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The precise causes of twisted esophagus are currently unknown. Through exploring and researching, medical science hopes to discover more information about this rare condition and to improve current treatment methods.

The esophagus is a long, muscular tube which helps push food through the throat down into the stomach using a muscular action.  Diffuse esophageal spasm is a condition in which contractions occur in the esophagus and do not propel food into the stomach. Esophageal spasms are not uncommon, but it is definitely something which should not be ignored.

What are the two types of esophageal spasms?

There are two main kinds of esophageal spasms and these include the following (which research indicates might be related) [1] :

  • Nutcracker esophagus: this type of esophageal spasm squeezes in a coordinated manner, the same way that food is moved down the esophagus normally. However, the squeezing is extremely strong and may cause severe pain.
  • Diffuse esophageal spasm: this type of spasm is an irregular squeezing in the muscles of the esophagus. Uncoordinated squeezing prevents food from reaching the stomach and leaves it stuck in the esophagus.

What causes an esophageal spasm?

The precise causes of esophageal spasms are unknown. [2]

Many medical professionals believe it could result from an interruption of the nerve activity which coordinates the swallowing action of the esophagus.

In some individuals, very cold or very hot foods might trigger an episode of esophageal spasm.

What are the symptoms of an esophageal spasm?

The signs and symptoms of an esophageal spasm may include any or all of the following [2]:

  • Difficulty swallowing
  • Squeezing pain in the chest that could be mistaken for heart pain
  • Regurgitation of foods and liquids back into the esophagus
  • The sensation of having something lodged in your throat

What causes esophageal spasms?

As mentioned above, the precise causes of esophageal spasms are not clear. While a healthy esophagus will normally move food into the stomach through a series of coordinated muscle contractions, the same is not possible with diffuse esophageal spasms. Esophageal spasms disrupt normal esophageal contractions and make it difficult for the muscles in the lower esophagus to move food into the stomach.

What are the risk factors of esophageal spasms?

Esophageal spasms are more common in females than in males. [3] However there are other factors which could increase the risk of esophageal spasms and these include:

  • Consuming very hot and cold foods or drinks
  • Drinking red wine 
  • Gastroesophageal reflux disease
  • High blood pressure
  • Anxiety
  • Heartburn
  • abuse of opioids 

How is esophageal spasm diagnosed?

A medical doctor can often figure out the cause of esophageal spasms from a person’s medical history and by asking a series of questions. These questions can include what types of food or drinks seem to trigger the symptoms, where it feels like the food is getting stuck, other symptoms or conditions a person may have, and whether medications are being taken for the symptoms.

Esophageal spasm can be confirmed with testing which includes esophagus manometry or a barium swallow x-ray (Esophagogram).[2]

Esophageal manometry involves a small tube attached to transducers which measure pressure in the esophagus. A barium swallow is performed by using x-rays. Other testing may be done, such as Esophagogastroduodenoscopy (EGD) to find out whether the chest pain may be the result of gastroesophageal reflux disease, or due to reflux of food or stomach acid into the esophagus.

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