esophageal spasms

[KLB32]

I think I may be suffering from esophageal spasms and was wondering if anyone else does too and what tests you had to diagnose it and also, what seems to give you relief.

I have been having these strange "episodes" for several months now.  Sometimes I feel great then I will have episodes several times a week which leave me with little quality of life.

I get pain near my breastbone and also my throat near where my throat and collarbone are located.  It usually feels like a tightening like someone is choking me and like I have food stuck.  When it gets really bad, I have a pressure/squeezing sensation that comes up from my breastbone and can spread to my back, throat and jaw.  I feel like I need to sit down when this happens and sometimes I feel really hot.

I can't tell you how many times I have thought I was having a heart attack or angina.  I've been to the ER three times this year and they never find anything.  I've also had a full cardiac work-up including a nuclear stress test, Holter monitoring, multiple EKG's and echo.  All were normal.

I am a 32 year old female, don't smoke, not overweight (underweight, actually), low cholesterol, low BP, eat healthy, no diabetes, very limited family history of heart disease (only 1 grandfather with CAD--did not start until he was older).  So I am pretty sure I don't have heart disease.  Although it has been hard to convince myself I don't since my symptoms are that of a heart attack/angina.

As I've been doing some research lately, I have found that esophageal spasms and angina produce very similar symptoms.  The description of esophageal spasms sound exactly like what I am suffering from.  I had severe acid reflux as a child which resulted in an ulcer so it's entirely possible it has resurfaced.

I was just hoping someone could give me some advice on what to do.  I have an appt. with my family Dr. this week and am hoping he will investigate this and not just push some antacids on me.

[PYBrown]

Oh, actually, my son does it at least once a month.  It seems that once he has had an "episode," his esophagus is very sensitive and it doesn't take much for it to happen again.  He has battled SEVERE food allergies since he was an infant, and I can't help but think that this has made his entire digestive tract more sensitive and fragile.  I think what scares me the most is that he doesn't like to draw attention to himself, so he often times (especially if I'm not there) just excuses himself to the bathroom without telling anyone that he's got something "hung," and stays there until he gets relief.  If I'm around, I can tell by his actions and the look on his face, and I'll go with him, but no one else seems to notice he's having problems and they don't seem to miss him very quickly when he disappears.  I'm scared to death he'll get off by himself and pass out from this sometime.  But like you said . . . whaddya do?  

[Jaybay]

Neither does my husband.  :-\  He seems to do it about annually, and just waits however many hours it takes to go down.  I'm laughing about that "clogged drain" sound - that's exactly what it sounds like!  Oh well, as long as his airway is OK, and it doesn't happen all the time... whaddya do?  LOL!

[PYBrown]

It's good to know that someone else out there knows what I'm talking about!!!  My son has suffered for as long as 6 hours before, just waiting for the "cramp" in his chest to allow whatever is stuck in there to either come up or go down.  I know what you mean about the "fountain" of water.  There is just no way that anything is going to go down until the spasm releases - and then when it does, if what's in there goes down, I can literally hear what sounds like a clogged drain releasing (gurgle, gurgle, gurgle).  He never seems to learn though.!!!!

[Jaybay]

PYB - your son sounds just like my husband and brother-in-law.  Both have a habit of grazing out of the fridge - particularly when there is something very tempting like brisket or ribs.  Bro-in-law inhaled a piece of brisket and it got stuck somewhere in the middle of his chest.  He could still breathe, but his esophogus spazzed so badly it would go up or down.  He tried flushing it down with water, and it just fountained right back up.  Ended up he had to go to the ER and have it removed with the endoscope.  The piece of meat had one - ONE! - bite mark in it.  LOL!  Even worse, it's happened again a couple times since then, but no ER trip required.  Just a couple hours of absolute misery... and my sister raising the roof.  :-)

When it happened to my husband with ribs a few months later, I knew exactly what it was.  Tried the same thing with the water and got a fountain all over the kitchen.  Just as we were getting ready to go to the ER, it thankfully went down.  Men!

[PYBrown]

My 14-year old son suffers from what the doctor thinks is esophageal spasms, and it sounds a lot like what you're experiencing.  He doesn't have them often, but it seems that once he starts, he is likely to have them 2 or 3 days in a row before they stop.  They are usually triggered, in his case, by "inhaling" meats.  When eating something he really likes, he often doesn't take the time to chew like he should.  Once this happens, we try to keep him away from meats for a few days, and start him on an antacid to allow his esophagus time to heal.

[wmac]

You are describing exactly what I have. I did have a endo scope like six yrs ago they determined it was espohegual spasms, but it could also be globus hysteria also look it up. It feels like a lump in the throat, or like when they put there hands around your throat and tell you to swallow to check for thyroid. right? I had it every day for two yrs and before that off on and and still off and on. And when it gets bad yes it causes very bad chest pain you want to die. My daughter also devoloped it as well. I will say I have gaggy today and she says shhh or ill get it and vise versa. but thats what we call it. Now go figure I was taking tums two at night or when needed it helped and dr pepper the carbonaton helped too but oddly enough i dont know if you like salt and vingegar chips but im tellin ya that helps alot. lays kind. worth a try but it really helped when I had a bad spell with it. But I also noticed anxiety or stress brings it on and also yogart helps it if you eat some every  day . good luck I know the pain been there done that.
wendy

[Jaybay]

Sounds to me like the old GERD has come back to haunt you.  Either way, I suspect your family doc will refer you to a gastroenterologist.  Since you have such a long history of GERD, it would be wise to do an endoscopy to see what kind (if any) damage the acid has done over the years.  My husband has a pretty severe case of Barrett's Esophogus, and had no idea.  The pain wasn't all that bad because the tissue had been burned up so badly, that the nerves were damaged.

The front-line treatment for GERD is a proton-pump inhibitor (PPI) such as Prilosec over-the-counter, or Aciphex, Nexium, etc.  Don't want to forget the usual common sense remedies either: avoid citrus and other acid-producing foods; caffiene; grab an extra pillow and prop yourself up a bit while sleeping; don't eat at least 3 hours before bed; and sit up straight at the table when you eat.

If the meds don't work, or the esophogus is too badly damaged, the next step is a surgery called laparascopic Nissen's Fundoplication.  The surgeon wraps the upper part of the stomach around the lower esophogus to make it physically impossible for stomach contents to reflux.  The surgery is a pretty drastic step, so give the meds a solid try.