Materiały źródłowe

• #1 Esophageal spasms | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/esophageal-spasms

  Treatment depends on how often the esophageal spasms happen and how bad they are. […] If your spasms make it difficult to eat or drink, your provider might recommend: […] Managing any underlying conditions. Esophageal spasms are sometimes associated with conditions such as heartburn or gastroesophageal reflux disease (GERD). A healthcare professional might recommend a proton pump inhibitor to treat GERD. Sometimes an antidepressant, such as imipramine, may be prescribed. This medicine may help reduce the feeling of pain in the esophagus. […] Medicines to relax your swallowing muscles. Peppermint oil, onabotulinumtoxinA (Botox) injections into the esophagus or calcium channel blockers, such as diltiazem (Cardizem, Tiazac, others), can make spasms less severe. […] Surgery (myotomy). If medicine doesn’t work, a healthcare professional might recommend a procedure that involves cutting the muscle at the lower end of the esophagus. This procedure, called a myotomy, can help weaken esophageal contractions. Long-term studies of this approach aren’t available, so myotomy generally isn’t recommended for esophageal spasms. However, it might be considered if other treatments don’t work.

• #2 Esophageal spasms – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/esophageal-spasms/symptoms-causes/syc-20372250

  Esophageal spasms usually happen only now and then, and they might not need treatment. But sometimes the spasms happen a lot and can prevent food and liquids from traveling through the esophagus. If esophageal spasms affect the ability to eat or drink, treatments are available. […] There are two types of esophageal spasms distal esophageal spasm and hypercontractile esophagus, also known as nutcracker esophagus.

• #3 Esophageal spasms – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/esophageal-spasms/symptoms-causes/syc-20372250

  Esophageal spasms usually happen only now and then, and they might not need treatment. But sometimes the spasms happen a lot and can prevent food and liquids from traveling through the esophagus. If esophageal spasms affect the ability to eat or drink, treatments are available. […] There are two types of esophageal spasms distal esophageal spasm and hypercontractile esophagus, also known as nutcracker esophagus.

• #4 Esophageal Spasms: Symptoms, Causes, Treatment & Medication

  https://my.clevelandclinic.org/health/diseases/15575-esophageal-spasms

  Esophageal spasm treatments focus on relaxing your esophageal muscles to relieve your symptoms. If esophageal spasms don’t cause symptoms, you may not need treatment. […] Your healthcare provider may recommend any of the following to treat esophageal spasms: […] Home remedies: Research shows that peppermint oil may help relax esophageal muscles. Drinking water with a few drops of peppermint oil may relieve minor symptoms. Identifying what triggers your symptoms could help you avoid future spasms. […] Medication: Taking calcium channel blockers (blood pressure medicine) before eating helps many people swallow more easily. Taking nitrates can help relieve chest pain. Tricyclic antidepressants can target the faulty esophageal nerves, relieving pain. […] Botulinum toxin (Botox) injections: Botox injections temporarily paralyze your esophagus muscles, stopping spasms. If other therapies haven’t helped, your provider may recommend this option. Treatment benefits last about six months.

• #5 Esophageal Spasm – Southeast OB/GYN

  https://seobgynpc.com/womens-health/health-library?DOCHWID=ut1638spec

  Esophageal spasm is not common. […] Treatment for esophageal spasm includes treating other conditions that may make esophageal spasms worse, such as gastroesophageal reflux disease (GERD). GERD is usually treated with changes to diet and lifestyle and medicines to reduce the amount of acid in the stomach. […] Other treatment for esophageal spasm may include: Changing the foods you eat. Your doctor may tell you to eat certain foods and liquids to make swallowing easier. […] Medicines. If you can’t have dilation or surgery, your doctor may suggest medicines, such as botulinum toxin, to relax the muscles in the esophagus. […] Surgery. Surgery is sometimes used in people who have a problem that affects the lower esophageal muscle (achalasia).

• #6 Esophageal Spasms | Loma Linda University Health

  https://lluh.org/conditions/esophageal-spasms

  Treatment for esophageal spasms will vary depending on the frequency and severity of the spasms. Treatment recommendations may include: […] Lifestyle changes and home remedies These are the first steps in reducing or eliminating occasional esophageal spasms. To help reduce occasional esophageal spasms, try to: […] Avoid triggers Identify foods and beverages that seem to cause your esophageal spasms and avoid them. […] Adjust food and beverage temperatures Let very hot or very cold foods and drinks sit long enough to cool a bit before eating or drinking them. […] Control your stress Esophageal spasms seem to be more common or more severe in people who are feeling stressed. Control stress by getting more sleep, using relaxation techniques and avoiding caffeine. […] Take a peppermint lozenge Peppermint oil is a smooth-muscle relaxant and might help ease esophageal spasms. Put the lozenge under the tongue.

• #7 Esophageal Spasms | Loma Linda University Health

  https://lluh.org/conditions/esophageal-spasms

  Treatment for esophageal spasms will vary depending on the frequency and severity of the spasms. Treatment recommendations may include: […] Lifestyle changes and home remedies These are the first steps in reducing or eliminating occasional esophageal spasms. To help reduce occasional esophageal spasms, try to: […] Avoid triggers Identify foods and beverages that seem to cause your esophageal spasms and avoid them. […] Adjust food and beverage temperatures Let very hot or very cold foods and drinks sit long enough to cool a bit before eating or drinking them. […] Control your stress Esophageal spasms seem to be more common or more severe in people who are feeling stressed. Control stress by getting more sleep, using relaxation techniques and avoiding caffeine. […] Take a peppermint lozenge Peppermint oil is a smooth-muscle relaxant and might help ease esophageal spasms. Put the lozenge under the tongue.

• #8 Esophageal spasm relief: Treatments and home remedies

  https://www.medicalnewstoday.com/articles/321656

  Doctors may use surgery as a last resort if other remedies have not worked. […] In some cases, a doctor may suggest an injection of Botox to help reduce esophageal spasms. […] The International Society for Diseases of the Esophagus’s 2018 guidelines recommend that doctors primarily use Botox injections to treat older adults with esophageal achalasia who have found other remedies ineffective. […] The best way to stop an esophageal spasm is to prevent it from starting. Identifying the foods and drinks that trigger muscle spasms in the esophagus and then avoiding them can be a good starting point. […] Medication may help control the symptoms of esophageal spasms. […] Surgery may also help, as may Botox injections, in some cases. […] Treatments are available to help people with esophageal spasms manage and prevent their symptoms. […] Avoiding triggers and making lifestyle changes are often the recommended way to treat and prevent esophageal spasms.

• #9 Esophageal Spasms | Loma Linda University Health

  https://lluh.org/conditions/esophageal-spasms

  Treatment for esophageal spasms will vary depending on the frequency and severity of the spasms. Treatment recommendations may include: […] Lifestyle changes and home remedies These are the first steps in reducing or eliminating occasional esophageal spasms. To help reduce occasional esophageal spasms, try to: […] Avoid triggers Identify foods and beverages that seem to cause your esophageal spasms and avoid them. […] Adjust food and beverage temperatures Let very hot or very cold foods and drinks sit long enough to cool a bit before eating or drinking them. […] Control your stress Esophageal spasms seem to be more common or more severe in people who are feeling stressed. Control stress by getting more sleep, using relaxation techniques and avoiding caffeine. […] Take a peppermint lozenge Peppermint oil is a smooth-muscle relaxant and might help ease esophageal spasms. Put the lozenge under the tongue.

• #10

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ut2352

  Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take. […] Treat other conditions that can make esophageal spasms worse, such as gastroesophageal reflux disease (GERD). […] Your doctor may recommend an over-the-counter medicine. For mild or occasional indigestion, it may help to take antacids, such as Tums. […] Your doctor also may recommend over-the-counter acid reducers, such as famotidine (Pepcid) or omeprazole. […] Ask your doctor about relaxation and controlled breathing exercises. These may help reduce symptoms. […] Avoid very hot or cold foods if they trigger esophageal spasms.

• #11 3 Ways to Stop Esophageal Spasms – wikiHow

  https://www.wikihow.com/Stop-Esophageal-Spasms

  Esophageal spasms occur when your esophagus contracts abnormally or not at all, making it hard for you to swallow food or liquids. […] Adjusting your diet and lifestyle as well as taking medication can help to stop the spasms and make it easier for you to swallow properly. If your spasms are severe or chronic, you may need surgery to address the issue. […] To help prevent esophageal spasms, try eating 5-6 small meals during the day rather than 2-3 big meals. […] Avoid spicy, acidic foods. Food with lots of pepper and other spices can make your symptoms worse. […] Talk to your doctor about muscle relaxants to make it easier for you to swallow. […] Use proton pump inhibitors to manage your stomach acid. […] Get botulinum toxin injections to relax your esophagus. […] Consider a myotomy if your symptoms are severe. […] Allow several weeks for recovery from the dilation or myotomy surgery.

• #12 Esophageal Spasms: Symptoms, Causes, Treatment & Medication

  https://my.clevelandclinic.org/health/diseases/15575-esophageal-spasms

  Esophageal spasm treatments focus on relaxing your esophageal muscles to relieve your symptoms. If esophageal spasms don’t cause symptoms, you may not need treatment. […] Your healthcare provider may recommend any of the following to treat esophageal spasms: […] Home remedies: Research shows that peppermint oil may help relax esophageal muscles. Drinking water with a few drops of peppermint oil may relieve minor symptoms. Identifying what triggers your symptoms could help you avoid future spasms. […] Medication: Taking calcium channel blockers (blood pressure medicine) before eating helps many people swallow more easily. Taking nitrates can help relieve chest pain. Tricyclic antidepressants can target the faulty esophageal nerves, relieving pain. […] Botulinum toxin (Botox) injections: Botox injections temporarily paralyze your esophagus muscles, stopping spasms. If other therapies haven’t helped, your provider may recommend this option. Treatment benefits last about six months.

• #13 Esophageal spasm relief: Treatments and home remedies

  https://www.medicalnewstoday.com/articles/321656

  An esophageal spasm is an involuntary and often painful contraction in the esophagus, or food pipe. Medical treatments and lifestyle remedies can help relieve symptoms of esophageal spasms. […] The treatment options to stop esophageal spasms vary depending on the frequency and severity of a persons symptoms. […] A doctor may recommend several different approaches for treating esophageal spasms, including: identifying and avoiding trigger foods, making lifestyle changes, trying natural remedies, managing underlying medical conditions, taking medication, undergoing surgery. […] Some research suggests that using peppermint products may help reduce esophageal spasms. […] A 2018 review suggests that peppermint oil may be effective in treating distal esophageal spasms in some people. […] If traditional treatments do not work, a person may be able to try other therapies that help relax the esophageal muscles.

• #14 Esophageal Spasms | Loma Linda University Health

  https://lluh.org/conditions/esophageal-spasms

  Treatment for esophageal spasms will vary depending on the frequency and severity of the spasms. Treatment recommendations may include: […] Lifestyle changes and home remedies These are the first steps in reducing or eliminating occasional esophageal spasms. To help reduce occasional esophageal spasms, try to: […] Avoid triggers Identify foods and beverages that seem to cause your esophageal spasms and avoid them. […] Adjust food and beverage temperatures Let very hot or very cold foods and drinks sit long enough to cool a bit before eating or drinking them. […] Control your stress Esophageal spasms seem to be more common or more severe in people who are feeling stressed. Control stress by getting more sleep, using relaxation techniques and avoiding caffeine. […] Take a peppermint lozenge Peppermint oil is a smooth-muscle relaxant and might help ease esophageal spasms. Put the lozenge under the tongue.

• #15 Diffuse Esophageal Spasm | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/d/diffuse-esophageal-spasm.html

  Treatment options include: […] Botulinum toxin (BoTox). Botulinum toxin is a poison produced by the bacteria that causes botulism. During an upper GI endoscopy, a small amount of the Botulinum toxin can be injected into the muscle. The Botulinum toxin inhibits acetylcholine release from nerve endings in the muscle which blocks the function of nerves that make the muscle contract. This procedure may need to be repeated over time. […] Drugs to relax the muscles. While medications can help some patients, they are not effective overall. […] Peppermint oil. A small amount mixed in water makes the muscles of the esophagus contract normally again. […] Surgery to cut the muscles along the lower esophagus. This procedure is usually performed only in serious cases that do not respond to other therapy.

