Esophageal Spasms - my story

This is one of the first places I've found online where others have similar experiences so I thought I'd share mine. To clarify, I don't have any symptoms of heartburn or GERD and those are not part of my condition. I did post this as a reply to another post, but realize it is pretty hidden there so I'm posting most of it again here.

5 years ago, I had an episode where I was drinking water and it felt like it got stuck in my throat and was extremely painful for a few minutes. For a week or so, everything seemed to get stuck in my throat - hard foods, soft foods, liquids - and then it went away. A few months after that I had severe chest pain that made me think I was having a heart attack, but it subsided after about 20 minutes and I was fine. This happened again a few months later, but again was gone after about 20 minutes. Then it started happening more and more frequently and lasting longer and longer. I also had what felt like an ulcer in my stomach, but had a scope which showed everything was fine.

The pain was in right below my breast-bone and slightly to the right side of my chest. Usually it also hurt between my shoulder blades in the back too. I had lung x-rays, a ct-scan, a cardiac work-up, and everything came back as normal, yet I continued to have the pain on a regular basis.

I moved from one state to another in the summer of 2008 and continued to have problems, but had found that if I stuck it out for about 20 minutes or got in the shower or found a way to sleep, it would go away. Then, in October I had such severe pain that nothing would help and after 3 hours of agony, my children called 911 and I was taken to the ER and again they did a cardiac work-up and x-rays and everything check out fine. They did give my nitro-glycerin in the ambulance on the way to the hospital and then some good painkillers once I got there.

I was then referred to a gastroenterologist who then did a barium swallow and a manometry test. The barium swallow x-ray came back normal, but the manometry showed very strong uncoordindated spasms and thus I was diagnosed with esophageal spasms.

As treatment, I was put on calcium channel blockers and given nitro-glycerin pills to knock down the painful episodes. I was on these for a few months and the side effects of the calcium channel blockers were awful. I moved again back to my original state and decided I was going to find a way to get off these meds because they weren't really helping (continued to have episodes daily) and I hated the side effects. I normally have very low blood pressure and the calcium channel blockers caused it to be even lower.

But, before I could find help, I again had a very painful episode and took the nitro-glycerin as directed. I was on my 3rd pill after a period of about an hour and my blood pressure bottomed out and I was incapacitated on my bedroom floor while trying to get to the phone for help. My family came home and found me and called 911. At that point my blood pressure was something crazy like 80/40. I was rushed to the ER and treated for the low blood pressure.

After this, I was determined to get off the meds and sought the help of a trusted naturopath. They suggested testing for vitamin/mineral deficiencies and food allergies (blood testing). When the tests came back, they showed I was deficient in folic acid and vitamin E and allergic to 9 different common foods that I ate on a regular basis. It was suggested that I do a 90 day elimination of these foods. I didn't really think it would work, but was desperate to get off the meds. After 3 days of eliminating these 9 foods from my diet, I was pain-free. After 90 days I added these foods back into my diet a little at a time. Now, when I have 'too much' of these foods, I have an attack.

I have also been taking magnesium oxide and L-tryptophan supplements daily. The magnesium relaxes the smooth muscles and the L-tryptophan also helps keep things calm in my digestive tract. If I miss these, I have issues. My episodes are now far and few between.

My theory is, for me, inflammation sets off the spasms. Food allergens, lack of sleep over several days, getting sick with a cold or flu or something all sets these off.

That's my story thus far. I wish I could say I found a cure, but have really just found a way to manage them for the most part. I try to eat healthy, avoid my allergen foods, take my supplements, and for most days in the last 3 years I am spasm free. I hope that helps someone or at least lets someone know they aren't alone in their experiences.<!-- Edit -->

Could I ask what your food triggers are? A lot of people do have spasms triggered by foods. The foods are often related in some way, although how they are related may not be obvious.

My foods include things like maple syrup, gelatin, pork, brown sugar, wine and beer, wine or cider vinegar, corn syrup, corn starch - but not corn. And on and on. I did testing with a very experienced allergist, kept a good food journal and did challenge testing of the ingredients in my foods ro find my list. Mine happen to be related as sources of sulfite, but there are many other triggers!

I haven't had any luck with magnesium or other supplements, except a little bit with vitamin D, to which I had tested quite low. It was no cure though.

There are many other medically known causes of esophageal spasms. The major University of Pittsburgh hospitals do quite a bit of testing and research on it. You should be able to google research papers.

I have esophageal spasms as well and they are miserable! Thank goodness they dont last long (up to an hour) and it feels like I need to go to the ER but I know what it is so I try not to freak out. I've had them before and after my nissen, and my trigger seems to be an empty stomach.

I have had my problem for about 11 years and have yet to find a diagnosis or treatment. It has become so debilitating that I am feeling hopeless. I will include a summary below:

Cause:
-Empty stomach (even slightly empty)

Symptoms:
-It is a very predictable process almost always beginning with the same cause (empty stomach), followed by the exact same pattern of symptoms
-If I do not eat immediately after getting even a very slight sensation of hunger, this can put me in a flair up (described below)
-When I do eat, I experience no immediate pain or uncomfortableness
-However, around 3-5 hours after the initial time of hunger, I get a very subtle feeling of uncomfortableness in my upper stomach area, a few fingers below my xiphoid process
-Right when I get this sensation, I know it is too late and I am now getting an episode of my problem. Regardless of what I do, the next 2-3 days my stomach will be extremely sensitive and easily at risk of another flair up. All I can do at this point is try to prevent the excruciating pain that eventually drives me to forcefully vomit to rid myself of the acid pain

If I am NOT able to stop the progression:
-If I am not able to halt the initial subtle feeling of uncomfortableness, then all hell breaks loose and I am in for an excruciating, agonizing episode that will inevitably cause me to have no choice but force myself to vomit to rid myself of the acid pain. Below is a description of the progression of this:
o The subtle feeling of uncomfortableness just below my xiphoid process slowly raises in height and gets worse in terms of the pain. It turns from a “feeling” to a stabbing pain
o By the time it reaches my chest, it is a severe, stabbing pain in the substernal area
o Also, I get stabbing pains in my upper back
o At this point, it is so unbearable and painful that I can not live a normal life and perform normal daily activities.
o The only way of alleviating the pain is to vomit. Most of the time, it immediately ceases the stabbing pain.
o However, if it is a really bad flair up, the stabbing pain still persists.

