Oesophageal spasm, anybody?

[Sasha]

Thought I was having a heart attack but no! Seems to have been an oesophageal spasm.

I don't want another one! Does anybody get these? Any issues I should know? Any ways to prevent them?

@Kernel - don't know if you're still around but a couple of years ago you posted that magnesium helps you with these. Could you give some details about how you take it, dosage and so on?

 

[lansbergen]

Thought I was having a heart attack but no! Seems to have been an oesophageal spasm.

I don't want another one! Does anybody get these? Any issues I should know? Any ways to prevent them?

@Kernel - don't know if you're still around but a couple of years ago you posted that magnesium helps you with these. Could you give some details about how you take it, dosage and so on?

There were times I could not swallow . Even liquid did not go down.

It disappeared like many other symptoms have. The only thing I did is using an immune modulator.

 

[daisybell]

Thought I was having a heart attack but no! Seems to have been an oesophageal spasm.

I don't want another one! Does anybody get these? Any issues I should know? Any ways to prevent them?

@Kernel - don't know if you're still around but a couple of years ago you posted that magnesium helps you with these. Could you give some details about how you take it, dosage and so on?

Do you get reflux?
Sometimes medication for reflux can help. The only other things I can suggest are to avoid really cold foods or liquids, as these can aggravate it, and to eat and drink slowly, chewing really thoroughly and having liquid with food to help prevent any food sticking on its way down.

 

[Sasha]

Do you get reflux?
Sometimes medication for reflux can help. The only other things I can suggest are to avoid really cold foods or liquids, as these can aggravate it, and to eat and drink slowly, chewing really thoroughly and having liquid with food to help prevent any food sticking on its way down.

No, I don't get reflux. I'm able to swallow normally.

Good advice about avoiding cold stuff - I'll make sure I do that.

 

[Sherlock]

avoid really cold foods or liquids, as these can aggravate it

That's a very good insight, daisybell. Cold can cause mast cells to release their histamine, and histamine can constrict smooth muscle. That's what happens, e.g., in cold induced asthma attacks.

 

[Ruthie24]

Yes, I get these and they are miserable! Like so many of my symptoms, they tend to come and go so not sure what I do differently that makes them reappear.

When I am having them, I find that anything that forms a firm bolus when I swallow (like rice, bread or meat) can trigger them so have to take a long time to chew those up and not swallow them too quickly. At my worst, even swallowing saliva was triggering them.

 

[Sea]

Yes I get them. Horrid excruciating pain that does mimic heart attack pain. First time I had one I was in hospital for 2 days until they were sure my heart was fine. After ruling out a heart attack they weren't interested in finding out what actually was wrong.

I haven't yet been able to determine what triggers it. Sometimes my swallowing is uncoordinated and that causes momentary pain but doesn't seem to trigger the ongoing spasm. I have a paraoesaphageal hiatus hernia (the uncommon kind) and I wonder whether that triggers the oesaphageal spasms.

 

[anciendaze]

Had these when my implanted vagus nerve stimulator was set too high. Yes, they are extremely scary.

This is very much a sign of dysautonomia, which a large part of the medical profession assumes is purely mental. They need a refresher on neuroanatomy.

 

[Seven7]

@Sasha Look the videos for OI or the POTs group, it happens a lot there. I had it twice, and both ended up in the hospital. They gave me a shot for nausea and pain med and that did it (the IV was bonus to calm down the OI).

The first was triggered by mushroom (I discovered since then I am allergic). The second no idea.

 

[Sasha]

@Sasha Look the videos for OI or the POTs group, it happens a lot there. I had it twice, and both ended up in the hospital. They gave me a shot for nausea and pain med and that did it (the IV was bonus to calm down the OI).

The first was triggered by mushroom (I discovered since then I am allergic). The second no idea.

That's interesting - all I've read is that people have no clue why it happens.

My (healthy) sister had one before Xmas too.

Fortunately I've not had one since - fingers crossed.

 

[WiseMonkey]

Yes, I'm having a bad time with these at present, the nagging pain goes through my chest to upper back.
I had my first one when I was in my mid 30's now 59.
The latest ones have been more persistent, sticking around for a few weeks. I've had a gastroscopy, all fine in oesophagus and stomach. I seem ok at night as well then it starts with a burp when I get up.

