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myotomy for esophegeal spasm?

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Posted 8/3/2010 6:33 PM (GMT 0)

My doctor has just suggested I have a myotomy for my esophegeal spasms.  The primary symptom I have is excruciating chest pain lasting anywhere from 5 minutes to 5 or more hours.  I have had all the usual tests done to confirm that I have sever nutcracker spasms.  I was wondering if anyone has had a myotomy done for this purpose and if so what the results were?  Thanks for any feedback.

Posted 8/3/2010 11:06 PM (GMT 0)
Most of use here had the manometry test. Is that what you're referring to?

It's not the most pleasant of test, but it's the most important.
1. They squirt numbing gel in your nose and you snort it up.
2. They feed a small, flexable straw-sized tube into you stomach via your nose. They have you drink sips of water to help it go down. There is some gagging feelings as they adjust it.
3. They lay you back and have you sip and swallow water 10 times. You have to do it when the doctor tells you to do it as they watch a computer screen.
4. They take out the tube and let you rest a bit and then you go home.

You don't get any type of sedative, because it will affect the reading.
Posted 8/4/2010 1:18 AM (GMT 0)

Thank you for your reply.  Yes, I have had the manometry.  My doctor said my pressures were extremly high and he is 100% sure that is what is causing the extreme pain.  Looking through the forum topics I could not find any mention of myotomy for esophegeal spasms but I did find many internet sites that mention it as a treatment for them.

Posted 8/4/2010 1:14 PM (GMT 0)
Do a search on the internet for the procedure. It's a serious operation, but necessary if you have nutcracker. Just make sure you find an experienced - as in 100's if not 1000's of procedures - and ask your gastroenterologist about the success rate of the local surgeons. This is something that would have to be done at a large teaching center.
Posted 8/4/2010 1:37 PM (GMT 0)
Here is some info that may be helpful to others as well as yourself as they read your thread.

Nutcracker esophagus, in which contractions proceed in a coordinated manner, but the amplitude is excessive.

Myotomy

This operation relieves symptoms eliminating the effectiveness of the contractions by  cutting down some layers of muscles. Traditionally, a thoracotomy, the opening of the chest, was required to obtain access to the esophagus, but now, a thoracoscopic approach can be used. Myotomy is, although very radical, also very effective in treating esophageal spasms. The myotomy should extend to the entire length of the involved segment, which should be determined preoperatively with manometry. The problem is that myotomy usually reduces the amplitude of the contractions, but does not consistently improve symptoms, especially if the primary complaint is pain.

I am wondering if you have had a second opinion re your  spasms and treatments recommended ?

I wish you the very best and please know we are here to support you.

Posted 8/4/2010 7:02 PM (GMT 0)
My dr. suggested I go to Vanderbilt or the Cleveland Clinic.
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