Chest Pain

Chest pain when I drink water

Muscles in the esophagus are disturbed or cause a problem, and this condition is called an esophageal spasm. The food or drink moves toward the stomach through this tube after you swallow. Abnormal muscle contraction occurs in the esophagus. Spasm makes it challenging for the food to reach the stomach. It can be painful. Chest pain has connections with;

  • Heartburn 
  • Gastroesophageal reflux disease (GERD)
  • Gallstones
  • Esophageal spasm 
  • Achalasia 
  • Heart issues 


The esophagus is a muscular food tube that makes up part of the digestive system. It carries food or water toward the stomach when you swallow. 

Esophagus work:

Muscles that make the esophagus work together in a complex way. Muscular valves (sphincter) are present at the start and end of the esophagus and can stop food or drink from coming back from the stomach to the mouth. They work efficiently. 

After swallowing, muscles of the esophagus contract and relax to move the food or drink. The waves of the contraction of the esophagus muscles push the food or liquid down to the stomach. A Series of movements or contractions is known as peristalsis. 

If these contractions don’t work efficiently or correctly, esophagus spasms occur. Sometimes powerful or inefficient muscle contractions occur in the esophagus, which makes operating the esophagus difficult. Not allowing the food or liquid to go down to the stomach. 

Types of esophageal spasms:

There are two types of esophageal spasms, which affect the esophagus differently. 

  • Diffuse esophageal spasm:

Awkward or uncoordinated muscle contractions occur in the lower part of the esophagus. In this type of esophageal spasm, already swallowed food or liquid comes back into the esophagus. 

  • Nutcrackers esophageal spasm:

It affects the esophagus muscles work and cause chest pain. Muscle contraction becomes too powerful or forceful in the nutcracker esophageal spasm. It causes pain when you swallow any food or liquid. The pain may be very severe and feel like squeezing in the chest. 

Causes of esophageal spasm:

The causes of esophageal spasms are unknown. Some medical studies show that the faulted nerves may cause weak muscle contraction or esophageal work. Too much acid in the esophagus also causes esophageal spasms. Excess acid may be due to heartburn for a long time. Some people face esophageal spasm symptoms after eating hot or cold food or liquid. But esophageal spasms can happen at any time. Some other causes are;

  1. Irritation
  2. Injury
  3. Drug-induced esophagitis
  4. Gastroesophageal reflux disease
  5. Hiatal hernia
  6. Esophageal motility disorder
  7. Crohn’s disease
  8. Eosinophilic esophagitis 
  9. Esophageal cancer

Symptoms of esophageal spasm:

Signs and symptoms of esophageal spasm can be mild to severe. Some people feel no symptoms. Some may feel symptoms of cramps when eating hot or taking cold food. Symptoms include;

  • Burning chest pain 
  • Trouble swallowing food
  • When you consume, feel pain near the breastbone
  • Feels like something is stuck in the throat 
  • Frequent vomiting
  • Regurgitation (backup of food or liquid after eating)

Diagnosis of esophageal spasm:

Esophageal spasm is very difficult to diagnose. The doctor does a physical examination initially. If you have chest pain, then Electrocardiogram is used to roles out heart disease. Other tests are the following that are used to evaluate the esophageal spasm;

  • Endoscopy:

A narrow tube is inserted into the esophagus to check the structural abnormalities in the esophagus. The endoscope contains a tiny light and camera at one end, which can give a view of the inside of the esophagus. 

  • Barium swallow:

In this test, a barium solution is required to swallow. An X-ray is taken when the barium solution goes to the esophagus. The barium may become stuck or slow down if the narrowing is present. 

  • Esophageal manometry:

If there is no abnormality in the structure detected, then this test is done to check the pressure of the waves in the esophagus. A large number of unusual contractions in the lower esophagus is the primary or significant indicator of esophageal spasm. 

When to see the doctor:

See the doctor if you are facing or experiencing the following symptoms;

  • Chest pain 
  • Difficulty in swallowing 
  • Frequent vomiting 
  • Loss of appetite
  • Blood in the stool
  • Sudden weight loss 

Risk factors of esophageal spasm:

Risk factors of the esophageal spasm are;

  • Pressure on the esophagus (frequent cough and vomiting can cause pressure on the esophagus, which causes a fault in the nerve)
  • Medications (non-steroidal anti-inflammatory drugs (NSAIDs) and aspirin can irritate the esophagus and cause pain)
  • Pregnancy (frequent vomiting in pregnancy also causes esophagitis)
  • Obesity (overweight is a risk factor for GERD and hiatal hernia)
  • Smoking (smoking disturbs the esophagus and increases the risk of esophageal cancer)
  • Alcohol (drinking alcohol can irritate the esophagus and cause esophageal spasms)
  • Genetics (run in families)

Treatment of esophageal spasm:

The aim of treating esophageal spasms is to relax the esophageal muscles to relieve the symptoms. If an esophageal spasm causes no symptoms, then no treatment is required. Treatment includes;

  • Medications:

Many medications are used to treat the esophageal spasm in many ways. Taking calcium channel blockers before eating something can easily pass the food or liquid. Tricyclic antidepressants can trigger or treat the faulty nerve in the esophagus and relieve pain. 

  • Botulinum toxin injections: 

Botulinum toxin injections can temporarily paralyze the esophagus muscles and stop the spasms. If other therapies do not work, then this option is given. Treatment result usually lasts one year. 

  • Surgery:

In severe cases, a health care providers or doctor recommend surgery to fix the fault permanently. 

During myotomy, an incision is made in the lower esophageal muscles, which can stop the muscles from working completely and may further stop the abnormal contractions. When the esophageal muscles stop working, gravity helps to force the food or liquid to move into the esophagus. 

  • Home remedies:

Studies or research show that peppermint oil help in calming the esophageal muscles. Drinking water with added drops of peppermint oil can stop the minor symptoms. Avoid triggers that cause esophageal spasms. 

Tips or guidelines:

The following tips are used or recommended to cope with the esophageal spasm;

  • Eat small meals
  • Eat more frequent meals
  • Chew food thoroughly
  • Eat soft foods
  • Avoid fast, fatty, or spicy foods
  • Avoid smoking 
  • Avoid alcohol
  • Avoid caffeine
  • Limit orange juice 
  • Wait for hours after eating a meal or drinking water or liquid 
  • Avoid allergens
  • Take pills or medicines with a lot of water 


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