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8 This is esophageal spasms

Esophagus spasms are a condition that can be divided into two different groups:

-Diffuse Esophageal Spasms (DES): Where the contractions are uncoordinated. Several segments of the esophagus contract simultaneous and therefore DES does not propel food effectively to the stomach. DES can be caused by disruptions or damage to the nerves that coordinate the muscles of the esophagus. This condition can lead to achalasia.
-Nutcracker Esophageal Spasms (NES): Where the contractions proceed in a coordinated manner, but the amplitude is excessive. People with NES experience painfully strong contractions in the esophageal muscles.

Symptoms of esophageal spasms can be:
Dysphagia (Difficulty swallowing) 
Regurgitation (The return of food and liquids back up your esophagus)
Non cardiac chest pains (that can spread outward to the arms, back, neck, or jaw)
Globus (The feeling that an object is stuck in your throat)  
Heartburn. But because the symptoms are very vague it often goes untreated.

Diagnoses: To see if you have spasms in the esophagus you have to take this test:  
-Manometry: Your doctor inserts a thin tube through your nose into your esophagus. Once placed, the tube is slowly withdrawn, allowing it to detect pressure changes. The patient is asked several times to swallow some water. The procedure takes about 45 min. Manometry measure the effectiveness of your esophageal muscles in the swallowing process. 
-High Resolution Manometry: The pressure sensors need to be spaced at most 1 cm apart to be called high resolution. The procedure time is cut by 35 min.
-Barium X-ray: You're given thick liquid containing barium that temporarily coats the lining of your esophagus. Studies show that the x-ray shouldn't be trusted alone to give a diagnosis.
-Esophageal pH recording: Is a 24-hour ambulatory manometry that will help to detect esophageal muscle dysfunction.
-Endoscopy: Is a thin, hollow tube equipped with a camera that is put through your mouth and down your throat to look at your esophagus. This test is not useful to help diagnose dysmotility.


Treatments:
-Calcium Channel Blockers: Effectively reduce the amplitude of the contractions. But the chest pain usually doesn't go away.
-Nitrates: Is used to reduce acute symptoms of esophageal spasm.
-Tricyclic Antidepressants: Have been shown to decrease chest pain with no apparent cause on angiogram.
-Opioids: Those who suffer from severe Esophageal spasms, uses opioids from time to time, and/or on a everyday basis. (Durogesic®, OxyNorm®, OxyNorm liquid®,Morphine® etc.) 
-Botulinum toxin(BoTox®): The effect is temporary (from weeks to 6 months), and the effect decreases with repeated injections.
-Balloon dilatation: It doesn’t work for everyone, and symptoms recur. But it is used for treating Achalasia.
-Acupuncture: Temporary improvement of esophageal spasms has been reported. Both the World Health Organization (WHO) and the National Institute of Health (NIH) consider esophageal spasms as a treatable condition with acupuncture.
-Peppermint oil: Take 2-3drops of peppermint oil in a glass of water. This makes the muscles of the esophagus contract normally again.
-Diet:  Every person has different things, but pureed foods can help decrease symptoms temporarily. Very cold or hot beverages can trigger a spasm, therefore always eat hot foods and drinks cool, and let cold foods and drinks warm. 
-Myotomy: This is a surgery where the muscle is cut out. Myotomy reduces the amplitude of the contractions. Dysphagia can develop or worsen after myotomy because the effectiveness of the propagative waves is eliminated. This shouldn't be used with with nutcracker esophagus because it may worsen the symptoms.
-Esophagectomy: Is the surgical removal of all or part of the esophagus. The stomach is transplanted into the neck and the stomach takes the place originally occupied by the esophagus. In some cases the esophagus is replaced by the patient's colon.

It's not really known how they occur, but in my case it came from a surgery Nissen fundoplication. Study has shown that those who have had this operation are at risk to develop esophageal motility disorders.
Microvascular compression of the Vagus nerve in the brain stem has been demonstrated in current research as the possible triggering event



8 comments:

  1. Flott skrevet :-)

    Mvh
    Hege

    ReplyDelete
  2. very well written

    ReplyDelete
  3. thank you very much
    ♥ ♥ ♥ Alex

    ReplyDelete
  4. This blog site is pretty good! How was it made . I view something genuinely interesting about your site so I saved to my bookmarks . You can visit my site.
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  5. This is very helpful. I had a nissen in 2011. Since then I've had a few episodes of very mild spasm. Hard to diagnose. Also cialis and viagra do help with them. You didn't mention that, but they are confirmed to help with the spasms.

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  6. The calcium channel blockers have worked wonders for me! Wish I'd had them 25 years ago!

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  7. Try Natural Treatment for Achalasia because the mixture of different natural ingredients makes a proper herbal remedy such as Achalasia Herbal Remedy produced by Natural Herbs Clinic. This herbal remedy work properly and can help to treat your achalasia successfully.

    ReplyDelete