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Smooth Muscle Spasms
I have smooth muscle spasms in my gut, mostly in the diaphragm area, though they often spread up my chest, and sometimes affect my lower abdomen. A colonoscopy has shown no organic disease in the colon, and u/sound scans and MRI scans have ruled out any disease in other abdominal organs.
The spasms have a severe effect on my breathing, making me constantly breathless, and I am woken several times a night struggling to breathe.
I have been prescribed several drugs in the past, at different times, to treat the problem. None of them helped, partly because of the side effects I experienced . The drugs were a small dose of benzodiazipine, which made me too tired to do anything all day. Later I tried a very small dose of Amitryptiline, but it made me too agitated to continue with it, and did little to relieve my symptoms.
I do not suffer from diarrhoea or constipation. But when I tried taking one of the smooth muscle relaxant drugs (cannot remember the name of it) it gave me terrible constipation, which was a nightmare to resolve. There is just no point in me taking a drug that makes my quality of life worse than it already is. Can anyone recommend a drug that might relax the muscle spasms, without giving me constipation or other intolerable side effects?
Thank you.
The spasms have a severe effect on my breathing, making me constantly breathless, and I am woken several times a night struggling to breathe.
I have been prescribed several drugs in the past, at different times, to treat the problem. None of them helped, partly because of the side effects I experienced . The drugs were a small dose of benzodiazipine, which made me too tired to do anything all day. Later I tried a very small dose of Amitryptiline, but it made me too agitated to continue with it, and did little to relieve my symptoms.
I do not suffer from diarrhoea or constipation. But when I tried taking one of the smooth muscle relaxant drugs (cannot remember the name of it) it gave me terrible constipation, which was a nightmare to resolve. There is just no point in me taking a drug that makes my quality of life worse than it already is. Can anyone recommend a drug that might relax the muscle spasms, without giving me constipation or other intolerable side effects?
Thank you.
Check out the thread on this forum about the Vagus Nerve. Read all of it because there is lots of info. there. Also, you should see a specialist on dysautonomia a.k.a. dysautonomia. The autonomic nervous system controls many of the "problems" you've experienced. Have you tried a competent, knowledgeable chiropractor? I've had some of the issues you describe and I'm still looking for answers, but the dysautonomia doctor and chiropractor are on my medical team in this quest. I know how those spasms feel and I often wonder if I have a "real heart attack" how I'll know it because the spasms mimic those symptoms. Not good!
I began experiencing upper abdominal pain about 2 yrs ago. It was a squeezing pain that lasted for 2-3hrs. My dr ordered ultrasound-neg,
mri-clear, HidaScan-clear and full labs. She and I both were suspecting gallbladder but the pain "moves" around my upper ribcage. She sent me to a GI dr. I had been keeping a journal and his dx was IBS. I was skeptical at first because my good friend has IBS and her symptoms are very different but when I began to research IBS I realized the dr was correct. My spasms occur in the transverse colon/smooth muscle and are triggered by too much fat in my diet. They can be triggered by many things in different people. I also have GERD and migraines. I have had usual muscle pain and have been noting that also. It is not uncommon for a person to have IBS, migraines, and fibromyalgia. Don't know if this helps but it took several months for us to get to the bottom of my triggers. I kept a journal noting the foods I ate, meds I took, and anything else remarkable. I am currently taking Levsin extended release. When I have the "attacks" I have a pill that contains phenobarbital and 2 smooth muscle relaxants. It is somewhat effective but because the pain is excruciating I have to take Vicadin.
mri-clear, HidaScan-clear and full labs. She and I both were suspecting gallbladder but the pain "moves" around my upper ribcage. She sent me to a GI dr. I had been keeping a journal and his dx was IBS. I was skeptical at first because my good friend has IBS and her symptoms are very different but when I began to research IBS I realized the dr was correct. My spasms occur in the transverse colon/smooth muscle and are triggered by too much fat in my diet. They can be triggered by many things in different people. I also have GERD and migraines. I have had usual muscle pain and have been noting that also. It is not uncommon for a person to have IBS, migraines, and fibromyalgia. Don't know if this helps but it took several months for us to get to the bottom of my triggers. I kept a journal noting the foods I ate, meds I took, and anything else remarkable. I am currently taking Levsin extended release. When I have the "attacks" I have a pill that contains phenobarbital and 2 smooth muscle relaxants. It is somewhat effective but because the pain is excruciating I have to take Vicadin.
