Esophageal Spasms (Diffuse Esophageal Spasms DES)
What it is:
Diffuse esophageal spasm is when the esophageal
muscles spasm shut, which closes the esophagus.
The spasming of the esophageal muscles can lead to a
feeling of food sticking, food obstructing, regurgitation,
and chest pain. Symptoms may be worse with cold foods
or drinks, but may improve with warm liquids.
Diagnostic testing requires at least 2 esophageal tests:
1. Endoscopy: sedated exam with a flexible camera
scope to assess the esophagus directly.
2. Esophageal manometry: a nasal passed
esophageal tube that measures esophageal muscle
strength and looks for spasming.
There is not a cure for DES, though most cases of DES become stable or improve with treatment. About
10% of DES can worsen which may require surgery to open up the lower esophageal valve.
Treatment for Diffuse Esophageal Spasm is:
a) Treat for acid reflux with medicine that suppresses acid (PPI) and anti-reflux lifestyle measures.
b) Drink warm liquids for trouble swallowing, chest pain, and with meals.
c) If trouble swallowing or food sticking is the primary symptom, esophageal muscle relaxing
medicines can be tried. Nitroglycerin can be used for symptoms that come and go. Diltiazem can
be used for more constant symptoms.
d) If chest pain is the primary symptom, then medicines to regulate the nerve sensations are used,
namely Amitriptyline or Desipramine.
e) Changing eating habits to eat softer and more liquid foods. These foods will tend to slide down
the esophagus easier. Problem foods such as grisly meats, dry foods, or raw vegetables and fruits
should be eaten with care.
f) In rare cases, surgery is required to break esophageal muscle spasming.
Follow up depends on the treatment program. In most cases, follow up will be 3 months after starting
medicines. Patients need to track their trouble with eating, drinking, and changes in weight, chest pain, or
Your health care team may have given you this information as part of your care. If so, please use it and call if you have any
questions. If this information was not given to you as part of your care, please check with your doctor. This is not medical advice.
This is not to be used for diagnosis or treatment of any medical condition. Because each person’s health needs are different,
you should talk with your doctor or others on your health care team when using this information. If you have an emergency,
please call 911. Copyright © 12/2015 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by
the Department of Nursing. HF#7846