Diffuse esophageal spasm is when muscle spasms shut and close the esophagus.

Symptoms
The spasms can lead to a feeling of food sticking, food blocking, vomiting, and chest pain. Symptoms may be worse with cold foods or drinks. The feeling may improve with warm liquids.

At least 2 tests are needed to diagnose:

  • Endoscopy: sedated exam with a flexible camera scope to assess the esophagus.

  • Esophageal manometry: a tube passed through the nose that measures muscle strength in the esophagus and looks for spasms.

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There no cure, though most cases become stable or improve with treatment. About 1 in 10 cases can worsen. These patients need surgery.

  • Treatment

  • Treat acid reflux with medicine that controls acid (PPI) and anti-reflux.

  • Drink warm liquids with meals for trouble swallowing and chest pain.

  • If trouble swallowing or food sticking is the main symptom, you can try medicine to relax the muscles.

  • If chest pain is the main symptom, you can take medicine to control the nerve sensations.

  • Change eating habits. Eat softer and more liquid foods. These foods will tend to slide down easier. Problem foods such as grisly meats, dry foods, or raw vegetables and fruits should be eaten with care.

  • In rare cases, surgery is needed.

Follow Up
Follow up depends on the treatment program. In most cases, follow up will be 3 months after starting medicines. Patients need to track any trouble with eating, drinking, and changes in weight, chest pain, or vomiting.