• #16 Know About the Types, Signs, and Treatment for Esophagus Spasms

  https://www.okddsi.net/blog/know-about-the-types-signs-and-treatment-for-esophagus-spasms

  Esophageal spasms are certain problems with the muscles present in your esophagus. It is a tube that carries food and drinks to your stomach once you consume it. Spasms can bring minimal to severe symptoms like problems in swallowing as well as chest pain. […] For this reason, medication as well as other therapies often work. However, surgery is not necessary in esophageal spasms. In case you have severe chest pain, it is better to take proper medical care immediately. […] One of the best ways of treating esophageal spasms is by focusing on relaxing the muscles. Also, it is better if you consult any GI doctor. Home remedies are also there like peppermint oil helps in calming the esophageal muscles. […] All you have to do is drink some water with a few drops of peppermint oil in it. Do not forget to identify the trigger factors, which prevents the future spasms. Also, medicines like esophageal channel blockers are one of the best solutions.

• #17 Esophageal Spasms | Loma Linda University Health

  https://lluh.org/conditions/esophageal-spasms

  Treatment for esophageal spasms will vary depending on the frequency and severity of the spasms. Treatment recommendations may include: […] Lifestyle changes and home remedies These are the first steps in reducing or eliminating occasional esophageal spasms. To help reduce occasional esophageal spasms, try to: […] Avoid triggers Identify foods and beverages that seem to cause your esophageal spasms and avoid them. […] Adjust food and beverage temperatures Let very hot or very cold foods and drinks sit long enough to cool a bit before eating or drinking them. […] Control your stress Esophageal spasms seem to be more common or more severe in people who are feeling stressed. Control stress by getting more sleep, using relaxation techniques and avoiding caffeine. […] Take a peppermint lozenge Peppermint oil is a smooth-muscle relaxant and might help ease esophageal spasms. Put the lozenge under the tongue.

• #18

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ut2352

  Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take. […] Treat other conditions that can make esophageal spasms worse, such as gastroesophageal reflux disease (GERD). […] Your doctor may recommend an over-the-counter medicine. For mild or occasional indigestion, it may help to take antacids, such as Tums. […] Your doctor also may recommend over-the-counter acid reducers, such as famotidine (Pepcid) or omeprazole. […] Ask your doctor about relaxation and controlled breathing exercises. These may help reduce symptoms. […] Avoid very hot or cold foods if they trigger esophageal spasms.

• #19 Esophageal Spasm – What You Need to Know

  https://www.drugs.com/cg/esophageal-spasm.html

  Dilatation: Dilators to widen your esophagus are gently inserted through a scope into your esophagus. […] Myotomy: Muscles in your esophagus are cut to widen the area and allow food and liquids to move into the stomach more easily. […] Biofeedback: Biofeedback is a type of therapy that helps you control how your body reacts to stress or pain. Your healthcare provider will use electrodes (wires) on different parts of your body, such as your chest, to monitor your body responses. This may help you learn ways to reduce your pain or spasms. […] Relaxation therapy may help decrease physical and emotional stress. Stress may cause pain, lead to illness, and slow healing. Deep breathing, muscle relaxation, and music are some forms of relaxation therapy.

• #20 Esophageal Spasm

  https://mobile.fpnotebook.com/GI/Esophagus/EsphglSpsm.htm

  Functional disorders and Hypercontractile Esophagus improve or resolve spontaneously in a majority of patients. […] Optimize GERD Management. […] Antisecretory therapy (e.g. Proton Pump Inhibitor). […] Stress management. […] Consider Cognitive Behavioral Therapy. […] Consider Antidepressants. […] Mindful eating. […] Eat smaller, more frequent meals. […] Eat slowly. […] Choose softer foods. […] Avoid foods and situations that trigger symptoms. […] These medications decrease lower esophageal sphincter pressure and may worsen GERD. […] Smooth Muscle relaxants are best limited to hypermotility confirmed by manometry. […] Calcium Channel Blockers. […] Nitrates (Nitroglycerin). […] Phosphodiesterase-5 Inhibitors (release nitric oxide). […] Peppermint Oil (2 mints sublingual before each meal).

• #21 Esophageal spasms | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/esophageal-spasms

  Treatment depends on how often the esophageal spasms happen and how bad they are. […] If your spasms make it difficult to eat or drink, your provider might recommend: […] Managing any underlying conditions. Esophageal spasms are sometimes associated with conditions such as heartburn or gastroesophageal reflux disease (GERD). A healthcare professional might recommend a proton pump inhibitor to treat GERD. Sometimes an antidepressant, such as imipramine, may be prescribed. This medicine may help reduce the feeling of pain in the esophagus. […] Medicines to relax your swallowing muscles. Peppermint oil, onabotulinumtoxinA (Botox) injections into the esophagus or calcium channel blockers, such as diltiazem (Cardizem, Tiazac, others), can make spasms less severe. […] Surgery (myotomy). If medicine doesn’t work, a healthcare professional might recommend a procedure that involves cutting the muscle at the lower end of the esophagus. This procedure, called a myotomy, can help weaken esophageal contractions. Long-term studies of this approach aren’t available, so myotomy generally isn’t recommended for esophageal spasms. However, it might be considered if other treatments don’t work.

• #22 Esophageal Spasm Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/174975-treatment

  Usually, the workup and treatment are performed in an outpatient setting. Patients in whom medical management fails and who require operative intervention should have routine postoperative care based on the procedure performed. […] Calcium channel blockers and nitrates are first-line therapy. […] Sildenafil, a phosphodiesterase inhibitor, is a smooth muscle relaxant that can lower the LES pressure and spastic contractions of the esophagus in nutcracker esophagus. […] Botulinum toxin binds receptors in the nerve endings, thereby decreasing the release of acetylcholine. By endoscopically injecting botulinum toxin above the LES, symptoms may improve. The effect is temporary, and the response decreases with repeated injections. […] Balloon dilatation is commonly used for achalasia, but it has been also used to treat diffuse esophageal spasm and nutcracker esophagus. The studies are small, the relief is not uniform, and symptoms recur.

• #23 Esophageal Spasm Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/174975-treatment

  Usually, the workup and treatment are performed in an outpatient setting. Patients in whom medical management fails and who require operative intervention should have routine postoperative care based on the procedure performed. […] Calcium channel blockers and nitrates are first-line therapy. […] Sildenafil, a phosphodiesterase inhibitor, is a smooth muscle relaxant that can lower the LES pressure and spastic contractions of the esophagus in nutcracker esophagus. […] Botulinum toxin binds receptors in the nerve endings, thereby decreasing the release of acetylcholine. By endoscopically injecting botulinum toxin above the LES, symptoms may improve. The effect is temporary, and the response decreases with repeated injections. […] Balloon dilatation is commonly used for achalasia, but it has been also used to treat diffuse esophageal spasm and nutcracker esophagus. The studies are small, the relief is not uniform, and symptoms recur.

• #24 Esophageal Spasms: Symptoms, Causes, Treatment & Medication

  https://my.clevelandclinic.org/health/diseases/15575-esophageal-spasms

  Esophageal spasm treatments focus on relaxing your esophageal muscles to relieve your symptoms. If esophageal spasms don’t cause symptoms, you may not need treatment. […] Your healthcare provider may recommend any of the following to treat esophageal spasms: […] Home remedies: Research shows that peppermint oil may help relax esophageal muscles. Drinking water with a few drops of peppermint oil may relieve minor symptoms. Identifying what triggers your symptoms could help you avoid future spasms. […] Medication: Taking calcium channel blockers (blood pressure medicine) before eating helps many people swallow more easily. Taking nitrates can help relieve chest pain. Tricyclic antidepressants can target the faulty esophageal nerves, relieving pain. […] Botulinum toxin (Botox) injections: Botox injections temporarily paralyze your esophagus muscles, stopping spasms. If other therapies haven’t helped, your provider may recommend this option. Treatment benefits last about six months.

• #25 Esophageal Spasms | Loma Linda University Health

  https://lluh.org/conditions/esophageal-spasms

  Medications A proton pump inhibitor like lansoprazole may be used to treat GERD, or an antidepressant, like trazodone or imipramine (Tofranil) may help to reduce or eliminate spasms. Antidepressants may also reduce pain in the esophagus. Using certain medications to relax swallowing muscles like Sildenafil (Revatio, Viagra), Botox injections may help. Diltiazem (Cardizem CD, Tiazac, and others) are calcium channel blockers that may reduce the severity of esophageal spasms. […] Myotomy Surgery If medication, lifestyle changes and home remedies dont sufficiently reduce or eliminate esophageal spasms, myotomy surgery may be recommended. In this procedure, the muscle at the lower end of the esophagus is cut to weaken esophageal contractions. Long-term studies of myotomy are not yet available.

• #26 Esophageal Spasm Medication: Calcium channel blockers, Nitrates, Tricyclic antidepressants, Toxins (botulinum toxin), Phosphodiesterase-5 Enzyme Inhibitors

  https://emedicine.medscape.com/article/174975-medication

  Medical therapy is the first line of treatment for esophageal spasm. Because the etiology is unknown, all medical therapies are directed at symptoms, not the etiology. […] Calcium channel blockers and nitrates may decrease pain associated with esophageal spasms. […] Botulinum toxin decreases acetylcholine available at nerve endings. […] Imipramine improves pain by an unknown mechanism of action. […] Calcium channel blockers reduce the amplitude of contractions. […] Like calcium channel blockers, nitrates may decrease the pain associated with esophageal spasm. […] These agents, specifically imipramine, have been shown to decrease chest pain of no apparent cause on angiography. […] Injecting botulinum toxin endoscopically above the lower esophageal sphincter (LES) improves the symptoms of patients with esophageal spasms. However, the effect is temporary and the response decreases with repeated injections.

• #27 Esophageal Motility Disorder/Eosinophilic Esophagitis – Midtown East/Upper East Side New York, NY

  https://www.alberthararymd.com/contents/conditions-we-treat/esophageal-motility-disorder

  Esophageal motility disorders can cause difficulty swallowing or chest pain. […] Diffuse esophageal spasm is usually treated with medications that relax the muscle of the esophagus, for example calcium channel blockers (diltiazem, nifedipine, and verapamil), anti-spasmodics (hyoscyamine, dicyclomine, propantheline, and methscopolamine), or nitroglycerin, which are either taken by mouth or dissolved under the tongue. […] Nutcracker esophagus and jackhammer esophagus are esophageal motility disorders in which the esophageal muscle contracts in a coordinated fashion, but the contractions are too strong and often prolonged. They can cause either chest pain or difficulty swallowing. The diagnosis and treatment are the same as for diffuse esophageal spasm. […] Hypertensive lower esophageal sphincter may cause symptoms such as difficulty swallowing or chest pain. It can be treated with medications, Botox injection into the lower esophageal sphincter, and esophageal dilation.

• #28 Esophageal spasm – UF Health

  https://ufhealth.org/conditions-and-treatments/esophageal-spasm

  Nitroglycerin given under the tongue (sublingual) may help a sudden episode of esophageal spasm. Long-acting nitroglycerin and calcium channel blockers are also used for the problem. […] Long-term (chronic) cases are sometimes treated with low-dose antidepressants such as trazodone or nortriptyline to reduce symptoms. […] Rarely, severe cases may need dilation (widening) of the esophagus or surgery to control symptoms.

• #29 Esophageal Spasm Medication: Calcium channel blockers, Nitrates, Tricyclic antidepressants, Toxins (botulinum toxin), Phosphodiesterase-5 Enzyme Inhibitors

  https://emedicine.medscape.com/article/174975-medication

  Medical therapy is the first line of treatment for esophageal spasm. Because the etiology is unknown, all medical therapies are directed at symptoms, not the etiology. […] Calcium channel blockers and nitrates may decrease pain associated with esophageal spasms. […] Botulinum toxin decreases acetylcholine available at nerve endings. […] Imipramine improves pain by an unknown mechanism of action. […] Calcium channel blockers reduce the amplitude of contractions. […] Like calcium channel blockers, nitrates may decrease the pain associated with esophageal spasm. […] These agents, specifically imipramine, have been shown to decrease chest pain of no apparent cause on angiography. […] Injecting botulinum toxin endoscopically above the lower esophageal sphincter (LES) improves the symptoms of patients with esophageal spasms. However, the effect is temporary and the response decreases with repeated injections.

• #30 Esophageal spasm – UF Health

  https://ufhealth.org/conditions-and-treatments/esophageal-spasm

  Nitroglycerin given under the tongue (sublingual) may help a sudden episode of esophageal spasm. Long-acting nitroglycerin and calcium channel blockers are also used for the problem. […] Long-term (chronic) cases are sometimes treated with low-dose antidepressants such as trazodone or nortriptyline to reduce symptoms. […] Rarely, severe cases may need dilation (widening) of the esophagus or surgery to control symptoms.

