Upper Esophageal Spasm????

  I was diagnosed with GERD earlier this year after having an
  upper GI (no history of heartburn).  Zantac (300 mg) per day
  worked pretty well.  About 2 months ago, I started having trouble
  swallowing.  Sometimes, my throat feels swollen (I have trouble swallowing pills) or it feels like there is a tight band that forms
   across my throat or my neck muscles tighten up on the sides
  when I swallow.  However, I can actually swallow food, but
  sometimes, it feels so weird I don't want to eat so I drink Ensure.
   I've lost about 45 pounds since my GERD was diagnosed in
  January.  My doctor believes I just need a psychiatrist but he did
  finally sent me to a gastroenterologist.  The endoscopy came
  back perfectly normal, no swelling or anything, although he did
  stretch my esophagus alittle.  That afternoon, everything was
  great, but the next day, the tightness returned tho not as bad.  
  He has switched me to Prevacid (30mg) per day which I've
  taken for 8 days so far.  The gastro doctor says it's probably
  either globus or upper esophageal spasm.  I've heard of LES but
   UES is a new one on me.  Should the Prevacid help these two?
   My throat and mouth are also very dry and I sometimes wake up every hour on the hour to take a drink.  I'm sick of this!  Any
  suggestions?  Thanks
____________
Dear Pam,
The upper esophageal sphicter is the barrier at the upper end of the esophagus that prevents regurgitation back into the mouth.  Failure of this muscle to relax is associated with an inability to swallow, regurgitation of food into the nose and aspiration of food.
Esophageal spasm is a condition in which there are simultaneous, prolonged, hig-pressure contractions at several sites in the esophagus.  Symptoms of esophageal spasm are the chest pain and the senation tht solids and liquids are sticking in the esophagus.
To diagnose either of these condition your physician can either order a cine-esophagram ( movie of the swallowing act) or an esophageal motility study that measures esophageal muscle coordination and contractions.
If you have esophageal spasm ue to acid reflux from stomach to esophagus, there may be some symptomatic improvement with Prevacid.  However, most patients with spasm do not benefit from Prevacid treatment.
This information is presented for educational purposes.  Alaways discuss personal questions with your physician.
HFHSM.D.-rf
*keywords; esophageal spasm. achalasia
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