The muscles of the esophagus push the swallowed food down until it reaches the stomach. Esophageal spasm and esophageal achalasia are disorders that affect these muscles.

In the case of esophageal spasm, the muscles of the esophagus contract inconsistently, causing severe chest pain and difficulty swallowing food and liquids.

In the case of esophageal achalasia, the normal undulating movements of the lower part of the esophagus do not occur, causing food that would normally pass all the way to the stomach to accumulate in the lower part of the esophagus. This can make undigested food go up the throat with a foul smell and bad taste in the mouth.

In most patients, the causes of both esophageal spasm and esophageal achalasia are not known. Achalasia affects women more than men, but esophageal spasm affects both men and women equally. If you have difficulty or pain when swallowing, go to the doctor immediately. A barium bolus can reveal any changes in the structure of the esophagus and in the way you swallow. Another test (esophageal manometry) uses a small instrument that measures pressures inside the esophagus in various places.

Echlacia with barium tincture

The most beneficial treatments for esophageal spasm are medications that relax the muscles of the esophagus, such as calcium channel blockers and nitrates. These tablets may be swallowed or dissolved under the tongue at the time of pain.

Esophageal achalasia can be treated with prescription medications that relax the choked lower part of the esophagus, or with mechanical devices (such as a balloon inserted and inflated) specially designed to widen the esophagus. As a last resort, in some cases, surgery is performed either laparoscopically or by the traditional method called myotomy, in which the muscle at the lower end of the esophagus is cut in order to relieve the narrowing.

It differs from esophageal stricture, which is a narrowing of the esophagus that makes swallowing difficult. Other symptoms include pain while swallowing, weight loss, and food reflux. Stenosis can be caused by congenital (from birth) narrowing of the esophagus (called an esophageal ring or membrane), esophageal cancer, esophagitis, or the formation of scar tissue (fibrosis) as a result of ingestion of caustic substances.

The method of esophageal dilatation is the most common method for relieving esophageal strictures, rings and membranes. For the dilation procedure, a group of rods or balloons (of various sizes) are inserted into the esophagus to widen its duct. Sometimes a surgical procedure is necessary to remove the narrowed part.