• #31 Esophageal spasm – Emergency Department Analgesia

  https://www.cambridge.org/core/books/emergency-department-analgesia/esophageal-spasm/18CD985D83B7EA9BE50A3733F6A33540

  Proton pump inhibitors (PPIs) are recommended as a first-line therapy when chest pain is thought to be caused by esophageal spasm. […] Both long- and short-acting nitrates have been shown to provide some relief of pain caused by esophageal spasm. […] Calcium channel blockers decrease the amplitude and duration of esophageal spasms, but their use does not consistently result in better analgesia than achieved with placebo. […] This chapter discusses the use of anticholinergic agents such as atropine, hyoscyamine, or propantheline bromide decrease peristaltic contractions and reduce esophageal sphincter tone. […] There is evidence supporting the use of antidepressants such as tricyclics, trazodone, and SSRIs for treating chest pain caused by esophageal spasm. […] Regardless of their possible utility in the long term, antidepressants are not likely to be of help in the acute management of esophageal spasm pain in the ED.

• #32 What Is the Treatment for Esophageal Spasms?

  https://www.medicinenet.com/esophageal_pain/ask.htm

  Isordil is one of the more frequently used drugs in the treatment of esophageal spasm.

• #33 Esophageal Spasm Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/174975-treatment

  Proton pump inhibitors (PPIs) effectively reduce or alleviate the symptoms of gastroesophageal reflux disease, which may mimic diffuse esophageal spasm. A trial of acid-lowering therapy may be undertaken prior to instituting other treatments. Although PPI treatment is often ineffective, the symptoms from diffuse esophageal spasm and nutcracker esophagus usually improve over time. […] Tricyclic antidepressants have produced much success in the treatment of many patients with esophageal motility disorders. Some of these patients may have associated psychiatric illnesses, and concomitant treatment of those conditions may improve outcomes. […] Patients in whom medical management fails should be referred to a thoracic surgeon for possible operative intervention. […] For extreme cases, operative treatment usually involves a myotomy. Myotomy relieves symptoms by eliminating the effectiveness of the contractions.

• #34 Esophageal Spasm Medication: Calcium channel blockers, Nitrates, Tricyclic antidepressants, Toxins (botulinum toxin), Phosphodiesterase-5 Enzyme Inhibitors

  https://emedicine.medscape.com/article/174975-medication

  Medical therapy is the first line of treatment for esophageal spasm. Because the etiology is unknown, all medical therapies are directed at symptoms, not the etiology. […] Calcium channel blockers and nitrates may decrease pain associated with esophageal spasms. […] Botulinum toxin decreases acetylcholine available at nerve endings. […] Imipramine improves pain by an unknown mechanism of action. […] Calcium channel blockers reduce the amplitude of contractions. […] Like calcium channel blockers, nitrates may decrease the pain associated with esophageal spasm. […] These agents, specifically imipramine, have been shown to decrease chest pain of no apparent cause on angiography. […] Injecting botulinum toxin endoscopically above the lower esophageal sphincter (LES) improves the symptoms of patients with esophageal spasms. However, the effect is temporary and the response decreases with repeated injections.

• #35 Esophageal spasms | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/esophageal-spasms

  Treatment depends on how often the esophageal spasms happen and how bad they are. […] If your spasms make it difficult to eat or drink, your provider might recommend: […] Managing any underlying conditions. Esophageal spasms are sometimes associated with conditions such as heartburn or gastroesophageal reflux disease (GERD). A healthcare professional might recommend a proton pump inhibitor to treat GERD. Sometimes an antidepressant, such as imipramine, may be prescribed. This medicine may help reduce the feeling of pain in the esophagus. […] Medicines to relax your swallowing muscles. Peppermint oil, onabotulinumtoxinA (Botox) injections into the esophagus or calcium channel blockers, such as diltiazem (Cardizem, Tiazac, others), can make spasms less severe. […] Surgery (myotomy). If medicine doesn’t work, a healthcare professional might recommend a procedure that involves cutting the muscle at the lower end of the esophagus. This procedure, called a myotomy, can help weaken esophageal contractions. Long-term studies of this approach aren’t available, so myotomy generally isn’t recommended for esophageal spasms. However, it might be considered if other treatments don’t work.

• #36 Esophageal spasm – UF Health

  https://ufhealth.org/conditions-and-treatments/esophageal-spasm

  Nitroglycerin given under the tongue (sublingual) may help a sudden episode of esophageal spasm. Long-acting nitroglycerin and calcium channel blockers are also used for the problem. […] Long-term (chronic) cases are sometimes treated with low-dose antidepressants such as trazodone or nortriptyline to reduce symptoms. […] Rarely, severe cases may need dilation (widening) of the esophagus or surgery to control symptoms.

• #37

  https://journals.lww.com/ebp/fulltext/2008/09000/what_is_the_best_treatment_for_esophageal_spasms_.4.aspx

  Trazodone, at doses of 100 to 150 mg/d relieves symptoms due to esophageal spasm (SOR B, based on a single randomized controlled trial [RCT]). […] Other therapies with less supporting evidence include calcium channel blockers, proton-pump inhibitors (PPIs), sildenafil, and botulinum toxin injections (SOR C, based on low-quality RCTs, case series, and expert opinion).

• #38 Diffuse Esophageal Spasm – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK541106/

  Patients with DES and other esophageal motility disorders who suffer from psychiatric illnesses like anxiety and depression as well can receive tricyclic antidepressant therapy. They improve esophageal as well as psychological symptoms, leading to better outcomes. […] Initiation or change in therapy requires adequate follow-up care by the physician. The efficacy of the medication in terms of improvement of the symptoms requires close monitoring, and any serious adverse effect should be identified and managed. If medical management of the patient fails, the patient is a candidate for surgical treatment with a referral to a thoracic surgeon.

• #39 Esophageal Spasm – Southeast OB/GYN

  https://seobgynpc.com/womens-health/health-library?DOCHWID=ut1638spec

  Esophageal spasm is not common. […] Treatment for esophageal spasm includes treating other conditions that may make esophageal spasms worse, such as gastroesophageal reflux disease (GERD). GERD is usually treated with changes to diet and lifestyle and medicines to reduce the amount of acid in the stomach. […] Other treatment for esophageal spasm may include: Changing the foods you eat. Your doctor may tell you to eat certain foods and liquids to make swallowing easier. […] Medicines. If you can’t have dilation or surgery, your doctor may suggest medicines, such as botulinum toxin, to relax the muscles in the esophagus. […] Surgery. Surgery is sometimes used in people who have a problem that affects the lower esophageal muscle (achalasia).

• #40 Esophageal Spasms: Symptoms, Causes, Treatment & Medication

  https://my.clevelandclinic.org/health/diseases/15575-esophageal-spasms

  Surgery: If your symptoms are severe and other treatments haven’t helped, your provider may recommend surgery called a myotomy. During a myotomy, a provider makes an incision along your lower esophagus muscle. This incision stops the muscle from working entirely, which stops abnormal contractions. With the esophageal muscle no longer in use, gravity moves food and liquid down your esophagus. […] Many people with esophageal spasms and GERD experience symptom relief for both conditions by taking proton pump inhibitors (PPIs). These medicines reduce stomach acid production. […] Esophageal spasms related to opioid use often resolve after you stop taking them.

• #41 Esophageal Spasm Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/174975-treatment

  Proton pump inhibitors (PPIs) effectively reduce or alleviate the symptoms of gastroesophageal reflux disease, which may mimic diffuse esophageal spasm. A trial of acid-lowering therapy may be undertaken prior to instituting other treatments. Although PPI treatment is often ineffective, the symptoms from diffuse esophageal spasm and nutcracker esophagus usually improve over time. […] Tricyclic antidepressants have produced much success in the treatment of many patients with esophageal motility disorders. Some of these patients may have associated psychiatric illnesses, and concomitant treatment of those conditions may improve outcomes. […] Patients in whom medical management fails should be referred to a thoracic surgeon for possible operative intervention. […] For extreme cases, operative treatment usually involves a myotomy. Myotomy relieves symptoms by eliminating the effectiveness of the contractions.

• #42 Diffuse Esophageal Spasm – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK541106/

  Current treatment agents include nitrates (both short and long-acting), calcium-channel blockers, visceral analgesics (tricyclic agents or SSRI), and esophageal dilation. First-line therapy is with calcium channel blockers and nitrates. Endoscopic botulinum toxin injection and pneumatic dilation are second-line therapies. […] Concomitant gastroesophageal reflux disease (GERD) should also receive treatment, especially if the esophageal testing shows pathologic reflux. Initiation of a proton pump inhibitor (PPI) half an hour before meals can help relieve GERD symptoms. Patients who are responsive to PPIs will continue with PPI therapy for three months. […] Botulinum toxin injection is also considered an effective and low-risk procedure for short-term symptom relief. It is usually only an option for medically high-risk patients.

• #43 Diffuse Esophageal Spasm (DES) – Esophageal Health | UCLA Health

  https://www.uclahealth.org/medical-services/gastro/esophageal-health/diseases-we-treat/diffuse-esophageal-spasm-des

  Several treatment options are available for DES, although the predictability of response is variable. Typically, proton pump inhibitors (PPIs) are tried first. Second-line options include medications that can have a relaxing effect on the esophageal smooth muscle, such as calcium channel blockers (a type of blood pressure medication), anti-spasmodic agents, and nitroglycerin (used commonly for blood pressure and chest pain related to the heart). […] Sometimes, an upper endoscopy can be performed to inject BoTox into the esophageal muscle, which causes it to relax. Longer-lasting options include a surgical myotomy or a special endoscopic procedure called POEM to cut the circular muscle within the esophagus, leaving it in a more relaxed state.

• #44 Esophageal Spasm Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/174975-treatment

  Usually, the workup and treatment are performed in an outpatient setting. Patients in whom medical management fails and who require operative intervention should have routine postoperative care based on the procedure performed. […] Calcium channel blockers and nitrates are first-line therapy. […] Sildenafil, a phosphodiesterase inhibitor, is a smooth muscle relaxant that can lower the LES pressure and spastic contractions of the esophagus in nutcracker esophagus. […] Botulinum toxin binds receptors in the nerve endings, thereby decreasing the release of acetylcholine. By endoscopically injecting botulinum toxin above the LES, symptoms may improve. The effect is temporary, and the response decreases with repeated injections. […] Balloon dilatation is commonly used for achalasia, but it has been also used to treat diffuse esophageal spasm and nutcracker esophagus. The studies are small, the relief is not uniform, and symptoms recur.

• #45 What Are Esophageal Spasms? – Gastroenterology Medical Associates

  https://gastrospecialistsnj.com/what-are-esophageal-spasms/

  Chest pain and dysphagia (difficulty in swallowing) account for a reasonable percentage of hospital consultations. In some patients, these occur due to a spasm of the esophagus, a muscular tube that moves food from the mouth to the stomach. […] An esophageal spasm is an involuntary painful muscular contraction of the esophagus, a tube connecting the mouth and the stomach. […] The first management line is medical therapy with calcium channel blockers and nitrates. […] The initial treatment of choice is lifestyle modification and medical treatment. Suppose you don’t respond to medical therapy; your doctor will recommend surgery. […] The use of phosphodiesterase inhibitors such as sildenafil can relax your esophagus, thus relieving pain. In addition, sildenafil will also relax the lower esophageal sphincter, alleviating difficulty in swallowing.

• #46 Esophageal Spasm: Symptoms, Causes, Treatment and More

  https://www.healthline.com/health/esophageal-spasm

  Esophageal spasms are typically rare, but they may occur with frequency in some people. This can inhibit your ability to eat and drink. When esophageal spasms happen often, they may require treatment. […] The type of esophageal spasm you’re experiencing may influence your treatment options. The two types of esophageal spasm are: […] Treatment options include: […] If you have diffuse esophageal spasms, you may be able to treat them simply by identifying and eliminating food and drink triggers. […] Standardized deglycyrrhizinated licorice (DGL) extract, taken an hour or two before or after meals, may help reduce spasms. […] Peppermint oil is a smooth-muscle relaxant that may also help calm down spasms. […] Your doctor may prescribe medications, such as a proton pump inhibitor or an H2 blocker if you have GERD, to address the underlying cause of your symptoms.

