Esophageal spasms occur when the esophageal musculature may spontaneously overly tighten and have difficulty relaxing. This produces immediate chest discomfort and pain. The sensation can last 5-30 minutes. It can be associated with increased acid reflux. Unlike eosinophilic esophagitis, esophageal spasms are not mediated by food intake, but can occur indepentent of swallowing.
Treatment can be best achieved with nitroglycerin. Just as nitroglycerin takes just a few moments to help relax and dilate the cardiac vasculature to relieve angina, it also only takes a few minutes to relax the esophagus. Patients are often surprised to find out how quick it works. For spasms that occur on a regular basis, calcium channel blockers can often deliver a more sustained baseline control.