If your thyroid disease is well controlled, it is not likely a cause of muscular spasms. Having cramps in feet speaks for a systemic disorder rather then something specifically related to abdomen or diaphragm. With metabolic disorders I've mainly meant changed levels of potassium or sodium that are controlled by hormones aldosterone and cortisol...or changed levels of calcium that is controlled by parathormone and vitamin D.
It seems reasonable to have a metabolic panel test done (K, Ca, Mg, P...) and, if doctor decides, aldosterone, cortisol, parathormone, vitamin D and vitamins B.
Hypokalemia and hypocalcemia are known cause of painfull muscular cramps.
It seems reasonable to have a metabolic panel test done (K, Ca, Mg, P...) and, if doctor decides, aldosterone, cortisol, parathormone, vitamin D and vitamins B.
Hypokalemia and hypocalcemia are known cause of painfull muscular cramps.
Thank you for your helpful comments.
I was seen by a neurologist a year ago, and, interesting what you say about spinal problems, as I was diagnosed with 'mild' spondylitis of the spine, in the upper back. The neurologist did not feel it was serious enough to warrant having me MRI scanned at that stage. Maybe I will go back and ask him to arrange an MRI for me....
The neurologist considered pain from the spine might travel round to the front chest wall, and cause pain, but did not think it could cause pain in the muscles of the diaphragm. He therefore dismissed the idea of my diaphragm pain/spasms being due to the spondylitis. My physical therapist also felt the same. Do you think they could be right?
The spasms are not limited to my back and chest -- mostly they are in the diaphragm muscles, located either side at the bottom of the ribcage. Sometimes the spasms spread to the back and chest, usually after exercise or bending whilst doing chores, or gardening
or from rough massage. But the pain, spasms and soreness always originate in the diaphragm.
There was one exception to this :- when I had a colonoscopy. The radiologist has to pump the colon with air for the x-ray, and when he did so I experienced very painful muscle spasms up my back. Apparently he never had a patient react this way before.
Ocasionally I get quite severe spasms (cramp) in my calves and feet, often in both feet at the same time. You mention that this might indicate a metabolic disorder. As mentioned previously I have thyroid disease, which is a metabolic disorder. There is a causative link between low thyroid levels and fibromyalgia, though my rheumatologist has ruled out fibromyalgia. Blood tests have also ruled out any rheumatic disease.
Could the muscle spasms be caused by my thyroid, even though I have been on
thyroid replacement meds for 5 yrs and my levels have been optimised for the past 3 yrs?
I have not had Vit B12 levels tested recently. My iron and ferritin were mid range normal when they were last tested 4 yrs ago. I have had several fasting glucose tests in the past
5 years, the last one being about a year ago, and they were all normal. I have not had potassium levels checked. My magnesium levels were mid range normal when tested a year ago.
When the muscles in my sternum get really sore, it feels like they are burning hot, and
it is as though the skin itself is sore too, maybe nerve endings in the skin? Or maybe just an impression because of the burning pain in the muscles.
I was seen by a neurologist a year ago, and, interesting what you say about spinal problems, as I was diagnosed with 'mild' spondylitis of the spine, in the upper back. The neurologist did not feel it was serious enough to warrant having me MRI scanned at that stage. Maybe I will go back and ask him to arrange an MRI for me....
The neurologist considered pain from the spine might travel round to the front chest wall, and cause pain, but did not think it could cause pain in the muscles of the diaphragm. He therefore dismissed the idea of my diaphragm pain/spasms being due to the spondylitis. My physical therapist also felt the same. Do you think they could be right?