• #47 Esophageal spasm – Emergency Department Analgesia

  https://www.cambridge.org/core/books/emergency-department-analgesia/esophageal-spasm/18CD985D83B7EA9BE50A3733F6A33540

  Proton pump inhibitors (PPIs) are recommended as a first-line therapy when chest pain is thought to be caused by esophageal spasm. […] Both long- and short-acting nitrates have been shown to provide some relief of pain caused by esophageal spasm. […] Calcium channel blockers decrease the amplitude and duration of esophageal spasms, but their use does not consistently result in better analgesia than achieved with placebo. […] This chapter discusses the use of anticholinergic agents such as atropine, hyoscyamine, or propantheline bromide decrease peristaltic contractions and reduce esophageal sphincter tone. […] There is evidence supporting the use of antidepressants such as tricyclics, trazodone, and SSRIs for treating chest pain caused by esophageal spasm. […] Regardless of their possible utility in the long term, antidepressants are not likely to be of help in the acute management of esophageal spasm pain in the ED.

• #48 Hypercontractile (Nutcracker) Esophagus: Symptoms, Causes, and More

  https://www.healthline.com/health/nutcracker-esophagus

  Several oral and injection treatment options may help reduce symptoms of hypercontractile esophagus, such as: proton pump inhibitors, calcium channel blockers, some antidepressants, nitrates, such as sublingual nitroglycerin (Nitrostat), hyoscyamine (Levsin), anticholinergic drugs, botulinum toxin (Botox) injection. […] Sometimes, a healthcare professional may recommend surgery to cut one of the muscles in your esophagus to weaken contractions. This may include peroral endoscopic myotomy (POEM), which uses an endoscope rather than traditional surgery to cut back a section of muscle within the esophagus. […] However, research on treating hypercontractile esophagus is limited, and more research is needed to establish the best treatment. […] Some ways to quickly calm an esophageal spasm include taking nitroglycerin or calcium channel blockers. If your symptoms persist, a healthcare professional may recommend other medical treatments or surgery. […] Some treatment methods may help you manage symptoms, but more research is needed.

• #49 Esophageal spasms | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/esophageal-spasms

  Peroral endoscopic myotomy (POEM). The POEM procedure is minimally invasive. This newer technique involves placing an endoscope through the mouth and down the throat. This allows a surgeon to make a cut in the inside lining of the esophagus. Then, as in standard myotomy, the surgeon cuts the muscle at the lower end of the esophagus. Like standard myotomy, POEM is usually considered only if other treatments don’t work.

• #50 Esophageal Spasms: Symptoms, Causes, Treatment & Medication

  https://my.clevelandclinic.org/health/diseases/15575-esophageal-spasms

  Esophageal spasm treatments focus on relaxing your esophageal muscles to relieve your symptoms. If esophageal spasms don’t cause symptoms, you may not need treatment. […] Your healthcare provider may recommend any of the following to treat esophageal spasms: […] Home remedies: Research shows that peppermint oil may help relax esophageal muscles. Drinking water with a few drops of peppermint oil may relieve minor symptoms. Identifying what triggers your symptoms could help you avoid future spasms. […] Medication: Taking calcium channel blockers (blood pressure medicine) before eating helps many people swallow more easily. Taking nitrates can help relieve chest pain. Tricyclic antidepressants can target the faulty esophageal nerves, relieving pain. […] Botulinum toxin (Botox) injections: Botox injections temporarily paralyze your esophagus muscles, stopping spasms. If other therapies haven’t helped, your provider may recommend this option. Treatment benefits last about six months.

• #51 Esophageal Spasm Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/174975-treatment

  Usually, the workup and treatment are performed in an outpatient setting. Patients in whom medical management fails and who require operative intervention should have routine postoperative care based on the procedure performed. […] Calcium channel blockers and nitrates are first-line therapy. […] Sildenafil, a phosphodiesterase inhibitor, is a smooth muscle relaxant that can lower the LES pressure and spastic contractions of the esophagus in nutcracker esophagus. […] Botulinum toxin binds receptors in the nerve endings, thereby decreasing the release of acetylcholine. By endoscopically injecting botulinum toxin above the LES, symptoms may improve. The effect is temporary, and the response decreases with repeated injections. […] Balloon dilatation is commonly used for achalasia, but it has been also used to treat diffuse esophageal spasm and nutcracker esophagus. The studies are small, the relief is not uniform, and symptoms recur.

• #52 Diffuse Esophageal Spasm | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/d/diffuse-esophageal-spasm.html

  Treatment options include: […] Botulinum toxin (BoTox). Botulinum toxin is a poison produced by the bacteria that causes botulism. During an upper GI endoscopy, a small amount of the Botulinum toxin can be injected into the muscle. The Botulinum toxin inhibits acetylcholine release from nerve endings in the muscle which blocks the function of nerves that make the muscle contract. This procedure may need to be repeated over time. […] Drugs to relax the muscles. While medications can help some patients, they are not effective overall. […] Peppermint oil. A small amount mixed in water makes the muscles of the esophagus contract normally again. […] Surgery to cut the muscles along the lower esophagus. This procedure is usually performed only in serious cases that do not respond to other therapy.

• #53 Esophageal Spasm Medication: Calcium channel blockers, Nitrates, Tricyclic antidepressants, Toxins (botulinum toxin), Phosphodiesterase-5 Enzyme Inhibitors

  https://emedicine.medscape.com/article/174975-medication

  Medical therapy is the first line of treatment for esophageal spasm. Because the etiology is unknown, all medical therapies are directed at symptoms, not the etiology. […] Calcium channel blockers and nitrates may decrease pain associated with esophageal spasms. […] Botulinum toxin decreases acetylcholine available at nerve endings. […] Imipramine improves pain by an unknown mechanism of action. […] Calcium channel blockers reduce the amplitude of contractions. […] Like calcium channel blockers, nitrates may decrease the pain associated with esophageal spasm. […] These agents, specifically imipramine, have been shown to decrease chest pain of no apparent cause on angiography. […] Injecting botulinum toxin endoscopically above the lower esophageal sphincter (LES) improves the symptoms of patients with esophageal spasms. However, the effect is temporary and the response decreases with repeated injections.

• #54 Extreme Esophageal Spasm Treated with Botulinum Toxin

  https://www.jscimedcentral.com/jounal-article-info/JSM-Gastroenterology-and-Hepatology/Extreme-Esophageal-Spasm-Treated-with-Botulinum-Toxin-7301

  Diffuse esophageal spasm is a rare motility disorder. The primary symptoms include dysphagia, and chest pain. There is array of treatments available from medical therapy with nitrates to surgical therapy; Heller myotomy. […] Patient was treated with Botulinum Toxin (BTX) with complete resolution of symptoms. The use of botulinum toxin for treatment of motility disorders; achalasia and diffuse esophageal spasm is well reported. […] Multiple treatments have been used to treat severe esophageal spasms including: Calcium-Channel Blockers (CCBs), nitrates and surgical approaches, including Heller myotomy. More recently, boutlinum toxin (BTX) has been introduced as a treatment option for patients with DES. […] This case highlights an extreme case of DES and symptomatic relief after treatment with botulinum toxin injections.

• #55 Esophageal spasm relief: Treatments and home remedies

  https://www.medicalnewstoday.com/articles/321656

  Doctors may use surgery as a last resort if other remedies have not worked. […] In some cases, a doctor may suggest an injection of Botox to help reduce esophageal spasms. […] The International Society for Diseases of the Esophagus’s 2018 guidelines recommend that doctors primarily use Botox injections to treat older adults with esophageal achalasia who have found other remedies ineffective. […] The best way to stop an esophageal spasm is to prevent it from starting. Identifying the foods and drinks that trigger muscle spasms in the esophagus and then avoiding them can be a good starting point. […] Medication may help control the symptoms of esophageal spasms. […] Surgery may also help, as may Botox injections, in some cases. […] Treatments are available to help people with esophageal spasms manage and prevent their symptoms. […] Avoiding triggers and making lifestyle changes are often the recommended way to treat and prevent esophageal spasms.

• #56 Extreme Esophageal Spasm Treated with Botulinum Toxin

  https://www.jscimedcentral.com/jounal-article-info/JSM-Gastroenterology-and-Hepatology/Extreme-Esophageal-Spasm-Treated-with-Botulinum-Toxin-7301

  Our case supports a novel approach using botulinum toxin injections for effective, symptomatic relief of diffuse esophageal spasm, even in rather severe case. Use of BTX can be a safer alternative for patients who are unfit for surgeries and or have failed medical therapies. This case highlights the severe disease with very high DCI and complete resolution with BTX treatment.

• #57 Esophageal Spasm Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/174975-treatment

  Usually, the workup and treatment are performed in an outpatient setting. Patients in whom medical management fails and who require operative intervention should have routine postoperative care based on the procedure performed. […] Calcium channel blockers and nitrates are first-line therapy. […] Sildenafil, a phosphodiesterase inhibitor, is a smooth muscle relaxant that can lower the LES pressure and spastic contractions of the esophagus in nutcracker esophagus. […] Botulinum toxin binds receptors in the nerve endings, thereby decreasing the release of acetylcholine. By endoscopically injecting botulinum toxin above the LES, symptoms may improve. The effect is temporary, and the response decreases with repeated injections. […] Balloon dilatation is commonly used for achalasia, but it has been also used to treat diffuse esophageal spasm and nutcracker esophagus. The studies are small, the relief is not uniform, and symptoms recur.

• #58 Diffuse Esophageal Spasm: An Alternative Treatment Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11156245/

  Diffuse esophageal spasm (DES) is a rare esophageal motility disorder characterized by abnormal contractions of the esophagus, leading to curling of the esophagus. […] There are no well-established guidelines for the treatment of DES. Treatment options include surgical myotomy, oral medications to aid in smooth muscle relaxation, esophageal dilation, and several newer approaches such as endoscopic botulinum toxin injections. […] After attempts at pharmacological therapy, the patients dysphagia continued to worsen. Upper gastrointestinal endoscopy with pneumatic esophageal dilation was performed. The patients swallowing improved in the days following endoscopic dilation. […] The gold standard for the diagnosis of DES includes esophageal manometry. First-line treatment includes calcium channel blockers and nitrates. The second line includes endoscopic procedures such as botulinum toxin injections and pneumatic dilation.

• #59 Diffuse Esophageal Spasm: An Alternative Treatment Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11156245/

  Surgical approaches are reserved for particularly complex or refractory cases. Surgical approaches, such as the Heller myotomy (through thoracotomy or with thoracoscopic access), have previously yielded better outcomes than endoscopic procedures. […] In patients who are not candidates for the more invasive treatment options or are intolerant to medications, endoscopic pneumatic dilation can be an effective management strategy to improve outcomes for these patients. […] After a failed trial with metoclopramide and nifedipine, when weighing the risks and benefits of the various treatment options, it was decided to utilize a second-line treatment option, esophageal pneumatic dilation. […] A previous study analyzing the long-term outcomes of esophageal dilation in 51 patients with diffuse esophageal spasm revealed that four years after esophageal dilation, 56.25% reported improvement in their symptoms. […] Recommendations for the management of DES include following evidence-based guidelines that are available for both diagnosis and treatment.

• #60 Spastic Esophageal Motility Disorder Treatments | Northwestern Medicine

  https://www.nm.org/conditions-and-care-areas/gastroenterology/spastic-esophageal-motility-disorder/treatments

  Treatment for Spastic EMD will depend on the specific nature of the disorder. For many EMDs, there are a variety of treatments available. They include: […] Botox, a commercial name for botulinum toxin, can be injected into the muscles that control your esophageal sphincter to relax the opening. The results may last anywhere from three months to a year. […] Two commonly used medicines to treat motility disorders are calcium channel blockers and long-acting nitrates. These medicines are used if surgery is not a choice and symptoms continue even with Botox injections. […] Using an endoscope, a special balloon is passed through the mouth and into the esophagus, where it is inflated to stretch the restrictive muscles. […] During this surgical procedure, the muscles of the esophageal sphincter are cut. […] Using an endoscope inserted in the mouth and through the esophagus, surgeons can access and cut abnormal muscle fibers that prevent the valve at the base of the esophagus from opening.

• #61 Esophageal Spasm – What You Need to Know

  https://www.drugs.com/cg/esophageal-spasm.html

  Dilatation: Dilators to widen your esophagus are gently inserted through a scope into your esophagus. […] Myotomy: Muscles in your esophagus are cut to widen the area and allow food and liquids to move into the stomach more easily. […] Biofeedback: Biofeedback is a type of therapy that helps you control how your body reacts to stress or pain. Your healthcare provider will use electrodes (wires) on different parts of your body, such as your chest, to monitor your body responses. This may help you learn ways to reduce your pain or spasms. […] Relaxation therapy may help decrease physical and emotional stress. Stress may cause pain, lead to illness, and slow healing. Deep breathing, muscle relaxation, and music are some forms of relaxation therapy.

