Пт, 22 апр 2016 Автор: врач АртёмShiman
The spasm of the esophagus, one way or another, is quite common,
another thing is that not always this state is pronounced
character
The intensity of its manifestations is different, therefore insignificant
discomfort a person can write off to the mass of extraneous factors
without even knowing what is really happening.
To understand well what constitutes a spasm of the esophagus,
should turn to anatomy and determine the concepts.
Spasm refers to involuntary and painful contraction.
musculature
The esophagus spasm is thus a private
happening. Meanwhile, a spasm of the esophagus is often accompanied by a strong
pain and discomfort.
In terms of anatomy, the esophagus is an elastic tube,
serving to carry food into the stomach. The esophagus itself is by no means
not uniform in structure: it has several bends along the entire length
and therefore different in thickness throughout its length. In the initial
department (near the pharynx) and at the end (right in front of the stomach)
there are special muscle structures – sphincters. They have the appearance
muscle rings and perform a barrier function. When swallowing food
smooth muscles of the walls of the esophagus is reduced, leading to their
smoothing and expanding the lumen of the body.
The musculature of the esophagus is thus responsible for
movements of the walls of the esophagus and contributes to the normal progress
food in the stomach. Under normal conditions, a person does not feel movements.
walls of the esophagus. However, if a spasm of the esophagus occurs,
muscles become inadequate: the lumen of the body narrows,
food cannot normally pass through the esophagus and painful
sensations.
Contents
Spasm of the esophagus: symptoms
Not always the spasm of the esophagus is felt acutely. For this reason
many may not notice this transient violation. In separate
cases, the patient may observe one or more characteristic
symptoms.
Sphincters most susceptible to pathological contractions
esophagus. Somewhat less frequently, the esophageal walls themselves experience spasm. AND
sphincters, and walls richly innervated (esophagus penetrated by nerve
окончаниями), что объясняется функциями esophagus.
The most frequent manifestation of this condition is pain of various
intensity and character. It is described by patients as stabbing.
either burning, or bursting and crushing. Localization of pain
sensations determined in the neck (about 2-3 fingers below
chin) or chest (at heart level). Have a similar character
pain during a heart attack or an attack of angina. With these pathologies
spasm of the esophagus is often confused by the patients themselves. In most cases
suspicions are groundless.
Pain in spasm lasts from 10 to 60 minutes. On
throughout this time the intensity of the pain may
persist.
Pain syndrome is very variable:
• Pain may radiate to the shoulder, back, lower area
jaws, ears and even hands.
• Discomfort can be aggravated by turning the head, changing
body position, physical activity.
In addition, symptoms include:
• Feeling of coma in the throat, pressure in the chest.
• The inability to swallow (and both solid food and
fluid). So-called developing dysphagia.
Pain and dysphagia do not always develop in parallel. One thing can
exist without the other.
As already mentioned, the spasm of the esophagus is a common phenomenon.
This condition may be accompanied by discomfort, severe pain.
However, do not panic: after a certain period of time
(usually up to half an hour) symptoms disappear. This period is important
refrain from further eating, so as not to annoy and without
addition irritated esophagus.
Spasm of the esophagus: causes
Causes of spasm of the esophagus are different. According to statistics,
most often spasm is observed in people with a mobile type of nervous
systems (such individuals are prone to depression, easily excitable and, as
usually impressionable). Therefore, the most prone to spasm
esophagus young women. In addition, the risk group includes:
• Persons suffering from chronic diseases of the cervical
spine.
• Persons prone to insufficient chewing
food.
• Patients with infectious diseases of the upper
respiratory tract.
• People suffering from gastrointestinal diseases (especially GERD –
gastroesophageal reflux disease).
ANDсходя из этого, все причины развития спазма можно разделить на
several groups:
• Механические причины. Not affiliated with
concomitant pathologies. Onиболее часто спазм пищевода
develops when you try to swallow too much of a piece,
use of highly carbonated or excessively chilled
drinks.
• ANDнфекционные причины. After recently
previous infectious diseases risk of esophageal spasm
above. A secret in which bacteria proliferate (mucus,
sputum) in some quantities is ingested. Part of the pathogenic
microorganism settles on the wall of the esophagus, destroying its mucous membrane.
In response, a reflex occurs. organ contraction (usually such
the spasm is less intense, but more prolonged).
• Diseases ЖКТ. Spasm of the esophagus is observed
with gastritis with high acidity and some others
diseases.