The spasms are not limited to my back and chest -- mostly they are in the diaphragm muscles, located either side at the bottom of the ribcage. Sometimes the spasms spread to the back and chest, usually after exercise or bending whilst doing chores, or gardening
or from rough massage. But the pain, spasms and soreness always originate in the diaphragm.
There was one exception to this :- when I had a colonoscopy. The radiologist has to pump the colon with air for the x-ray, and when he did so I experienced very painful muscle spasms up my back. Apparently he never had a patient react this way before.
Ocasionally I get quite severe spasms (cramp) in my calves and feet, often in both feet at the same time. You mention that this might indicate a metabolic disorder. As mentioned previously I have thyroid disease, which is a metabolic disorder. There is a causative link between low thyroid levels and fibromyalgia, though my rheumatologist has ruled out fibromyalgia. Blood tests have also ruled out any rheumatic disease.
Could the muscle spasms be caused by my thyroid, even though I have been on
thyroid replacement meds for 5 yrs and my levels have been optimised for the past 3 yrs?
I have not had Vit B12 levels tested recently. My iron and ferritin were mid range normal when they were last tested 4 yrs ago. I have had several fasting glucose tests in the past
5 years, the last one being about a year ago, and they were all normal. I have not had potassium levels checked. My magnesium levels were mid range normal when tested a year ago.
When the muscles in my sternum get really sore, it feels like they are burning hot, and
it is as though the skin itself is sore too, maybe nerve endings in the skin? Or maybe just an impression because of the burning pain in the muscles.
Secondary breathing muscles are striated muscles that connect ribs (so, they are part of the chest wall). They are like muscles in the abdominal wall. If spasms were occuring in either abdominal or chest wall muscles, you would be able (at least partially) control spasms with certain body movements like streching the trunk.
Spasms triggered by certain moves, exercise, and massage and spasms in the back strongly suggest that they affect striat muscles (including breath muscles).
If spasms are always limited to abdominal/back/chest area this sugessts a spinal disorder affecting nerves arising from certain segments of thoracic spine (several bulging discs or spinal arthritis - spondylitis)...or something other pressing on these nerves (spinal tumor), a neurological disorder including multiple sclerosis or other. MRI of the spine/spinal cord would be needed to find this.
If spasms also appear in the hands, fingers, feet, calfs..this speaks for metabolic disorder (iron, potassium, calcium, magnesium, natrium, vit B, folate..also...deficiency... ) or some rheumatic disease. Checking main vitamins and minerals, also morning glucose in the blood would be needed to find out this.
Hunger causing cramps may be due to hypoglycemia or because of anxiousness that increases muscle tone.
"I get a pain like a stitch in my left hand side, my sternum* becomes very painful and sore, like the skin has been burnt, so sore I cannot bear to touch it.
Skin in the sternum area is tender to touch?
Spasms triggered by certain moves, exercise, and massage and spasms in the back strongly suggest that they affect striat muscles (including breath muscles).
If spasms are always limited to abdominal/back/chest area this sugessts a spinal disorder affecting nerves arising from certain segments of thoracic spine (several bulging discs or spinal arthritis - spondylitis)...or something other pressing on these nerves (spinal tumor), a neurological disorder including multiple sclerosis or other. MRI of the spine/spinal cord would be needed to find this.
If spasms also appear in the hands, fingers, feet, calfs..this speaks for metabolic disorder (iron, potassium, calcium, magnesium, natrium, vit B, folate..also...deficiency... ) or some rheumatic disease. Checking main vitamins and minerals, also morning glucose in the blood would be needed to find out this.
Hunger causing cramps may be due to hypoglycemia or because of anxiousness that increases muscle tone.
"I get a pain like a stitch in my left hand side, my sternum* becomes very painful and sore, like the skin has been burnt, so sore I cannot bear to touch it.
Skin in the sternum area is tender to touch?
Many thanks for your helpful reply. When I have the spasms in the diaphragm area my abdomen does not become hard. I get a pain like a stitch in my left hand side, my sternum becomes very painful and sore, like the skin has been burnt, so sore
I cannot bear to touch it.