• #62 Esophageal spasms | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/esophageal-spasms

  Peroral endoscopic myotomy (POEM). The POEM procedure is minimally invasive. This newer technique involves placing an endoscope through the mouth and down the throat. This allows a surgeon to make a cut in the inside lining of the esophagus. Then, as in standard myotomy, the surgeon cuts the muscle at the lower end of the esophagus. Like standard myotomy, POEM is usually considered only if other treatments don’t work.

• #63 Diffuse Esophageal Spasm (DES) – Esophageal Health | UCLA Health

  https://www.uclahealth.org/medical-services/gastro/esophageal-health/diseases-we-treat/diffuse-esophageal-spasm-des

  Several treatment options are available for DES, although the predictability of response is variable. Typically, proton pump inhibitors (PPIs) are tried first. Second-line options include medications that can have a relaxing effect on the esophageal smooth muscle, such as calcium channel blockers (a type of blood pressure medication), anti-spasmodic agents, and nitroglycerin (used commonly for blood pressure and chest pain related to the heart). […] Sometimes, an upper endoscopy can be performed to inject BoTox into the esophageal muscle, which causes it to relax. Longer-lasting options include a surgical myotomy or a special endoscopic procedure called POEM to cut the circular muscle within the esophagus, leaving it in a more relaxed state.

• #64 Esophageal Spasms | Loma Linda University Health

  https://lluh.org/conditions/esophageal-spasms

  Peroral endoscopic myotomy (POEM) POEM is a minimally-invasive treatment for esophageal spasms. An endoscope is inserted through the mouth and down the throat to make an incision in the inside lining of the esophagus. The surgeon cuts the muscle at the lower end of the esophagus. Like myotomy, POEM is usually considered only if other treatments don’t work.

• #65 Diffuse Esophageal Spasm – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK541106/

  Selected cases may receive treatment with extended myotomy of the esophageal body or peroral endoscopic myotomy. Myotomy should involve the entire length of the affected segment (determined preoperatively with manometry) and extend several centimeters superior to the proximal border of the spastic region to prevent remnants of spasticity. It should also extend through the lower esophageal sphincter to prevent dysphagia by preventing outlet obstruction postoperatively. An antireflux procedure like a partial wrap or a Nissen fundoplication can be performed concomitantly. Most patients with dysphagia as the primary symptom improve after a myotomy. […] Peroral endoscopic myotomy (POEM) is a safe and effective treatment for patients, especially those who are refractory to medical therapy. […] Heller myotomy combined with fundoplication is a rare alternative for the refractory patient.

• #66 Esophageal Spasm: Symptoms, Causes, Treatment and More

  https://www.healthline.com/health/esophageal-spasm

  If medications and lifestyle changes aren’t enough to do the trick, a minimally invasive procedure called peroral endoscopic myotomy (POEM) may be tried. […] Another minimally invasive surgical procedure, called the Heller myotomy, may also be an option for people with esophageal spasms. […] Treating the underlying cause is your first line of defense in eliminating or reducing symptoms. It’s also important to maintain healthy lifestyle habits and to identify food and drink triggers that may bring on spasms. Even though their cause is not completely understood, esophageal spasms can usually be treated effectively.

• #67 Esophageal spasms | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/esophageal-spasms

  Peroral endoscopic myotomy (POEM). The POEM procedure is minimally invasive. This newer technique involves placing an endoscope through the mouth and down the throat. This allows a surgeon to make a cut in the inside lining of the esophagus. Then, as in standard myotomy, the surgeon cuts the muscle at the lower end of the esophagus. Like standard myotomy, POEM is usually considered only if other treatments don’t work.

• #68 Esophageal Spasm Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/174975-treatment

  Proton pump inhibitors (PPIs) effectively reduce or alleviate the symptoms of gastroesophageal reflux disease, which may mimic diffuse esophageal spasm. A trial of acid-lowering therapy may be undertaken prior to instituting other treatments. Although PPI treatment is often ineffective, the symptoms from diffuse esophageal spasm and nutcracker esophagus usually improve over time. […] Tricyclic antidepressants have produced much success in the treatment of many patients with esophageal motility disorders. Some of these patients may have associated psychiatric illnesses, and concomitant treatment of those conditions may improve outcomes. […] Patients in whom medical management fails should be referred to a thoracic surgeon for possible operative intervention. […] For extreme cases, operative treatment usually involves a myotomy. Myotomy relieves symptoms by eliminating the effectiveness of the contractions.

• #69 Esophageal Spasm: Symptoms, Causes, Treatment

  https://www.verywellhealth.com/esophageal-spasm-symptoms-causes-treatment-7370744

  Research also shows while Botox injections work for reducing esophagus spasms, this treatment may also induce or trigger symptoms of GERD. […] Surgery […] In severe cases in which other options have not provided adequate relief from esophageal spasms, your healthcare provider may suggest surgical treatment. Surgery for esophageal spasm is called myotomy. It requires an incision in the lower esophagus muscle, which permanently stops it from being able to spasm. In these cases, gravity will be the force to carry food and drink from your mouth to your stomach. […] Effectiveness of Surgery […] One study on spasm symptom frequency and surgical intervention from France shows esophageal surgery for spasms is a highly effective method of treatment. Researchers found in a follow-up of 20 patients who underwent surgery for esophagus spasm treatment, all clinical outcomes were significantly improved compared with results from preoperative surveys or symptoms recorded before surgical intervention. The researchers note that one study limitation is it reports on frequency rather than intensity of symptoms.

• #70 Esophageal spasms | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/esophageal-spasms

  Treatment depends on how often the esophageal spasms happen and how bad they are. […] If your spasms make it difficult to eat or drink, your provider might recommend: […] Managing any underlying conditions. Esophageal spasms are sometimes associated with conditions such as heartburn or gastroesophageal reflux disease (GERD). A healthcare professional might recommend a proton pump inhibitor to treat GERD. Sometimes an antidepressant, such as imipramine, may be prescribed. This medicine may help reduce the feeling of pain in the esophagus. […] Medicines to relax your swallowing muscles. Peppermint oil, onabotulinumtoxinA (Botox) injections into the esophagus or calcium channel blockers, such as diltiazem (Cardizem, Tiazac, others), can make spasms less severe. […] Surgery (myotomy). If medicine doesn’t work, a healthcare professional might recommend a procedure that involves cutting the muscle at the lower end of the esophagus. This procedure, called a myotomy, can help weaken esophageal contractions. Long-term studies of this approach aren’t available, so myotomy generally isn’t recommended for esophageal spasms. However, it might be considered if other treatments don’t work.

• #71 Esophageal Spasm Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/174975-treatment

  Myotomy is effective for treating diffuse esophageal spasm. […] Myotomy should be used with caution in patients with nutcracker esophagus because it may worsen the symptoms. […] As a last resort, esophagectomy can be used to relieve symptoms. The esophagus is resected, and the stomach, small intestine, or colon is used to restore the continuity of the GI tract. Morbidity and mortality of esophagectomy are substantial; therefore, this procedure should be performed only after other treatments have been exhausted. […] Overall, surgical therapy is reserved for those refractory to medical therapy.

• #72 Esophageal Spasms | Loma Linda University Health

  https://lluh.org/conditions/esophageal-spasms

  Medications A proton pump inhibitor like lansoprazole may be used to treat GERD, or an antidepressant, like trazodone or imipramine (Tofranil) may help to reduce or eliminate spasms. Antidepressants may also reduce pain in the esophagus. Using certain medications to relax swallowing muscles like Sildenafil (Revatio, Viagra), Botox injections may help. Diltiazem (Cardizem CD, Tiazac, and others) are calcium channel blockers that may reduce the severity of esophageal spasms. […] Myotomy Surgery If medication, lifestyle changes and home remedies dont sufficiently reduce or eliminate esophageal spasms, myotomy surgery may be recommended. In this procedure, the muscle at the lower end of the esophagus is cut to weaken esophageal contractions. Long-term studies of myotomy are not yet available.

• #73 Diffuse Esophageal Spasm – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK541106/

  Selected cases may receive treatment with extended myotomy of the esophageal body or peroral endoscopic myotomy. Myotomy should involve the entire length of the affected segment (determined preoperatively with manometry) and extend several centimeters superior to the proximal border of the spastic region to prevent remnants of spasticity. It should also extend through the lower esophageal sphincter to prevent dysphagia by preventing outlet obstruction postoperatively. An antireflux procedure like a partial wrap or a Nissen fundoplication can be performed concomitantly. Most patients with dysphagia as the primary symptom improve after a myotomy. […] Peroral endoscopic myotomy (POEM) is a safe and effective treatment for patients, especially those who are refractory to medical therapy. […] Heller myotomy combined with fundoplication is a rare alternative for the refractory patient.

• #74 Esophageal Spasm: Causes, Symptoms, Treatments, & Diagnosis

  https://www.webmd.com/digestive-disorders/what-is-esophageal-spasm

  Esophageal Spasm Treatment […] Options include: […] Medications. The goal of taking medicine is to relax the smooth muscle of the esophagus. One of the first recommendations may be to take peppermint oil or lozenges. Peppermint is a natural smooth muscle relaxant. If this doesn’t work, you may be asked to try a calcium channel blocker, often also given for heart issues, or a tricyclic antidepressant. […] Botulinum injections into the esophagus. This treatment relaxes the muscles of the esophagus. Its considered a helpful treatment for people with spasms. But the relief is temporary. Youll need repeated injections every few months. […] Surgery. The only permanent cure for esophageal spasms is a surgical procedure called myotomy. The surgeon cuts the thick muscle in the lower part of the esophagus. This is only recommended in severe cases when medications and injections dont work.

• #75 Diffuse Esophageal Spasm – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK541106/

  Selected cases may receive treatment with extended myotomy of the esophageal body or peroral endoscopic myotomy. Myotomy should involve the entire length of the affected segment (determined preoperatively with manometry) and extend several centimeters superior to the proximal border of the spastic region to prevent remnants of spasticity. It should also extend through the lower esophageal sphincter to prevent dysphagia by preventing outlet obstruction postoperatively. An antireflux procedure like a partial wrap or a Nissen fundoplication can be performed concomitantly. Most patients with dysphagia as the primary symptom improve after a myotomy. […] Peroral endoscopic myotomy (POEM) is a safe and effective treatment for patients, especially those who are refractory to medical therapy. […] Heller myotomy combined with fundoplication is a rare alternative for the refractory patient.

• #76 Diffuse Esophageal Spasm – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK541106/

  Selected cases may receive treatment with extended myotomy of the esophageal body or peroral endoscopic myotomy. Myotomy should involve the entire length of the affected segment (determined preoperatively with manometry) and extend several centimeters superior to the proximal border of the spastic region to prevent remnants of spasticity. It should also extend through the lower esophageal sphincter to prevent dysphagia by preventing outlet obstruction postoperatively. An antireflux procedure like a partial wrap or a Nissen fundoplication can be performed concomitantly. Most patients with dysphagia as the primary symptom improve after a myotomy. […] Peroral endoscopic myotomy (POEM) is a safe and effective treatment for patients, especially those who are refractory to medical therapy. […] Heller myotomy combined with fundoplication is a rare alternative for the refractory patient.

• #77 Esophageal Spasm Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/174975-treatment

  Myotomy is effective for treating diffuse esophageal spasm. […] Myotomy should be used with caution in patients with nutcracker esophagus because it may worsen the symptoms. […] As a last resort, esophagectomy can be used to relieve symptoms. The esophagus is resected, and the stomach, small intestine, or colon is used to restore the continuity of the GI tract. Morbidity and mortality of esophagectomy are substantial; therefore, this procedure should be performed only after other treatments have been exhausted. […] Overall, surgical therapy is reserved for those refractory to medical therapy.

• #78 Diffuse Esophageal Spasm – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK541106/

  Selected cases may receive treatment with extended myotomy of the esophageal body or peroral endoscopic myotomy. Myotomy should involve the entire length of the affected segment (determined preoperatively with manometry) and extend several centimeters superior to the proximal border of the spastic region to prevent remnants of spasticity. It should also extend through the lower esophageal sphincter to prevent dysphagia by preventing outlet obstruction postoperatively. An antireflux procedure like a partial wrap or a Nissen fundoplication can be performed concomitantly. Most patients with dysphagia as the primary symptom improve after a myotomy. […] Peroral endoscopic myotomy (POEM) is a safe and effective treatment for patients, especially those who are refractory to medical therapy. […] Heller myotomy combined with fundoplication is a rare alternative for the refractory patient.