Chewing peppermint gum does help and also vocal zone lozenges. I've noticed that they are worse with stress.
I've got an appointment with the gastroenterologist in a couple of weeks so hope to get some more answers then and hopefully some more effective treatment.

I read a lot about these spasms and the vagus nerve is often the problem.

I've had cfs for many years, IC(from time to time) plus some dryness issues (maybe Sjogrens) but it's manageable. This autoimmune stuff really is the pits! Any advice/info gladly accepted

Lesley

 

[jimells]

I've got an appointment with the gastroenterologist in a couple of weeks so hope to get some more answers then and hopefully some more effective treatment.

This seems to be another area the psychobabblers are trying to take over. Watch out if the doctor says something about "functional", as that word is sometimes used as a synonym for "psychosomatic", especially by psychiatrists.

I've been having some problems swallowing lately. I don't really know how to describe it. I can swallow and the food/liquid goes down, but then it sorta feels like the esophagus stays mostly closed so that the air can barely get back out. It's a weird feeling but not really pain. I expect if I ask the doctor about it she will just tell me it's psychological, just like all my other symptoms are (according to the doctor).

 

[Stretched]

I had an upper GI attack a couple of years back. I was up all night with burn and pain, drinking Gavscon and eating tums. Later in the night I did toe touches and squats. It diminished to the point I got to sleep for a few hours.

I knew (hoped,) it wasn't a heart attack - had stents implanted a few years earlier and tried to stay on top of every hiccu heart could make,). I ruled out gallbladder attack, having run that treadmill earlier - similar pain
but more of a 'floor crash' (before midnight), with chills and fever being key - real serious feeling!

I was concerned but I knew it was GI related, so I assumed I wasn't going to die (right away - no emergency room runaround - yet; but it was a painful, miserable ordeal, with little sleep...basically over the next day.

When I got up I read the symptoms which best fit, and concluded it was Esophageal Spasm. At next appointment I discussed it with my then doc, an Integrative MD, and she agreed. She said it was caused from normal stuff backing up in my GI tract at 3 key valves: esophageal, duodenal and illeus (refer: anatomy chart).

Most importantly, she took my hand and showed me how to push the stuff so as to move it along, relieving the back up (cause) should it recur. I thought this generous on her part - in the spirit of teaching one how to fish vs giving one a fish. (This was a good, caring doc, hard to find, IMO).

From then to present day I added GI supplements: probiotics, carraway seed extract, asparagus extract, zinc,
and different digesting enzymes, along with 10G Omega 3's. No recurrence to date but you can bet I push around those valve areas when I feel bloated!

FWIW, the gallbladder stones, diagnosd and visible on x-rays dissolved on their own over the course of the next year! Prior to recommended surgery by a GP I doubled checked with my good surgeon to re-test, and sure enough - gone, saving me a painful, long recovery procdure... . Go figure???

 

[Sea]

I was up all night with burn and pain

I do suffer from burning reflux at times, but for me there is no burning or reflux associated with oesaphageal spasm. Neither is there bloating or fullness associated with it. There is nothing to indicate that it is GI related at all. For me it is an intense crushing and squeezing chest pain that I can bearly breathe through. I've read it is sometimes known as a nutcracker oesaphagus, which sounds like a perfect description.

 

[WiseMonkey]

I've just started back on the protein Betaine HCL enzymes and I think it's helping. I'd been taking the multi digestive enzymes but I'm pretty sure I have low stomach acid. I also bought a bottle of soda water which is helping with the burps (the burps relieve the spasms). I do have some caraway seeds and have used them before, I must hunt them out.

Your Dr does sound very knowledgeable about the digestive valves, hope the gastro shows me how to push those valve areas
Lesley.

 

[Stretched]

I do suffer from burning reflux at times, but for me there is no burning or reflux associated with oesaphageal spasm. Neither is there bloating or fullness associated with it. There is nothing to indicate that it is GI related at all. For me it is an intense crushing and squeezing chest pain that I can bearly breathe through. I've read it is sometimes known as a nutcracker oesaphagus, which sounds like a perfect description.