• Психосоматические причины. By
For psychosomatic reasons, most spasms occur.
esophagus. Byвторяя сказанное нужно отметить, что пищевод обильно
innervated because it reacts subtly to the most insignificant
changes in the nervous system. Strong experiences
Depression, stress cause disturbances in the work of the sympathetic nerve
and X pairs of cranial nerves (which are responsible for reducing
and relaxation of the muscles of the esophagus). In this case,
indeed, all diseases are from nerves.
• Diseases позвоночника (шеи). Diseases
spine (first of all the neck, to a lesser extent the thoracic
spine) are the cause of infringement of the nerve roots.
Normal innervation of the esophagus is broken and, as a result,
spasm develops.
Spasm of the esophagus: diagnosis
From the point of view of diagnosis, this condition is obvious. Enough
clarify the presence of characteristic symptoms and exclude more severe
diseases of the gastrointestinal tract, as well as diseases under which the spasm of the esophagus
может маскироваться (инфаркт, стенокардия, ANDБС).
Independently determine the spasm of the esophagus is not difficult. Often
patients have a question whether they should go to a doctor with
this pathology? It is important to pay attention to a number of factors:
• Pain and discomfort arose after eating, suffering
stress.
• No associated symptoms are observed (such as severe shortness of breath,
confusion).
• The pains are monotonous and pass after 30-60 minutes.
If the picture is similar, there is no reason to worry. Can get by
on their own. In all other cases it is recommended to refer to
to the doctor, but rather to the doctors (first of all, to the therapist, then to
otolaryngologist and gastroenterologist).
Diagnostic methods for spasm of the esophagus are aimed at excluding
other diseases and include:
• Survey (the doctor asks clarifying questions in order to understand what he is
deal with and decide on a further diagnostic strategy).
• Endoscopic examinations (Gastroesophagoscopy, goal
which – examination of the gastric mucosa and esophagus). These studies
associated with minimal patient discomfort, but recognized
most informative.
• X-ray of the esophagus with a contrast agent (patient
drinks a special contrast agent, after which it is held
standard radiography). This method is more informative than
conventional radiography, because it allows to evaluate the anatomical
состояние esophagus.
• Determination of the release of gastric juice into the esophagus (daily
pH-metry).
Esophagus spasm: treatment
To start treatment you need to establish the original cause.
pathology. If the spasm is single, or is it related to
mechanical reasons – no special treatment is required. Enough
perform a first aid. In all other cases shown
drug treatment.
What drugs are used for this:
• Antispasmodics (promote relaxation of smooth muscles):
No-spa, Duspatalin, Drotaverin, etc. Price ranges from 30 to 300
rubles. Byмогают get rid of от боли и дискомфорта.
• Calcium channel blockers. They reduce the contractile
muscle capacity Among the drugs: Diltiazem, Verapamil, etc. These
drugs cause a lot of side effects, because their use
permissible strictly according to indications and under the supervision of a physician.
If the cause of the spasm of the esophagus lies in psychosomatic
reasons to use sedatives:
• Extract of Valerian, Novo-Passit, etc.
When it is determined that a spasm of the esophagus occurs as a reaction to
throwing gastric juice into the esophagus, antacids are prescribed
drugs. They neutralize the acid:
• Rutacid, Gastal, Almagel, etc.
In most cases, specialized treatment is not
required. Enough снять основную симптоматику. How to help
to myself?
• First of all, you need to calm down completely. Nervous
stress will only aggravate the situation.
• If pain and discomfort occurred while eating, you can
try to drink a small amount of non-carbonated water
(temperature should be room temperature).
• In a number of cases, proper breathing helps:
inhale, count to four, exhale and count to four again.
Continue like this for 1-2 minutes.
• You can take a sedative, drink chamomile tea.
• If the listed methods did not help, you can chew
chewing gum with an intense mint flavor or dissolve
peppermint candy.
Medical methods (including atropine injections, etc.) need
apply with caution. Often atropine develops
allergy.
Fortunately, 99% of spasms can be relieved listed.
in ways. It is important to remember that the spasm of the esophagus is an unpleasant phenomenon.
painful, but generally harmless.
Thus, the spasm of the esophagus is not as rare as it can
seem at first glance. Most often it is due to insufficient
chewing on food is either a response to stress and increased
anxiety. Install the initial cause of the spasm can only be a doctor.
The treatment is mainly symptomatic. Usually enough
independent action. In any case, do not panic.
The spasm of the esophagus is not life threatening.
