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An esophageal spasm is an abnormal series of muscle contractions in the throat that causes pain and difficulties swallowing. Most spasms are spontaneous and short-lived, and may occur when a person takes a drink of a very hot or cold liquid. Some people, however, experience chronic or frequently occurring esophageal spasms that significantly impact their ability to eat and drink comfortably. Treatment beyond simply avoiding triggers is not needed for mild spasms, but a chronic case should be evaluated and treated by a doctor. A physician may suggest medications, diet and lifestyle changes, and occasionally surgery to help prevent future esophageal spasms.
It is not known what exactly causes an esophageal spasm, but several risk factors have been identified. Mild, occasional spasms are more likely to occur when a person is experiencing acute heartburn or high stress. Hot or cold food or drinks may cause sudden spasms when coming into contact with esophageal muscles in the throat. Many people who have chronic esophageal spasm problems also suffer from gastroesophageal reflux disease (GERD), a condition that causes frequent heartburn, chest pains, and food regurgitation. There is also evidence to suggest that some cases of esophageal spasms are related to nerve problems in or near the throat.
The symptoms of an esophageal spasm can be frightening because they tend to come on very suddenly. A severe spasm causes immediate pain and chest tightness, which can resemble the feeling of an impending heart attack. A person may find it impossible to swallow during and shortly after a spasm, and food may be regurgitated back into the mouth. A few minutes after the attack, it might feel as if an object is stuck in the throat.
A person who suffers a single esophageal spasm probably does not need to seek medical attention unless pain and swallowing difficulties persist for more than a few minutes. If esophageal problems become more frequent, it is generally a good idea to make a doctor's appointment. A doctor can ask about symptoms and perform a thorough physical exam to try to identify the cause of spasms. Additional tests such as x-rays and endoscopies may be needed if spasms and heartburn are chronic nuisances.
Most physicians advise patients to learn what triggers their occasional spasms and take steps to avoid them. Simple lifestyle changes, such as allowing coffee to cool down or avoiding cold ice cream, are enough for many people to prevent future spasms. If esophageal problems are related to heartburn, a doctor might suggest avoiding spicy dishes, getting more exercise, and taking over-the-counter acid-reducers during episodes. A person who has chronic spasms and GERD might need to take daily prescription drugs. In very severe cases, surgery to clip and relax esophageal muscles may be the best treatment option.