• #79 Extreme Esophageal Spasm Treated with Botulinum Toxin

  https://www.jscimedcentral.com/jounal-article-info/JSM-Gastroenterology-and-Hepatology/Extreme-Esophageal-Spasm-Treated-with-Botulinum-Toxin-7301

  Our case supports a novel approach using botulinum toxin injections for effective, symptomatic relief of diffuse esophageal spasm, even in rather severe case. Use of BTX can be a safer alternative for patients who are unfit for surgeries and or have failed medical therapies. This case highlights the severe disease with very high DCI and complete resolution with BTX treatment.

• #80 Diffuse Esophageal Spasm: An Alternative Treatment Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11156245/

  Surgical approaches are reserved for particularly complex or refractory cases. Surgical approaches, such as the Heller myotomy (through thoracotomy or with thoracoscopic access), have previously yielded better outcomes than endoscopic procedures. […] In patients who are not candidates for the more invasive treatment options or are intolerant to medications, endoscopic pneumatic dilation can be an effective management strategy to improve outcomes for these patients. […] After a failed trial with metoclopramide and nifedipine, when weighing the risks and benefits of the various treatment options, it was decided to utilize a second-line treatment option, esophageal pneumatic dilation. […] A previous study analyzing the long-term outcomes of esophageal dilation in 51 patients with diffuse esophageal spasm revealed that four years after esophageal dilation, 56.25% reported improvement in their symptoms. […] Recommendations for the management of DES include following evidence-based guidelines that are available for both diagnosis and treatment.

• #81 Surgical management of diffuse esophageal spasm | Nature Reviews Gastroenterology & Hepatology

  https://www.nature.com/articles/ncpgasthep0939

  Researchers from France have shown that extended myotomy with anterior fundoplication achieved excellent medium-term functional results in a series of patients with severe diffuse esophageal spasm (DES).

• #82 Esophageal Motility Disorders | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0901/p291.html

  Esophageal motility disorders usually respond to lifestyle modifications, although pharmacotherapy may occasionally be needed. […] Hypercontractile esophageal motility disorders usually respond to lifestyle modifications, although pharmacotherapy may occasionally be needed. […] Medical therapy is not effective for the treatment of achalasia but may be helpful for hypercontractile motility disorders. […] Patients with achalasia should undergo definitive therapy whenever possible. […] Invasive procedures are rarely needed for patients with hypercontractile motility disorders. […] Laparoscopic Heller myotomy, in which muscle fibers of the distal esophagus, lower esophageal sphincter, and gastric cardia are incised, is the definitive treatment for achalasia. […] Pneumatic dilation uses an endoscopically guided balloon to disrupt the lower esophageal sphincter.

• #83 Esophageal Spasm Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/174975-treatment

  Myotomy is effective for treating diffuse esophageal spasm. […] Myotomy should be used with caution in patients with nutcracker esophagus because it may worsen the symptoms. […] As a last resort, esophagectomy can be used to relieve symptoms. The esophagus is resected, and the stomach, small intestine, or colon is used to restore the continuity of the GI tract. Morbidity and mortality of esophagectomy are substantial; therefore, this procedure should be performed only after other treatments have been exhausted. […] Overall, surgical therapy is reserved for those refractory to medical therapy.

• #84 What Are Esophageal Spasms? – Gastroenterology Medical Associates

  https://gastrospecialistsnj.com/what-are-esophageal-spasms/

  Your doctor can also administer botulinum toxins, which reduce acetylcholine secretion, resulting in temporary symptom relief. Some doctors can also use balloon dilatation. […] In case of poor response to medical therapy, your doctor may refer you to a thoracic surgeon. Of note, surgical treatment is reserved for refractive cases. The procedure can be open or laparoscopic. The treatment modality can be a myotomy or esophagectomy (removal of part of the esophagus).

• #85 Esophageal Spasm Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/174975-treatment

  Myotomy is effective for treating diffuse esophageal spasm. […] Myotomy should be used with caution in patients with nutcracker esophagus because it may worsen the symptoms. […] As a last resort, esophagectomy can be used to relieve symptoms. The esophagus is resected, and the stomach, small intestine, or colon is used to restore the continuity of the GI tract. Morbidity and mortality of esophagectomy are substantial; therefore, this procedure should be performed only after other treatments have been exhausted. […] Overall, surgical therapy is reserved for those refractory to medical therapy.

• #86 What Are Esophageal Spasms? – Allied Digestive Health

  https://allieddigestivehealth.com/what-are-esophageal-spasms/

  Your doctor can also administer botulinum toxins, which reduce acetylcholine secretion, resulting in temporary symptom relief. Some doctors can also use balloon dilatation. […] In case of poor response to medical therapy, your doctor may refer you to a thoracic surgeon. Of note, surgical treatment is reserved for refractive cases. The procedure can be open or laparoscopic. The treatment modality can be a myotomy or esophagectomy (removal of part of the esophagus).

• #87 Esophageal spasms – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/esophageal-spasms/symptoms-causes/syc-20372250

  Esophageal spasms usually happen only now and then, and they might not need treatment. But sometimes the spasms happen a lot and can prevent food and liquids from traveling through the esophagus. If esophageal spasms affect the ability to eat or drink, treatments are available. […] There are two types of esophageal spasms distal esophageal spasm and hypercontractile esophagus, also known as nutcracker esophagus.

• #88 Distal Esophageal Spasm – Gastrointestinal Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gastrointestinal-disorders/esophageal-and-swallowing-disorders/distal-esophageal-spasm

  Symptomatic distal esophageal spasm (formerly called diffuse esophageal spasm) is part of a spectrum of motility disorders characterized variously by nonpropulsive contractions and hyperdynamic contractions, sometimes in conjunction with elevated lower esophageal sphincter pressure. […] Treatment is difficult but includes nitrates, calcium channel blockers, botulinum toxin injection, surgical or endoscopic myotomy, and antireflux therapy. […] Esophageal spasms are often difficult to treat, and controlled studies of treatment methods are lacking. Oral calcium channel blockers may be useful. Anticholinergics, tricyclic antidepressants, nitroglycerin, and long-acting nitrates may also be tried but generally have limited success. […] Rarely, a trial of injecting botulinum toxin type A into the esophagus and/or lower esophageal sphincter is done. […] If medical management fails, a myotomy may be considered. A surgical or peroral endoscopic extended myotomy of the esophagus has been tried in severe cases.

• #89 Distal Esophageal Spasm – Gastrointestinal Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gastrointestinal-disorders/esophageal-and-swallowing-disorders/distal-esophageal-spasm

  Symptomatic distal esophageal spasm (formerly called diffuse esophageal spasm) is part of a spectrum of motility disorders characterized variously by nonpropulsive contractions and hyperdynamic contractions, sometimes in conjunction with elevated lower esophageal sphincter pressure. […] Treatment is difficult but includes nitrates, calcium channel blockers, botulinum toxin injection, surgical or endoscopic myotomy, and antireflux therapy. […] Esophageal spasms are often difficult to treat, and controlled studies of treatment methods are lacking. Oral calcium channel blockers may be useful. Anticholinergics, tricyclic antidepressants, nitroglycerin, and long-acting nitrates may also be tried but generally have limited success. […] Rarely, a trial of injecting botulinum toxin type A into the esophagus and/or lower esophageal sphincter is done. […] If medical management fails, a myotomy may be considered. A surgical or peroral endoscopic extended myotomy of the esophagus has been tried in severe cases.

• #90 Extreme Esophageal Spasm Treated with Botulinum Toxin

  https://www.jscimedcentral.com/jounal-article-info/JSM-Gastroenterology-and-Hepatology/Extreme-Esophageal-Spasm-Treated-with-Botulinum-Toxin-7301

  Diffuse esophageal spasm is a rare motility disorder. The primary symptoms include dysphagia, and chest pain. There is array of treatments available from medical therapy with nitrates to surgical therapy; Heller myotomy. […] Patient was treated with Botulinum Toxin (BTX) with complete resolution of symptoms. The use of botulinum toxin for treatment of motility disorders; achalasia and diffuse esophageal spasm is well reported. […] Multiple treatments have been used to treat severe esophageal spasms including: Calcium-Channel Blockers (CCBs), nitrates and surgical approaches, including Heller myotomy. More recently, boutlinum toxin (BTX) has been introduced as a treatment option for patients with DES. […] This case highlights an extreme case of DES and symptomatic relief after treatment with botulinum toxin injections.

• #91 Diffuse Esophageal Spasm – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK541106/

  Current treatment agents include nitrates (both short and long-acting), calcium-channel blockers, visceral analgesics (tricyclic agents or SSRI), and esophageal dilation. First-line therapy is with calcium channel blockers and nitrates. Endoscopic botulinum toxin injection and pneumatic dilation are second-line therapies. […] Concomitant gastroesophageal reflux disease (GERD) should also receive treatment, especially if the esophageal testing shows pathologic reflux. Initiation of a proton pump inhibitor (PPI) half an hour before meals can help relieve GERD symptoms. Patients who are responsive to PPIs will continue with PPI therapy for three months. […] Botulinum toxin injection is also considered an effective and low-risk procedure for short-term symptom relief. It is usually only an option for medically high-risk patients.

• #92 Diffuse Esophageal Spasm: An Alternative Treatment Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11156245/

  Diffuse esophageal spasm (DES) is a rare esophageal motility disorder characterized by abnormal contractions of the esophagus, leading to curling of the esophagus. […] There are no well-established guidelines for the treatment of DES. Treatment options include surgical myotomy, oral medications to aid in smooth muscle relaxation, esophageal dilation, and several newer approaches such as endoscopic botulinum toxin injections. […] After attempts at pharmacological therapy, the patients dysphagia continued to worsen. Upper gastrointestinal endoscopy with pneumatic esophageal dilation was performed. The patients swallowing improved in the days following endoscopic dilation. […] The gold standard for the diagnosis of DES includes esophageal manometry. First-line treatment includes calcium channel blockers and nitrates. The second line includes endoscopic procedures such as botulinum toxin injections and pneumatic dilation.

• #93

  https://step2.medbullets.com/gastrointestinal/120139/diffuse-esophageal-spasm

  First-line treatment includes calcium channel blockers and nitrates, which reduce the severity of spasm. […] A proton pump inhibitor is used to treat associated reflux. […] A tricyclic antidepressant is prescribed to treat associated mood disorder. […] Interventional treatments may include endoscopic injection of botulinum toxin. […] Myotomy is indicated for severe and incapacitating symptoms refractory to other treatment. […] Complications include lack of response to treatment.

• #94 Esophageal Motility Disorder/Eosinophilic Esophagitis – Midtown East/Upper East Side New York, NY

  https://www.alberthararymd.com/contents/conditions-we-treat/esophageal-motility-disorder

  Esophageal motility disorders can cause difficulty swallowing or chest pain. […] Diffuse esophageal spasm is usually treated with medications that relax the muscle of the esophagus, for example calcium channel blockers (diltiazem, nifedipine, and verapamil), anti-spasmodics (hyoscyamine, dicyclomine, propantheline, and methscopolamine), or nitroglycerin, which are either taken by mouth or dissolved under the tongue. […] Nutcracker esophagus and jackhammer esophagus are esophageal motility disorders in which the esophageal muscle contracts in a coordinated fashion, but the contractions are too strong and often prolonged. They can cause either chest pain or difficulty swallowing. The diagnosis and treatment are the same as for diffuse esophageal spasm. […] Hypertensive lower esophageal sphincter may cause symptoms such as difficulty swallowing or chest pain. It can be treated with medications, Botox injection into the lower esophageal sphincter, and esophageal dilation.

• #95 Hypercontractile (Nutcracker) Esophagus: Symptoms, Causes, and More

  https://www.healthline.com/health/nutcracker-esophagus

  Several oral and injection treatment options may help reduce symptoms of hypercontractile esophagus, such as: proton pump inhibitors, calcium channel blockers, some antidepressants, nitrates, such as sublingual nitroglycerin (Nitrostat), hyoscyamine (Levsin), anticholinergic drugs, botulinum toxin (Botox) injection. […] Sometimes, a healthcare professional may recommend surgery to cut one of the muscles in your esophagus to weaken contractions. This may include peroral endoscopic myotomy (POEM), which uses an endoscope rather than traditional surgery to cut back a section of muscle within the esophagus. […] However, research on treating hypercontractile esophagus is limited, and more research is needed to establish the best treatment. […] Some ways to quickly calm an esophageal spasm include taking nitroglycerin or calcium channel blockers. If your symptoms persist, a healthcare professional may recommend other medical treatments or surgery. […] Some treatment methods may help you manage symptoms, but more research is needed.