The spasms affect the secondary muscles of respiration, which is the cause of the breathlessness. Are not the secondary muscles of respiration smooth muscle? As I understand it, the doctor seems to think the spasms in the smooth muscle (gut & respiration) have involved the striated muscle in the diaphragm area. I do not understand the reasons why.
I was dxed with celiac disease 30 yrs ago, and have been on strict gluten-free diet since. Dxed with lactose intolerance as a teenager, and have been on dairy free diet since. 5 yrs ago I became very ill with gastritis, and was dxed with autoimmune thryoid disease. A year later I developed more intolerances ...to all cereals (except rice), soy, nuts, beans, chocolate, tea, coffee, and some vegetables. I also developed asthma, which is triggered by the food intolerances, heat, exercise, stress etc.
Had some blood tests 3 yrs ago for mineral/vitamin imbalances. I was low on zinc and all B vits. Have been taking supplements since. Magnesium levels were mid range normal, but nowadays I take Cal/Mag supplement + Vit D3 as I have Osteopenia.
Interesting you mention gas collecting in the transverse colon can result from food intolerances, as this has been mentioned to me in the past by a doctor. However, as long as I keep to my exclusion diet (as above), I get very little gas, way less than anyone else in my family in fact! The one off occasions when I go off the diet, then I do get some gas. But I have the pain and the spasms whether I have gas or not.
Yesterday I went for a massage. My usual therapist is away, and I had a therapist who massaged with more force and pressure than I am used to. This was quite invigorating at the time, but afterwards I started getting bad spasms in my back, then they spread to my chest, and caused quite severe breathing problems involving my upper airway. It was horrible, and needless to say I won't be going back. These were the same kind of spasms I get from other causes, such as exercise, lifting, food intolerances etc.
Do you think it is possible for part of the transverse colon to become permanently distended, even when there is no excess gas, and none of the culprit foods are being eaten? It feels so much to me like something is out of place, resting on another organ, and causing a strong pulling, tugging sensation. My abdomen is not distended though. Nothing unusual was seen on the MRI scan.
I cannot bear to touch it.
The spasms affect the secondary muscles of respiration, which is the cause of the breathlessness. Are not the secondary muscles of respiration smooth muscle? As I understand it, the doctor seems to think the spasms in the smooth muscle (gut & respiration) have involved the striated muscle in the diaphragm area. I do not understand the reasons why.
I was dxed with celiac disease 30 yrs ago, and have been on strict gluten-free diet since. Dxed with lactose intolerance as a teenager, and have been on dairy free diet since. 5 yrs ago I became very ill with gastritis, and was dxed with autoimmune thryoid disease. A year later I developed more intolerances ...to all cereals (except rice), soy, nuts, beans, chocolate, tea, coffee, and some vegetables. I also developed asthma, which is triggered by the food intolerances, heat, exercise, stress etc.
Had some blood tests 3 yrs ago for mineral/vitamin imbalances. I was low on zinc and all B vits. Have been taking supplements since. Magnesium levels were mid range normal, but nowadays I take Cal/Mag supplement + Vit D3 as I have Osteopenia.
Interesting you mention gas collecting in the transverse colon can result from food intolerances, as this has been mentioned to me in the past by a doctor. However, as long as I keep to my exclusion diet (as above), I get very little gas, way less than anyone else in my family in fact! The one off occasions when I go off the diet, then I do get some gas. But I have the pain and the spasms whether I have gas or not.
Yesterday I went for a massage. My usual therapist is away, and I had a therapist who massaged with more force and pressure than I am used to. This was quite invigorating at the time, but afterwards I started getting bad spasms in my back, then they spread to my chest, and caused quite severe breathing problems involving my upper airway. It was horrible, and needless to say I won't be going back. These were the same kind of spasms I get from other causes, such as exercise, lifting, food intolerances etc.
Do you think it is possible for part of the transverse colon to become permanently distended, even when there is no excess gas, and none of the culprit foods are being eaten? It feels so much to me like something is out of place, resting on another organ, and causing a strong pulling, tugging sensation. My abdomen is not distended though. Nothing unusual was seen on the MRI scan.
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