How to Stop Esophageal Spasms

Co-authored by Roy Nattiv, MD

Last Updated: October 25, 2022 References

Esophageal spasms occur when your esophagus contracts abnormally or not at all, making it hard for you to swallow food or liquids. If you're having an esophageal spasm, you'll experience chest tightness, difficulty swallowing, feeling like there's an object in your throat, and the return of food or fluids.^{[1]
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Go to source} The cause of esophageal spasms is not known, though other medical issues or a family history of this condition can make it worse. Adjusting your diet and lifestyle as well as taking medication can help to stop the spasms and make it easier for you to swallow properly. If your spasms are severe or chronic, you may need surgery to address the issue.

Things You Should Know

To help prevent esophageal spasms, try eating 5-6 small meals during the day rather than 2-3 big meals.
Also, avoid food that's very spicy, hot, or cold, and avoid cigarettes and alcohol.
If you have trouble sleeping, use a foam wedge to raise the head of your bed about 6-8 inches, and wait 2-3 hours after you eat before you go to bed.

Method 1

Method 1 of 3:

Adjusting Your Diet and Lifestyle

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Have several small meals throughout the day. Rather than have 2-3 big meals, try having 5-6 meals with smaller portion sizes. This can help to prevent overwhelming your esophagus with a lot of food at once and make it easier for you to digest your food properly.^{[2]
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- For example, you may have a small portion of food in the morning and then several small meals during the day, rather than a set breakfast, lunch, and dinner with larger portions.
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Avoid spicy, acidic foods. Food with lots of pepper and other spices can make your symptoms worse. Acidic foods like tomatoes, oranges, strawberries, and lemons can also cause spasms. Try cutting these foods out of your diet to see if your symptoms improve.^{[3]
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- Acidic drinks like coffee can also make your spasms worse so you should avoid drinking these, if possible.
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Try not to prepare food that is very hot or very cold, as the extreme temperatures can make your symptoms worse. Eat food at room temperature to avoid aggravating your esophagus.^{[4]
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These two habits can make your symptoms worse and cause spasms to occur. Try quitting smoking or reducing how many cigarettes you smoke a day. Limit yourself to one to two drinks a month to prevent making your spasms worse.^{[5]
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Raise your bed 15 to 20 centimetres (5.9 to 7.9 in) to help you sleep. Esophageal spasms can become worse at night and make it difficult for you to sleep. To stop them, raise the head of your bed by using blocks under your bed frame or by placing a foam wedge under your mattress.^{[6]
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- Do not try adding extra pillows under your head when you sleep, as this is not an effective option unless you buy a special pillow. You can purchase a special pillow that keeps you elevated. However, raising the bed, or investing in a bed that you can raise up, is a better option.
- Wait two to three hours after you eat to lie down in bed, to give your body time to digest your food and prevent spasms or heartburn.
Keep these areas unrestricted by wearing clothing that is loose and flowy, such as tops that cut low at the neck. Go for clothing in breathable fabrics like cotton and linen to prevent these areas from getting too hot or tight.^{[7]
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Losing even 5 to 8 pounds (2.3 to 3.6 kg) can make your esophageal spasms less severe and reduce their frequency. Try adopting a healthy, balanced diet and following a meal plan. Go to a fitness class at your local gym or workout at home using video tutorials online. Try walking, jogging, or biking to work every day to lose weight.^{[8]
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These exercises can be done at work or at home in a quiet, low lit area. Sit in a comfortable position and close your eyes. Try breathing in through your nose for a count of 5 and then exhaling through your nose for a count of 5. Do this for 2-5 minutes to help you relax and stay calm.^{[9]
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Method 2

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Taking Medication

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Talk to your doctor about muscle relaxants to make it easier for you to swallow. Muscle relaxants can also help to reduce any pain you may experience when you try to swallow. Your doctor can discuss which muscle relaxants are right for you and determine your dosage. Never take more than the recommended amount and only have them as needed when you experience spasms.^{[10]
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- Muscle relaxants can cause lethargy and fatigue so you should not drive while on this medication.
- Ask your doctor about a referral to a gastroenterologist to rule out issues like an infection, allergy, or a problem with the nervous system in your intestines or esophagus.^{[11]
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  Roy Nattiv, MD
  Board Certified Gastroenterologist
  