• #96 Hypercontractile (Nutcracker) Esophagus: Symptoms, Causes, and More

  https://www.healthline.com/health/nutcracker-esophagus

  Several oral and injection treatment options may help reduce symptoms of hypercontractile esophagus, such as: proton pump inhibitors, calcium channel blockers, some antidepressants, nitrates, such as sublingual nitroglycerin (Nitrostat), hyoscyamine (Levsin), anticholinergic drugs, botulinum toxin (Botox) injection. […] Sometimes, a healthcare professional may recommend surgery to cut one of the muscles in your esophagus to weaken contractions. This may include peroral endoscopic myotomy (POEM), which uses an endoscope rather than traditional surgery to cut back a section of muscle within the esophagus. […] However, research on treating hypercontractile esophagus is limited, and more research is needed to establish the best treatment. […] Some ways to quickly calm an esophageal spasm include taking nitroglycerin or calcium channel blockers. If your symptoms persist, a healthcare professional may recommend other medical treatments or surgery. […] Some treatment methods may help you manage symptoms, but more research is needed.

• #97 Esophageal Spasm Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/174975-treatment

  Myotomy is effective for treating diffuse esophageal spasm. […] Myotomy should be used with caution in patients with nutcracker esophagus because it may worsen the symptoms. […] As a last resort, esophagectomy can be used to relieve symptoms. The esophagus is resected, and the stomach, small intestine, or colon is used to restore the continuity of the GI tract. Morbidity and mortality of esophagectomy are substantial; therefore, this procedure should be performed only after other treatments have been exhausted. […] Overall, surgical therapy is reserved for those refractory to medical therapy.

• #98 Esophageal Motility Disorders | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0901/p291.html

  Esophageal motility disorders usually respond to lifestyle modifications, although pharmacotherapy may occasionally be needed. […] Hypercontractile esophageal motility disorders usually respond to lifestyle modifications, although pharmacotherapy may occasionally be needed. […] Medical therapy is not effective for the treatment of achalasia but may be helpful for hypercontractile motility disorders. […] Patients with achalasia should undergo definitive therapy whenever possible. […] Invasive procedures are rarely needed for patients with hypercontractile motility disorders. […] Laparoscopic Heller myotomy, in which muscle fibers of the distal esophagus, lower esophageal sphincter, and gastric cardia are incised, is the definitive treatment for achalasia. […] Pneumatic dilation uses an endoscopically guided balloon to disrupt the lower esophageal sphincter.

• #99 Hypercontractile (Nutcracker) Esophagus: Symptoms, Causes, and More

  https://www.healthline.com/health/nutcracker-esophagus

  Several oral and injection treatment options may help reduce symptoms of hypercontractile esophagus, such as: proton pump inhibitors, calcium channel blockers, some antidepressants, nitrates, such as sublingual nitroglycerin (Nitrostat), hyoscyamine (Levsin), anticholinergic drugs, botulinum toxin (Botox) injection. […] Sometimes, a healthcare professional may recommend surgery to cut one of the muscles in your esophagus to weaken contractions. This may include peroral endoscopic myotomy (POEM), which uses an endoscope rather than traditional surgery to cut back a section of muscle within the esophagus. […] However, research on treating hypercontractile esophagus is limited, and more research is needed to establish the best treatment. […] Some ways to quickly calm an esophageal spasm include taking nitroglycerin or calcium channel blockers. If your symptoms persist, a healthcare professional may recommend other medical treatments or surgery. […] Some treatment methods may help you manage symptoms, but more research is needed.

• #100 Esophageal spasms | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/esophageal-spasms

  Treatment depends on how often the esophageal spasms happen and how bad they are. […] If your spasms make it difficult to eat or drink, your provider might recommend: […] Managing any underlying conditions. Esophageal spasms are sometimes associated with conditions such as heartburn or gastroesophageal reflux disease (GERD). A healthcare professional might recommend a proton pump inhibitor to treat GERD. Sometimes an antidepressant, such as imipramine, may be prescribed. This medicine may help reduce the feeling of pain in the esophagus. […] Medicines to relax your swallowing muscles. Peppermint oil, onabotulinumtoxinA (Botox) injections into the esophagus or calcium channel blockers, such as diltiazem (Cardizem, Tiazac, others), can make spasms less severe. […] Surgery (myotomy). If medicine doesn’t work, a healthcare professional might recommend a procedure that involves cutting the muscle at the lower end of the esophagus. This procedure, called a myotomy, can help weaken esophageal contractions. Long-term studies of this approach aren’t available, so myotomy generally isn’t recommended for esophageal spasms. However, it might be considered if other treatments don’t work.

• #101 Esophageal Spasm – Southeast OB/GYN

  https://seobgynpc.com/womens-health/health-library?DOCHWID=ut1638spec

  Esophageal spasm is not common. […] Treatment for esophageal spasm includes treating other conditions that may make esophageal spasms worse, such as gastroesophageal reflux disease (GERD). GERD is usually treated with changes to diet and lifestyle and medicines to reduce the amount of acid in the stomach. […] Other treatment for esophageal spasm may include: Changing the foods you eat. Your doctor may tell you to eat certain foods and liquids to make swallowing easier. […] Medicines. If you can’t have dilation or surgery, your doctor may suggest medicines, such as botulinum toxin, to relax the muscles in the esophagus. […] Surgery. Surgery is sometimes used in people who have a problem that affects the lower esophageal muscle (achalasia).

• #102 Esophageal Spasm – Southeast OB/GYN

  https://seobgynpc.com/womens-health/health-library?DOCHWID=ut1638spec

  Esophageal spasm is not common. […] Treatment for esophageal spasm includes treating other conditions that may make esophageal spasms worse, such as gastroesophageal reflux disease (GERD). GERD is usually treated with changes to diet and lifestyle and medicines to reduce the amount of acid in the stomach. […] Other treatment for esophageal spasm may include: Changing the foods you eat. Your doctor may tell you to eat certain foods and liquids to make swallowing easier. […] Medicines. If you can’t have dilation or surgery, your doctor may suggest medicines, such as botulinum toxin, to relax the muscles in the esophagus. […] Surgery. Surgery is sometimes used in people who have a problem that affects the lower esophageal muscle (achalasia).

• #103 Esophageal Spasms: Symptoms, Causes, Treatment & Medication

  https://my.clevelandclinic.org/health/diseases/15575-esophageal-spasms

  Surgery: If your symptoms are severe and other treatments haven’t helped, your provider may recommend surgery called a myotomy. During a myotomy, a provider makes an incision along your lower esophagus muscle. This incision stops the muscle from working entirely, which stops abnormal contractions. With the esophageal muscle no longer in use, gravity moves food and liquid down your esophagus. […] Many people with esophageal spasms and GERD experience symptom relief for both conditions by taking proton pump inhibitors (PPIs). These medicines reduce stomach acid production. […] Esophageal spasms related to opioid use often resolve after you stop taking them.

• #104

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ut2352

  Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take. […] Treat other conditions that can make esophageal spasms worse, such as gastroesophageal reflux disease (GERD). […] Your doctor may recommend an over-the-counter medicine. For mild or occasional indigestion, it may help to take antacids, such as Tums. […] Your doctor also may recommend over-the-counter acid reducers, such as famotidine (Pepcid) or omeprazole. […] Ask your doctor about relaxation and controlled breathing exercises. These may help reduce symptoms. […] Avoid very hot or cold foods if they trigger esophageal spasms.

• #105 Diffuse Esophageal Spasm – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK541106/

  Current treatment agents include nitrates (both short and long-acting), calcium-channel blockers, visceral analgesics (tricyclic agents or SSRI), and esophageal dilation. First-line therapy is with calcium channel blockers and nitrates. Endoscopic botulinum toxin injection and pneumatic dilation are second-line therapies. […] Concomitant gastroesophageal reflux disease (GERD) should also receive treatment, especially if the esophageal testing shows pathologic reflux. Initiation of a proton pump inhibitor (PPI) half an hour before meals can help relieve GERD symptoms. Patients who are responsive to PPIs will continue with PPI therapy for three months. […] Botulinum toxin injection is also considered an effective and low-risk procedure for short-term symptom relief. It is usually only an option for medically high-risk patients.

• #106 Diffuse Esophageal Spasm (DES) – Esophageal Health | UCLA Health

  https://www.uclahealth.org/medical-services/gastro/esophageal-health/diseases-we-treat/diffuse-esophageal-spasm-des

  Several treatment options are available for DES, although the predictability of response is variable. Typically, proton pump inhibitors (PPIs) are tried first. Second-line options include medications that can have a relaxing effect on the esophageal smooth muscle, such as calcium channel blockers (a type of blood pressure medication), anti-spasmodic agents, and nitroglycerin (used commonly for blood pressure and chest pain related to the heart). […] Sometimes, an upper endoscopy can be performed to inject BoTox into the esophageal muscle, which causes it to relax. Longer-lasting options include a surgical myotomy or a special endoscopic procedure called POEM to cut the circular muscle within the esophagus, leaving it in a more relaxed state.

• #107 Esophageal Spasm Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/174975-treatment

  Proton pump inhibitors (PPIs) effectively reduce or alleviate the symptoms of gastroesophageal reflux disease, which may mimic diffuse esophageal spasm. A trial of acid-lowering therapy may be undertaken prior to instituting other treatments. Although PPI treatment is often ineffective, the symptoms from diffuse esophageal spasm and nutcracker esophagus usually improve over time. […] Tricyclic antidepressants have produced much success in the treatment of many patients with esophageal motility disorders. Some of these patients may have associated psychiatric illnesses, and concomitant treatment of those conditions may improve outcomes. […] Patients in whom medical management fails should be referred to a thoracic surgeon for possible operative intervention. […] For extreme cases, operative treatment usually involves a myotomy. Myotomy relieves symptoms by eliminating the effectiveness of the contractions.

• #108 Diffuse Esophageal Spasm – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK541106/

  Patients with DES and other esophageal motility disorders who suffer from psychiatric illnesses like anxiety and depression as well can receive tricyclic antidepressant therapy. They improve esophageal as well as psychological symptoms, leading to better outcomes. […] Initiation or change in therapy requires adequate follow-up care by the physician. The efficacy of the medication in terms of improvement of the symptoms requires close monitoring, and any serious adverse effect should be identified and managed. If medical management of the patient fails, the patient is a candidate for surgical treatment with a referral to a thoracic surgeon.

• #109 Esophageal Spasm – What You Need to Know

  https://www.drugs.com/cg/esophageal-spasm.html

  Dilatation: Dilators to widen your esophagus are gently inserted through a scope into your esophagus. […] Myotomy: Muscles in your esophagus are cut to widen the area and allow food and liquids to move into the stomach more easily. […] Biofeedback: Biofeedback is a type of therapy that helps you control how your body reacts to stress or pain. Your healthcare provider will use electrodes (wires) on different parts of your body, such as your chest, to monitor your body responses. This may help you learn ways to reduce your pain or spasms. […] Relaxation therapy may help decrease physical and emotional stress. Stress may cause pain, lead to illness, and slow healing. Deep breathing, muscle relaxation, and music are some forms of relaxation therapy.

• #110 Esophageal Spasms And Anxiety – AnxietyCentre.com

  https://www.anxietycentre.com/anxiety-disorders/symptoms/esophageal-spasms-anxiety/

  When esophageal spasms are caused or aggravated by other factors, addressing those factors can reduce and eliminate it. […] When esophageal spasms are caused by stomach upset and acid reflux, eliminating the stomach upset and acid reflux problems can cause esophageal spasms to subside. […] When esophageal spasms are by apprehensive behavior and the accompanying stress response changes, calming yourself down will end the active stress response and its changes. […] When this symptom is caused by hyperstimulation, eliminating hyperstimulation will end this symptom. […] You can eliminate hyperstimulation by: […] Reducing stress. […] Regular deep relaxation. […] Avoiding stimulants. […] Regular light to moderate exercise. […] Eating a healthy diet of whole and natural foods. […] Passively accepting your symptoms until they subside.

• #111 Esophageal Spasm

  https://mobile.fpnotebook.com/GI/Esophagus/EsphglSpsm.htm

  Functional disorders and Hypercontractile Esophagus improve or resolve spontaneously in a majority of patients. […] Optimize GERD Management. […] Antisecretory therapy (e.g. Proton Pump Inhibitor). […] Stress management. […] Consider Cognitive Behavioral Therapy. […] Consider Antidepressants. […] Mindful eating. […] Eat smaller, more frequent meals. […] Eat slowly. […] Choose softer foods. […] Avoid foods and situations that trigger symptoms. […] These medications decrease lower esophageal sphincter pressure and may worsen GERD. […] Smooth Muscle relaxants are best limited to hypermotility confirmed by manometry. […] Calcium Channel Blockers. […] Nitrates (Nitroglycerin). […] Phosphodiesterase-5 Inhibitors (release nitric oxide). […] Peppermint Oil (2 mints sublingual before each meal).

