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What causes chest pain from esophageal spams and how to relieve it?

I am told I might have reflux, esophageal spasms and possibly a motility disorder. Tests are scheduled for next month. In addition to regurgitation and dysphagia, I have terrible chest pain in the heart area. It varies from somewhat irritating to very painful. From my reading, I know that the chest pain can be caused from the esophageal issues, but I can not find information about the how this occurs. Is it triggering a nerve(s) or is it a muscles issue? What is the pathology of this? None of my doctors seem to worried about it being a heart problem. I have been to my regular doctor, a GI (had endoscopy with dialation), and just FINALLY saw the motility specialist but now I have to wait a whole month for the tests. I can't stand this terrible feeling. I am wondering would muscle relaxers or magnesium help? The pain seems to be getting worse and lasts for hours throughout the day. I am now on a liquid/ very soft food diet so I know that food stuck in the esophagus is unlikely casuing this pain. Any suggestions.
3 Responses
Avatar universal
Esophageal spasms cause pain due to actual spasming of the muscles of the esophagus which causes a contraction much more forceful that that of the 'normal' propulsive forces of the esophagus to move food forward.

1/3 of the esophagus is striated muscle - like that found in the muscles that move the arms and leg. You know how strongly those muscles can contract from personal experience of walking and moving your arms - or if you've had a 'Charlie horse.' The other 2/3rds of the esophagus is smooth muscle, which is a bit different. It's extremely strong muscle that can produce highly contractive sustained contractions. Keep in mind the uterus is smooth muscle and it provides the force to expel a baby - that gives an idea of how 'strong' smooth muscle is and just how much force your esophagus can generate.

No one really knows the exact mechanism of why the esophagus spasms. It's thought it's in response to irritation of the lower portion that then results in a relay of signals to the rest of the esophagus.

There are classes of drugs that can be used to try to control the spasms. You need to talk to your doctor about trying some smooth muscle relaxers, or specific calcium channel blockers or meds such as nitroglycerin which can be helpful in some cases.
Avatar universal
Thanks for the info. I get the pain in the center of my chest so I assume that is the esophagus, but I still don't get why I get pain from my heart area that radiates at time across my chest and into my shoulder and outside left breast area. I'll call the doctor's to ask about the meds you mentioned. The doctor didn't bring these up but did say I would need to stop the PPI 5 days before the test. I wonder if these would affect my test results? I really want to figure this out ASAP and a month's wait seems like an eternity at this time.
Avatar universal
One thing I came across with my esophagus spasm issue is that the sensitivity increased to be almost daily when I started taking synthroid for my thyroid. Even though my doctor said it would not be related when I quit taking the synthroid my esophagus  settled down. I layer read synthroid can great gets issues. It also made my blood pressure hike and that too lowered immediately once I stopped it. Have not gone back to ant thyroid meds as it isn't consistent on its readings ever. So go any meds that can gerd!!
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