Treatments and drugs

By Mayo Clinic Staff

Treatment depends on the frequency and severity of your esophageal spasms.

If your spasms are occasional, your doctor might recommend avoiding trigger foods or situations.

If your spasms make it difficult to eat or drink, your doctor might recommend:

  • Managing any underlying conditions. Esophageal spasms are sometimes associated with conditions such as heartburn, GERD, anxiety or depression. Your doctor might recommend a proton pump inhibitor — such as lansoprazole — to treat GERD, or an antidepressant, such as trazodone or imipramine (Tofranil). Antidepressants might also help reduce the sensation of pain in the esophagus.
  • Medications to relax your swallowing muscles. Sildenafil (Revatio, Viagra), onobotulinumtoxin A (Botox) injections or calcium channel blockers, such as diltiazem (Cardizem CD, Tiazac, others), can reduce the severity of spasms.
  • Surgery (myotomy). If medication doesn't work, your doctor might recommend a procedure that involves cutting the muscle at the lower end of the esophagus, to weaken esophageal contractions. Long-term studies of this approach aren't available, so myotomy generally isn't recommended for esophageal spasms. However, it might be considered if other treatments don't work.
  • Peroral endoscopic myotomy (POEM). In this new minimally invasive technique, an endoscope inserted through your mouth and down your throat allows an incision in the inside lining of your esophagus. Then, as in myotomy, the surgeon cuts the muscle at the lower end of the esophagus. Like myotomy, POEM is usually considered only if other treatments don't work.
Oct. 21, 2015