Treatment for esophageal spasm range from diet change to surgery

Recently, I ended up in the emergency room. I felt as if I was choking, but I could still breathe. I couldn’t swallow anything. It was a blockage in my esophagus, called an esophageal spasm.

Normally, when people choke, they cannot cough, talk or breathe. If this is happening, most often we perform the abdominal thrust, formerly known as the Heimlich Maneuver.

But if the person can talk, cough and breathe, we do not do the abdominal thrust. In my case, I could talk, cough and breathe, but not swallow.

First, what is the esophagus and what does it do? The esophagus is an 8-inch-long muscular tube connecting the throat with the stomach. The upper part of the esophagus that we control consciously is used when breathing, eating, belching and vomiting. This keeps food and secretions from going down the windpipe.

The lower esophagus connects to the stomach. This part prevents acid and stomach contents from traveling backward from the stomach.

An esophageal spasm happens when contractions of the esophagus are irregular, uncoordinated and sometimes powerful. This condition is also called DES or diffuse esophageal spasm. These spasms can prevent food from reaching the stomach. When this happens, the food gets stuck in the esophagus.

The causes of esophageal spasms are unknown. Many doctors believe they result from a disruption of the nerve activity that coordinates the swallowing action of the esophagus. In some people, extremely hot or cold foods may trigger an episode. In my case, I am guessing it was caused by stress. The few times this has happened before was when I was in stressful situations and eating too fast.

The symptoms include chest pain that may spread outward to the arms, back, neck or jaw. This pain can feel similar to a heart attack. Always assume a heart attack if these symptoms appear as this could be a life-threatening emergency. Anyone with chest pain should seek immediate medical attention.

Other symptoms include difficulty or inability to swallow food or liquid, pain with swallowing, the feeling that food is caught in the center of the chest, and heartburn. For me, I could feel the spasm in my chest, and I was unable to swallow anything, including saliva. I spent five hours vomiting thick saliva before I went to the emergency room for treatment.

Treatment for esophageal spasms varies. My doctor gave me an IV in the emergency room that relaxed my esophagus and made me vomit. This time, the vomiting provided instant relief. I was told to then take omeprazole, an over-the-counter acid reducer, for the next 14 days.

So far, so good. I have not had a recurrence.

Often, people with symptoms similar to mine have gastroesophageal reflux disease (GERD), which is often treated with changes to diet and lifestyle and with medicines to reduce the amount of acid in the stomach.

Treatment for esophageal spasm may include:

• Change in diet. Certain foods and liquids can make swallowing easier.
• Dilation. I had this done several years ago. The doctor put a device down my esophagus to carefully expand any narrow areas of the esophagus. I was told that a repeat procedure may be necessary every two to three years.
• Surgery. Used for those who have a problem that affects the lower esophageal muscle (achalasia).
• Medicines. Some, such as botulinum toxin, can relax the muscles in the esophagus.

Knowing what to do and when to do it is important during medical emergencies. I hope my personal experience can help someone who experiences the same symptoms.

Trained as an emergency medical technician, Keith Murray now owns The CPR School, which provides onboard CPR, AED and first-aid training as well as AED sales and service. Contact him through www.TheCPRSchool.com.