CHECK-UP/MARION KERR: Sharp chest pains from oesophageal spasm are often confused with angina
I frequently experience a very sharp pain under my breast bone during which I momentarily have difficulty swallowing.
I know someone at work who has the same problem and they have been diagnosed with oesophageal spasm. But what exactly is this and is it known what causes it?
Food and drink are moved from the mouth to the stomach by the smooth, co-ordinated movements of the mouth and throat, the propulsive actions of the oesophagus (gullet) and the opening of the sphincter that lies between the oesophagus and stomach.
However, in some people, the normal smooth movements of the oesophagus can be replaced by non-propulsive contractions. Known as oesophageal spasm, the problem is thought to be caused by malfunctioning of the nerves which control these movements. In a proportion of sufferers, there is an associated problem with the opening and closing of the lower oesophageal sphincter.
Are my symptoms typical of the condition?
Symptoms can include a sharp pain or squeezing sensation under the breast bone, which may coincide with difficulty swallowing, as you describe.
For many sufferers, very hot or very cold liquids and solid foods seem to be the main triggers for symptoms. Some people experience pain at night which can be so severe as to wake them from sleep.
Symptoms may also occur during exercise or exertion and can, as a result, be confused with angina. Special investigations, which include barium X-rays or specialised imaging tests using food that has been tagged with tiny amounts of radioactive tracers, may be used to confirm the diagnosis.
How is this condition treated?
Oesophageal spasm can be difficult to treat. However, medications such as nitrates, anticholinergic drugs, or calcium channel blockers may help to relieve symptoms by relaxing the oesophageal muscles. Painkillers may be required to help reduce the pain associated with the condition. If a narrowing of the gullet occurs as a result of continuing spasm, then surgical dilation (widening of the stricture) may be required.