- Regardless of the outcome, in the end, I have the same sensitivity afterwards, where for the next few days my stomach is extremely sensitive and I can only eat light foods and drink water.


I have had ultrasounds, barium, endoscopy, been put on a plethora of different medications. I am finally going to get a esophageal menometry in 2 weeks and I am hoping that after a decade it will give me answers. They think it may be esophagus spasms.

I have two things that I seem to have not read before: 1) Mine is from an empty stomach and 2) My stomach is so sensitive afterwards that I can''t eat/drink normal for several days afterwards.

I feel like I am the only one in the words with this problem!! Why have no doctors helped this issue? Does anyone have any advice?

Hi Kristina and BernalR,

What a relief to find people who have similar issues. I hope you can help me with your experience.

After doing tons of test (endoscopy twice, byopsi, urine test, blood test, CT Scan, gallbladder scan, PH metric, X ray Barium, manometry, etc..).
Thanks to the manometry test, we have found out that my esophagus over contract (spams) .
I do not have acid reflux, GERD, ulcer, cancer, , high acid, helicobacter (use to have it but treated it successfully a year ago).

Since April the chest pain became constant at the xiphoid process but it is very very painful when my stomach is empty. Then the cycle starts:
- I can barely swallow food though my chest without almost crying
- it takes 1h30 to finish my food due to pain
- sometimes I get chill and goose bump on my arms when eating during this period, like getting hot and sweat
- I have to eat regularly for the pain to go after days or a week
- once the severe pain is gone I have to eat all the time to not have my stomach empty

but the pain is still here and gets worse when I woke up in the morning with empty stomach.

do you mind sharing with me your experience since you have had similar symptoms.

Thank you so much

I also have the same condition while trying to wean off ppi. I haven been put on pantoprazole 40 mg for 4 wks then omeprazole 20 mg currently. I tried to wean off omeprazole with nothing in the morning and Ranitidine 300 mg at night for the last 3 days with esophageal spam (probably due to silent reflux). Today I went back to omeprazole but with 10 mg dose taken at 7 AM and felt the esophageal spam getting worse at 7PM. The Just took Ranitidine 300 mg now to go to sleep. I don't know if I can ever wean off ppi with the esophageal spam getting in the way.

Thank you guys for sharing your experience.

Yellow19 you said you "had" esophagus spams. how did you do to take it away?
for me swallowing food or even water is very painful when the contractions have already started and already have pain in the chest (i.e. which occur when the stomach is empty).

Vdang2, does it help you when you take PPI? do you have acid reflux?
In my case, I don't have GERD or acid reflux and I try to stay away from the PPI as I heard they do have side effects when taken over a long period. Apparently it kills many acids in the stomach, while those acids are needed for digestion.

Paperbackwriter, from what I have read people suffering from esphogaus spams have pain the chest (at the xiphoid). I wish you find what is the issue and fix it. I feel you. I was so close to quit my job and go back live with my family in Europe as the pain is horrible and constant. yeap cant live like this. Sometimes I got depressed when the pain is so high. while I was never depressed before.

I suffer from esophageal spasms, not gerd. I’ve had the h pylori test, endoscopy, and finally I found a different GI doctor who listened to me. He had me have the manometry test, which showed the spasms, and another test which showed that I did not have acid reflux. He recommended that I put 5 drops of pure peppermint oil in 10 ml of water and drink it. What I can tell you is that I have had great success doing this. The spasms I have are extremely painful, and at times have lasted from 1 to 5 hours. I am also deficient in vitamin d, and recently started taking cod liver oil. Not sure yet if this is contributing to me feeling better, but I can honestly say the peppermint oil is a godsend. Just wanted to share because I know how awful having spasms can be.

Hi there, no, he didn’t mention Achalasia, but he did mention my sphincter was a little tight. He said my treatment options if the peppermint oil eventually wasn’t enough, would be either an antidepressant, which would trick the brain into thinking there was no pain when spasms occur, or Botox injections.
I am hoping this is something that will correct itself over time, until then, peppermint oil is a sure thing for me. I woke up with spasms last night, took my peppermint oil, and they subsided within 5 minutes.
Good luck, and let me know if you have any success with the peppermint oil.

One more thing, be careful using peppermint oil if you have acid reflux because it can aggravate it by relaxing the sphincter muscle. You might want to check with your doctor first.

Good luck!

Med N

IMO, you may want to reconsider taking the anti-depressant medication in the short term. There have been people that have gotten great relief from them. I would check with your doctor before using peppermint oil. My other suggestion would be not to self-diagnose with Dr. Google - there is a lot of misinformation out there.

Sharon

I had symptoms for 2 years where it felt like I was dying. Chest pain nausea vomiting extreme back pain trouble breathing. Ended up with pancreatitis and only then did we find out a gallbladder and bike duct full of gallstones. Please have an ultrasound of your gallbladder as I was diagnosed as esophageal spasms. Had gallbladder out 3 months ago, no more pain. Thank the Lord.