is essential to see a doctor to make a differential diagnosis.

Diagnosis of esophageal spasm

First, the doctor can rule out angina by an electrocardiogram, stress test, or another cardiac test.

Diagnostic tests for esophageal spasms include:

  1. Esophageal manometry: measures muscle contractions while swallowing water.
  2. Barium ingestion: this X-ray image test requires a contrast fluid such as barium to provide better vision in the esophageal images.
  3. Endoscopy: During endoscopy, a thin, flexible tube, called an endoscope, is inserted into the throat. This allows the doctor to see the inside of your esophagus through a small camera.
  4. Oesophageal pH monitoring: This test looks for acid reflux and regurgitation by measuring the pH balance in the esophagus.


The type of esophageal spasm that is experienced can influence treatment options. The two types of esophageal spasms are:

  1. Diffuse esophageal spasms occur only occasionally and are usually associated with the regurgitation of food or beverages.
  2. Nutcracker esophagus: These esophageal spasms may be more painful than diffuse ones, but they do not usually cause regurgitation, despite their severity.

Treatment options include:


Diffuse esophageal spasms can be treated by simply identifying and eliminating the triggers of food and beverages.

No matter what spasm is present, a food diary should be kept to identify which foods cause spasms.

The foods eaten or drunk, the temperature, and the amount, including the ingredients as species, must be recorded.

Spicy food can be a trigger for esophageal spasms for some people.

Natural medicine

Deglycerized licorice root extract, taken one or two hours before or after meals, can help reduce spasms. It is available in many forms, including chewable and powdered tablets.

Peppermint oil is a mild muscle relaxant that can help calm the spasms.

Mint pads or a water solution with drops of peppermint oil may also help.

Changes in lifestyle

These are some simple changes that you can also try:

  • Eat several small meals each day instead of large portions.
  • Losing weight if your BMI is higher than it should be.
  • Increase fiber consumption.
  • Reduce or eliminate alcohol consumption.
  • Do not eat too close to bedtime.
  • No Smoking.
  • Avoid wearing constrictive clothing on the abdomen.


Your doctor may prescribe medications, such as a proton pump inhibitor or an H2 blocker if you have gastroesophageal reflux disease, to address the underlying cause of your symptoms.

However, recent research suggests that long-term use of proton pump inhibitors can cause kidney disease.

If you have anxiety or depression, antidepressants can help improve your mood and reduce esophageal pain.

Medications may also be prescribed to relax the muscles that they swallow. These include Botox injections and calcium blockers.


A minimally invasive procedure called oral endoscopic myotomy may be tried if medications and lifestyle changes are insufficient to improve the condition.

During this procedure, a surgeon inserts an endoscope through the mouth and then cuts the muscle in the lower part of the esophagus to weaken the contractions.

Another minimally invasive surgical procedure is the so-called Heller myotomy, which may also be an option for people with esophageal spasms.

Prevention of esophageal spasms

If the patient has already presented esophageal spasms, it is essential to identify food triggers and eliminate substances that seem to cause cramps.

The most important thing is to make sure that you maintain healthy habits and change your lifestyle.

Eating nutritious foods rich in fiber and losing weight (if you are overweight) is a great help.

Esophageal spasms can occur due to an underlying condition, such as gastroesophageal reflux disease or depression.

Treating the underlying cause is your first line of defense to eliminate or reduce symptoms.

It is also essential to maintain healthy lifestyle habits and identify triggers for foods and beverages that can cause spasms.

Although its cause is not fully understood, esophageal spasms can usually be treated effectively.