From the Research
The most effective treatment for esophageal spasms is a proton pump inhibitor, which should be considered first due to the overlap with gastroesophageal reflux disease, as suggested by the most recent study 1. When managing esophageal spasms, it's essential to consider the latest evidence-based approaches.
- The pathophysiology of esophageal spasms may involve an excessive cholinergic drive with temporal asynchrony of circular and longitudinal muscle contractions, as noted in a recent review 1.
- Treatment options include smooth muscle relaxants like peppermint oil, calcium channel blockers such as nifedipine or diltiazem, and nitrates like isosorbide dinitrate, which can provide relief during acute episodes 2, 3.
- For patients with persistent symptoms, low-dose antidepressants such as amitriptyline may help by modulating pain perception, and pain medications like acetaminophen or NSAIDs can be used for associated discomfort 2.
- Lifestyle modifications, including avoiding trigger foods, eating smaller meals, and managing stress, can complement medication therapy and improve outcomes 2, 3.
- In some cases, endoscopic treatment with botulinum toxin injection or pneumatic dilation may be considered, but the response can be variable 1.
- Per-oral endoscopic myotomy may be superior to laparoscopic Heller myotomy in relieving dysphagia, but more data are needed to confirm this 1.