  Expert Interview. 14 October 2020.}
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Use proton pump inhibitors to manage your stomach acid. Your doctor may prescribe proton pump inhibitors like lansoprazole if you are having digestion issues or heartburn due to your spasms.^{[12]
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Research source} Usually, these are taken 30 minutes before your first meal of the day.^{[13]
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- Follow all of your doctor's instructions about dosage and frequency.
- This medication can cause side effects like nausea, rash, constipation, diarrhea, headaches, vomiting, and fever. If your side effects become severe, see your doctor right away.
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Get botulinum toxin injections to relax your esophagus. Also known as Botox, this medication is injected into your esophagus to keep the muscle relaxed. The needle will be small for the injections and you should feel no more than a slight sting. Your doctor will need to give you the injections in their office and the treatment should take no more than 30 minutes.^{[14]
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- The injections will last from 10-16 weeks, so you will need to go in for another treatment once the effects wear off.
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Ask your doctor for prescription pain medication. If your spasms are painful and making it difficult for you to function on a day-to-day basis, your doctor may suggest prescription pain medication. Only take the recommended amount, as taking too much can put you at the risk of other health issues.^{[15]
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- Certain pain medications are highly addictive, so your doctor may recommend that you only take a low dosage and use them as a short-term solution.

Method 3

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Undergoing Surgery

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Get dilation surgery on your esophagus to widen it. In this procedure, your doctor will insert dilators into your esophagus to widen it using a scope that is inserted in your throat. You will be under general anesthesia during the surgery so you will not feel any pain.^{[16]
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- This surgery is invasive but it is considered less extreme than a myotomy.
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Consider a myotomy if your symptoms are severe. If medication and other treatments do not work, your doctor may suggest a myotomy, where the muscles at the lower end of your esophagus are surgically cut. This can then weaken esophageal contractions in your throat and make it easier for you to swallow.^{[17]
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- You will be under general anesthesia during this procedure so you will not feel any pain. It is considered a serious surgery and is often only done as a last resort if other treatments for your spasms do not work.
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Allow several weeks for recovery from the dilation or myotomy surgery. You will need to stay in the hospital overnight after the surgery and allow 1-3 weeks for recovery. It will be difficult for you to swallow solid foods so a liquid diet, and some soft foods, are good during your recovery. You will also need to go in for a special X-ray of the area to ensure the surgery was successful.^{[18]
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- Your doctor will also schedule a follow up with you one to two weeks after the surgery to ensure the area is healing properly and there are no signs of infection.
- Foods will be limited to baby food, rice, and foods put through a blender.

Expert Q&A

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Question

What causes esophageal spasms?

Roy Nattiv, MD
Board Certified Gastroenterologist
Dr. Roy Nattiv is a Board-Certified Pediatric Gastroenterologist in Los Angeles, California. With over 20 years of experience he specializes in a broad range of pediatric gastrointestinal and nutritional illnesses such as constipation, diarrhea, reflux, food allergies, poor weight gain, SIBO, IBD, and IBS. He completed his pediatric residency at the Children’s Hospital at Montefiore, Albert Einstein College of Medicine in New York, and his fellowship at the University of California, San Francisco (UCSF). While at UCSF, he was a California Institute of Regenerative Medicine (CIRM) fellowship trainee and was awarded the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) Fellow to Faculty Award in Pediatric IBD Research. Dr. Nattiv received his undergrad degree from the University of California, Berkeley, and his medical degree (MD) from the Sackler School of Medicine in Tel Aviv, Israel.

Roy Nattiv, MD

Board Certified Gastroenterologist

Expert Answer

Esophageal spasm may be related to infection or allergy. It also might be something that is inherent to the nervous system that lines the intestines or the esophagus. In any case, if you feel that you're having esophageal spasms, you need to see a gastroenterologist to rule out one of these causes.

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