• #112

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ut2352

  Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take. […] Treat other conditions that can make esophageal spasms worse, such as gastroesophageal reflux disease (GERD). […] Your doctor may recommend an over-the-counter medicine. For mild or occasional indigestion, it may help to take antacids, such as Tums. […] Your doctor also may recommend over-the-counter acid reducers, such as famotidine (Pepcid) or omeprazole. […] Ask your doctor about relaxation and controlled breathing exercises. These may help reduce symptoms. […] Avoid very hot or cold foods if they trigger esophageal spasms.

• #113 Esophageal Spasm: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.esophageal-spasm-care-instructions.ut2352

  Follow-up care is a key part of your treatment and safety. […] Treat other conditions that can make esophageal spasms worse, such as GERD. […] Your doctor may recommend an over-the-counter medicine. […] Your doctor also may recommend over-the-counter acid reducers, such as famotidine (Pepcid AC), cimetidine (Tagamet HB), or omeprazole (Prilosec). […] Ask your doctor about relaxation and controlled breathing exercises. These may help reduce symptoms. […] Avoid very hot or cold foods if they trigger esophageal spasms.

• #114

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ut2352

  Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take. […] Treat other conditions that can make esophageal spasms worse, such as gastroesophageal reflux disease (GERD). […] Your doctor may recommend an over-the-counter medicine. For mild or occasional indigestion, it may help to take antacids, such as Tums. […] Your doctor also may recommend over-the-counter acid reducers, such as famotidine (Pepcid) or omeprazole. […] Ask your doctor about relaxation and controlled breathing exercises. These may help reduce symptoms. […] Avoid very hot or cold foods if they trigger esophageal spasms.

• #115 Diffuse Esophageal Spasm – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK541106/

  Patients with DES and other esophageal motility disorders who suffer from psychiatric illnesses like anxiety and depression as well can receive tricyclic antidepressant therapy. They improve esophageal as well as psychological symptoms, leading to better outcomes. […] Initiation or change in therapy requires adequate follow-up care by the physician. The efficacy of the medication in terms of improvement of the symptoms requires close monitoring, and any serious adverse effect should be identified and managed. If medical management of the patient fails, the patient is a candidate for surgical treatment with a referral to a thoracic surgeon.

• #116 Esophageal Spasm: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.esophageal-spasm-care-instructions.ut2352

  Follow-up care is a key part of your treatment and safety. […] Treat other conditions that can make esophageal spasms worse, such as GERD. […] Your doctor may recommend an over-the-counter medicine. […] Your doctor also may recommend over-the-counter acid reducers, such as famotidine (Pepcid AC), cimetidine (Tagamet HB), or omeprazole (Prilosec). […] Ask your doctor about relaxation and controlled breathing exercises. These may help reduce symptoms. […] Avoid very hot or cold foods if they trigger esophageal spasms.

• #117 Esophageal spasms | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/esophageal-spasms

  Treatment depends on how often the esophageal spasms happen and how bad they are. […] If your spasms make it difficult to eat or drink, your provider might recommend: […] Managing any underlying conditions. Esophageal spasms are sometimes associated with conditions such as heartburn or gastroesophageal reflux disease (GERD). A healthcare professional might recommend a proton pump inhibitor to treat GERD. Sometimes an antidepressant, such as imipramine, may be prescribed. This medicine may help reduce the feeling of pain in the esophagus. […] Medicines to relax your swallowing muscles. Peppermint oil, onabotulinumtoxinA (Botox) injections into the esophagus or calcium channel blockers, such as diltiazem (Cardizem, Tiazac, others), can make spasms less severe. […] Surgery (myotomy). If medicine doesn’t work, a healthcare professional might recommend a procedure that involves cutting the muscle at the lower end of the esophagus. This procedure, called a myotomy, can help weaken esophageal contractions. Long-term studies of this approach aren’t available, so myotomy generally isn’t recommended for esophageal spasms. However, it might be considered if other treatments don’t work.

• #118 Esophageal spasm relief: Treatments and home remedies

  https://www.medicalnewstoday.com/articles/321656

  An esophageal spasm is an involuntary and often painful contraction in the esophagus, or food pipe. Medical treatments and lifestyle remedies can help relieve symptoms of esophageal spasms. […] The treatment options to stop esophageal spasms vary depending on the frequency and severity of a persons symptoms. […] A doctor may recommend several different approaches for treating esophageal spasms, including: identifying and avoiding trigger foods, making lifestyle changes, trying natural remedies, managing underlying medical conditions, taking medication, undergoing surgery. […] Some research suggests that using peppermint products may help reduce esophageal spasms. […] A 2018 review suggests that peppermint oil may be effective in treating distal esophageal spasms in some people. […] If traditional treatments do not work, a person may be able to try other therapies that help relax the esophageal muscles.

• #119 Diffuse Esophageal Spasm – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK541106/

  Current treatment agents include nitrates (both short and long-acting), calcium-channel blockers, visceral analgesics (tricyclic agents or SSRI), and esophageal dilation. First-line therapy is with calcium channel blockers and nitrates. Endoscopic botulinum toxin injection and pneumatic dilation are second-line therapies. […] Concomitant gastroesophageal reflux disease (GERD) should also receive treatment, especially if the esophageal testing shows pathologic reflux. Initiation of a proton pump inhibitor (PPI) half an hour before meals can help relieve GERD symptoms. Patients who are responsive to PPIs will continue with PPI therapy for three months. […] Botulinum toxin injection is also considered an effective and low-risk procedure for short-term symptom relief. It is usually only an option for medically high-risk patients.

• #120 Diffuse Esophageal Spasm: An Alternative Treatment Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11156245/

  Diffuse esophageal spasm (DES) is a rare esophageal motility disorder characterized by abnormal contractions of the esophagus, leading to curling of the esophagus. […] There are no well-established guidelines for the treatment of DES. Treatment options include surgical myotomy, oral medications to aid in smooth muscle relaxation, esophageal dilation, and several newer approaches such as endoscopic botulinum toxin injections. […] After attempts at pharmacological therapy, the patients dysphagia continued to worsen. Upper gastrointestinal endoscopy with pneumatic esophageal dilation was performed. The patients swallowing improved in the days following endoscopic dilation. […] The gold standard for the diagnosis of DES includes esophageal manometry. First-line treatment includes calcium channel blockers and nitrates. The second line includes endoscopic procedures such as botulinum toxin injections and pneumatic dilation.

• #121 Esophageal spasm relief: Treatments and home remedies

  https://www.medicalnewstoday.com/articles/321656

  An esophageal spasm is an involuntary and often painful contraction in the esophagus, or food pipe. Medical treatments and lifestyle remedies can help relieve symptoms of esophageal spasms. […] The treatment options to stop esophageal spasms vary depending on the frequency and severity of a persons symptoms. […] A doctor may recommend several different approaches for treating esophageal spasms, including: identifying and avoiding trigger foods, making lifestyle changes, trying natural remedies, managing underlying medical conditions, taking medication, undergoing surgery. […] Some research suggests that using peppermint products may help reduce esophageal spasms. […] A 2018 review suggests that peppermint oil may be effective in treating distal esophageal spasms in some people. […] If traditional treatments do not work, a person may be able to try other therapies that help relax the esophageal muscles.

• #122 What Are Esophageal Spasms? – Gastroenterology Medical Associates

  https://gastrospecialistsnj.com/what-are-esophageal-spasms/

  Chest pain and dysphagia (difficulty in swallowing) account for a reasonable percentage of hospital consultations. In some patients, these occur due to a spasm of the esophagus, a muscular tube that moves food from the mouth to the stomach. […] An esophageal spasm is an involuntary painful muscular contraction of the esophagus, a tube connecting the mouth and the stomach. […] The first management line is medical therapy with calcium channel blockers and nitrates. […] The initial treatment of choice is lifestyle modification and medical treatment. Suppose you don’t respond to medical therapy; your doctor will recommend surgery. […] The use of phosphodiesterase inhibitors such as sildenafil can relax your esophagus, thus relieving pain. In addition, sildenafil will also relax the lower esophageal sphincter, alleviating difficulty in swallowing.

• #123 Oesophageal Spasm: Symptoms and Treatment | Doctor

  https://patient.info/doctor/oesophageal-spasm

  There is a lack of both evidence and controlled trials in this area. […] Non-drug treatment includes reassurance that this is not heart disease and that no significant progression occurs, dietary modification, and avoiding cold fluids, and taking hot liquids with meals, which helps some patients. […] Drug treatment options include ruling out gastro-oesophageal reflux with a trial of proton pump inhibitor, nitrates, calcium-channel blockers such as nifedipine or diltiazem, antidepressants like trazodone, imipramine or sertraline, phosphodiesterase inhibitors, peppermint oil, and theophylline. […] Invasive or surgical treatment options include botulinum toxin injection at the gastro-oesophageal junction and surgical options such as oesophageal dilatation and oesophageal myotomy, particularly in patients with symptomatic distal oesophageal spasm. […] The prognosis is probably good, with most patients showing improvement in symptoms over time, and distal oesophageal spasm and hypercontractile oesophagus are unlikely to progress to more severe conditions.

• #124 Esophageal Spasm Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/174975-treatment

  Proton pump inhibitors (PPIs) effectively reduce or alleviate the symptoms of gastroesophageal reflux disease, which may mimic diffuse esophageal spasm. A trial of acid-lowering therapy may be undertaken prior to instituting other treatments. Although PPI treatment is often ineffective, the symptoms from diffuse esophageal spasm and nutcracker esophagus usually improve over time. […] Tricyclic antidepressants have produced much success in the treatment of many patients with esophageal motility disorders. Some of these patients may have associated psychiatric illnesses, and concomitant treatment of those conditions may improve outcomes. […] Patients in whom medical management fails should be referred to a thoracic surgeon for possible operative intervention. […] For extreme cases, operative treatment usually involves a myotomy. Myotomy relieves symptoms by eliminating the effectiveness of the contractions.

• #125 Esophageal Spasm: Causes, Symptoms, Treatments, & Diagnosis

  https://www.webmd.com/digestive-disorders/what-is-esophageal-spasm

  Esophageal Spasm Treatment […] Options include: […] Medications. The goal of taking medicine is to relax the smooth muscle of the esophagus. One of the first recommendations may be to take peppermint oil or lozenges. Peppermint is a natural smooth muscle relaxant. If this doesn’t work, you may be asked to try a calcium channel blocker, often also given for heart issues, or a tricyclic antidepressant. […] Botulinum injections into the esophagus. This treatment relaxes the muscles of the esophagus. Its considered a helpful treatment for people with spasms. But the relief is temporary. Youll need repeated injections every few months. […] Surgery. The only permanent cure for esophageal spasms is a surgical procedure called myotomy. The surgeon cuts the thick muscle in the lower part of the esophagus. This is only recommended in severe cases when medications and injections dont work.

• #126 Esophageal Spasm: Symptoms, Causes, Treatment

  https://www.verywellhealth.com/esophageal-spasm-symptoms-causes-treatment-7370744

  Research also shows while Botox injections work for reducing esophagus spasms, this treatment may also induce or trigger symptoms of GERD. […] Surgery […] In severe cases in which other options have not provided adequate relief from esophageal spasms, your healthcare provider may suggest surgical treatment. Surgery for esophageal spasm is called myotomy. It requires an incision in the lower esophagus muscle, which permanently stops it from being able to spasm. In these cases, gravity will be the force to carry food and drink from your mouth to your stomach. […] Effectiveness of Surgery […] One study on spasm symptom frequency and surgical intervention from France shows esophageal surgery for spasms is a highly effective method of treatment. Researchers found in a follow-up of 20 patients who underwent surgery for esophagus spasm treatment, all clinical outcomes were significantly improved compared with results from preoperative surveys or symptoms recorded before surgical intervention. The researchers note that one study limitation is it reports on frequency rather than intensity of symptoms.

• #127 Esophageal Spasm: Symptoms, Causes and Treatment

  https://www.medicoverhospitals.in/diseases/esophageal-spasm/

  Esophageal spasm can be managed through various treatment options aimed at relieving symptoms and improving quality of life. Initial approaches often involve lifestyle modifications such as avoiding trigger foods, eating smaller meals, and practicing stress-reducing techniques. Medications like calcium channel blockers or nitrates may be prescribed to help relax the esophageal muscles. […] In more severe cases, botulinum toxin injections or surgical procedures like myotomy may be considered. It is essential for individuals with esophageal spasm to work closely with their healthcare provider to determine the most suitable treatment plan based on their specific symptoms and medical history.

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