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Chest pain due to cramps in the esophagus

  1. Every year, many people are admitted to cardiac surveillance with severe pain symptoms that indicate a heart attack. However, in a third of those people, no abnormalities of the heart are found. Reassured, but insecure, these people return home. Because if it's not the heart, then what is? One possible answer to this question is: esophageal spasms or spasms in the esophagus.

Cramps in the esophagus

  1. The esophagus is a muscular tube about thirty centimeters long and consists of a muscle layer, a layer of connective tissue and mucous membrane. When we swallow our food, it is actively transported by the muscles in the esophagus wall to the stomach. The muscles, as it were, push the food through the esophagus to the stomach, by constantly contracting and relaxing in an even rhythm. With esophageal spasm, this propelling movement of the esophagus is disturbed and the muscles (usually in the lower part of the esophagus) can suddenly spasm. The attacks can occur spontaneously or while you are eating. In severe cramps, the lower part of the esophagus looks like a kind of corkscrew or nutcracker. Esophageal spasm is therefore also called a corkscrew bowel or nutcracker bowel.

The cause of esophageal spasm is unclear

  1. What exactly causes esophageal spasms is unclear. In many cases there seems to be a connection with a disturbance in the nervous excitation of the esophagus, reflux (stomach acid in the esophagus) or psychological factors such as intense emotions, tension and stress. Eating certain foods or eating and drinking very hot or very cold foods can also sometimes trigger an attack.

Pain and a tight feeling in the chest are the main complaints

  1. Pain and a feeling of pressure behind the sternum are the most common complaints with esophageal spasm. The pain can radiate to the shoulder blades, arms and throat. If the cramps are very severe, this can lead to tightness and a tight feeling in the chest. The cramps can also occur at night and the pain is often so severe that it wakes you up. When the attack occurs during or right after eating, your food cannot properly pass through the esophagus into the stomach. The cramps constrict your esophagus to such an extent that your food lingers. This is a very unpleasant and sometimes painful feeling. If the muscles are tight, liquid food (or drink) can also get stuck in the esophagus. Some people with esophageal spasm also have difficulty swallowing. In particular, swallowing very hot or very cold food or drinks then causes the necessary problems. When the cramps stop, the complaints often disappear quickly. Some people have spasms only very occasionally, others very regularly.

Hospital examination necessary

  1. When you come to the doctor with your complaints, he will in most cases send you to the hospital for further examination. However, because the complaints are so similar to the symptoms of a heart attack, many people end up directly in the emergency room of the hospital.

Treatment of esophageal spasm

  1. Because the cause of esophageal spasm is by no means always found, definitive treatment is sometimes difficult. The doctor can prescribe (heavy) painkillers or medicines that, when you have severe cramps, relax the muscles.

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