oesophageal spasm

I underwent successful fundoplication surgery for severe GERD five years ago ; but continue to suffer from discomforting chest pain/heaviness; occasional fullness on eating and very disabling throat spasms which frequently interupt phonation.  Following extensive examination, including barium swallow; 48 pH study and oesophageal pull-through manometry my consultant concluded that I was suffering from upper oesophageal and crico-pharyngeal spasm and has prescribed Dilitazem, 120mg daily.  According to the oesophageal manometry results the peak amplitudes were 173mmHg (lower), 164mmHg (Mid) and 134mmHg (upper), whilst the LOS pressure was 28 mmHg with a maximum reading of 33mmHg.  As I have a heart pacemaker I am not keen on taking medication which can effect heart rhythm.  The most disabling symptoms are in my throat.  Can upper oesophageal spasm affect the throat in this way; and are there alternative treatments which may be open to me.

Many thanx.

VHM      

[Kevin Pho, MD]

Normally, the calcium channel blocker therapy is appropriate treatment.  But as you mentioned, it can affect the heart rhythm.

Tricyclic antidepressants such as trazodone and imipramine are also considerations and normally tried if calcium channel blockers cannot be used.  Nitrates are also used as second line.

Investigational therapies like botulinum toxin injection can also be considered.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

[wandabates]

i just had nissen fundoplication surgery 2 weeks ago and had severe nausea the first week and since then i have hurt really bad every time i eat or drink anything,even runny potatoes my back,chest and top of my stomach hurt so bad...the dr said today i am having esophageal spasms and i have to go tuesday for upper gi to see if  the surgery is messed up or something is not right ,might have to redo the surgery or fix something.does esophageal spasms hurt your back also,they said severe spasms would hurt your chest and back,i did not know.this is the worst pain i think i have had,i cant eat anything have lost about 30 pounds and still losing.i am 42 and had severe acid reflux for 2 years before i finally found a dr that checked my flap and said it was staying open,they had me on 15 acid pills per day and it was not helping the hoarse voice,coughing and choking every time i ate,i would cough for hours after eating anything,for over a year and half,,,then i found a dr in huntsville alabama that teaches the surgery and he did the esophageal monometry test and it showed the flap staying open and never shutting and i had alot of pressure building up in my esophagus from that.good luck with your problems hope they get better and hopefully they will be able to fix my problem easy this time.,,,wanda