You mentioned your 'spasm' was of 'the uncommon kind.' Perhaps this explains the perceptual differences. I can understand why you thought it was heart related. Scary, right?

Maybe we have different conditions. Mine is definitely reflux related, likely started yearts ago with stress (affiliated with
cortisol and/or epinephrine release).

When leaning over, eg touching my toes or similar stretching I can still feel the bile back up into my espohagus if I haven't taken a Protonix in a while. It burns and has that nasty bile taste, coming up through the esophogeal valve (in line with the definition of GERD). There isn't necessarily fullness nor bloating with it, nor shortness of breath. Then again, I don't consider
this the 'spasm' part of the condition.

I understand there is a surgical proceedure for this condition but my cynicism for doctors gives me pause; further, I learned that about 1% can be cancerous, ultimately terminal - ugh! So, I'm rolling the dice, hoping the 99% keeps on... .

Have you tried Protonix or more commonly Prevacid or other PPI's, which are quick, temporary fixes for the problem?

 

[Sea]

You mentioned your 'spasm' was of 'the uncommon kind.'

No, it's my hiatus hernia that is the uncommon kind. It is quite possible that for me it is the trigger for the spasm as it lies beside the oesaphagus. Mine is never triggered by reflux.

Reflux can be caused by too much acid in the stomach, but it can also be caused by too little. The lower sphinter needs a certain level of acidity to trigger opening to allow stomach contents to move on through the digestive process. Taking standard reflux meds or a PPI if the problem is too little stomach acid is not a good solution. Having done the bicarb burp test and finding my results fit in the too little acid category I prefer not to take acid reducing meds. My reflux is usually solved by having some apple cider vinegar.

 

[Stretched]

Quoted from Sea, above: "...Horrid excruciating pain that does mimic heart attack pain.

I haven't yet been able to determine what triggers it. Sometimes my swallowing is uncoordinated and that causes momentary pain but doesn't seem to trigger the ongoing spasm. I have a paraoesaphageal hiatus hernia (the uncommon kind) and I wonder whether that triggers the oesaphageal spasms."

The condition of an OES (or EOS) manifests in the pain you described, which appears that myself and others have experienced. It is indeed attributed to GI conditions, more specifically, backups near or caused by one or more of the 3 valves, ultimately with bile and acid causing the pain.

You received a diagnosis of a paraoesaphageal hiatus hernia and then described the pain associated with OES (or EOS).
So, to what do you attribute the resulting pain, since you ruled out GI attribution?

I agree the OS might not cause reflux of a painful sort; but then how would you know of the OS ocurrence, irrespective
of acid vs base aqueous conditions?

Is the difference a matter of semantics or are you questioning some unknown (or as yet undetermined) problem?
Doesn't your described condition translate into a bulging into the Esophagous...which ultimately would have the
same effects as a blocked GI valve...that can be felt in the chest (area of the transverse colon)?

As you know there are all sorts of pains associated with heart conditions...and they can appear sporadically . For your sake hope it was not a heart attack, but if you're convinced that your pain episode was NOT GI related but may have been heart related then by all means follow up with a stress test (even though it's a hassle; but easier when done with chemicals, eg with Adenosine).

Heart pain IS serious. IMO, better to err on the side of caution... .

 

[Sea]

@Stretched
No I don't believe it is heart related, that was ruled out.

When I said there is nothing to indicate it is GI related for me I meant that for me there are no digestive symptoms, not that it isn't in fact a part of the GI system. The spasm is a muscle contraction like a cramp not the pain of acid reflux. The spasm can be triggered for some people by reflux but for me that is not how it is triggered. Even in those whose spasm is related to reflux the pain of the spasm is not that of the bile or acid. It may be caused by it but is separate from it. My hernia lies beside the oesaphagus and I presume triggers the spasm by pressing up against the outside of it and irritating a nerve. Those whose spasm is triggered by reflux probably have a similar irritation happening inside the oesaphagus. They're both GI related, the difference is that it's obvious in the reflux scenario and not obvious in mine.

 

[Carola]

Sasha, I've had these spasms occasionally. The first time, I couldn't believe the intense pain and did wonder about a heart attack. I don't know what triggers them so can't offer any advice about avoidance. But I did read that drinking something hot when you feel it start can ease the spasm. This has helped me.