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Esophageal Contraction Disorders

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The esophagus is  long, muscular tube that carries food and liquid from the mouth to the stomach. When one swallows, the muscles of the esophagus contract and help in propelling the food and liquid towards the stomach.When these contractions become disorderly and disoriented, it leads to difficulties in the movement of food. This condition is called as esophageal contraction disorder or esophageal motility disorder.

What is Esophageal Contraction Disorder?

Esophagus is a hollow tube that begins from the throat and ends at the stomach. This muscular wall pushes food to the stomach by rhythmic wave motion of muscular contractions. This is muscular contraction is called as peristalsis. At the junction of the throat and esophagus, there is a band of muscles. This band is called as the upper esophageal sphincter. Similarly, at the junction of the esophagus and the stomach, there is another set of another muscle band called the lower esophageal sphincter. These bands of muscles make sure the food and the stomach acid does not come back from the stomach into the mouth.

When this normal process is disturbed, it leads to esophageal contraction disorder. The affected person finds it difficult to swallow food and suffers from chest and back pain. The irregular contractions of the esophagus  areunsynchronized and in some cases totally absent. This dysfunction can occur in the upper and lower esophageal sphincter.

Types of Esophageal Contraction Disorders

Esophageal contractions are of two types:

Diffuse esophageal spasm:

In this type, the muscular spasm is irregular, uncoordinated contraction. This causes the food to get stuck in the esophagus itself and not reach the stomach. This leads to other problems such as dysphagia, regurgitation, chest and back pain.

Nutcracker esophagus

This motility disorder of the esophagus causes problems swallowing, that is, dysphagia.  The spasm causes the esophagus to develop a strong squeeze in an odd manner. This leads to severe pain in the chest,

Symptoms of Esophageal Contraction Disorder

Symptoms of esophageal contraction disorder includes difficulty swallowing, a feeling that something is stuck in the throat and regurgitation of food.

Of these, the most common symptom of esophageal contraction disorder is squeezing, intense chest pain. The pain may radiate towards the back, arms, neck and even the jaw. At times, the pain is so severe, that one thinks they are having a heart attack. In this case, one should seek medical advice immediately, to rule out cardiac problems.

Causes of Esophageal Contraction Disorder

It is not clear as to what causes the esophageal spasms. Some experts are of the opinion, the disorder may arise due to disruption of the nerves that helps with contraction of the esophagus. For some, the condition may be triggered by swallowing hot or cold foods and liquids.

Diagnosis of Esophageal Contraction Disorder

The doctor will take a complete medical history and ask questions regarding your symptoms. Diagnostic tests will be ordered to confirm diagnosis. These tests includes:

  • X-rays
  • Esophahealmanometry
  • Endoscopy
  • Esophageal pH monitoring

Treatment for Esophageal Contraction Disorder

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Esophageal contraction disorder usually occurs as an occasional condition. Thus, it does not require any specific treatment. One just needs to take care, they avoid swallowing very hot or cold foods and liquids. In case, the esophageal spasms cause problems drinking and eating, one needs medical treatment.

The doctor may treat any underlying condition such as anxiety, depression or GERD that leads to esophageal contraction disorders. There are prescription medications that one can take to get relief from severe contractions.

Endoscopic therapy is recommended to some patients. They are given Botox injections to temporarily improve the symptoms for a few weeks. In some cases, pneumatic dilatation of the esophagus is carried out. In this technique, a high pressure balloon is inserted into the esophagus to stretch the muscles of lower esophageal sphincter.

Finally, if nothing helps, a surgery called the Heller myotomy can be carried out.

The esophageal contraction disorder is very common in people over the age of 60’s and 70’s. If you have problems swallowing along with chest burning, chest pain and other symptoms, talk to your doctor. You an find a solution to your problem with proper medical help.

Written by: Saptakee sengupta
Date last updated: April 01, 2015

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