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Oesophageal Patients Association
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Achalasia Spasms

With thanks to the staff in the OPA office we now have a new poll. This is to try and gain a better understanding of the spasms that can cause so much distress if you suffer from achalasia. It is not something that is the result of having had an oesophagectomy. It can be about the oesophagus becoming really painful, almost as if one is suffering a heart attack. Achalasia is condition where the muscles affecting the peristalsis, or swallowing process, do not work, resulting in food getting stuck and/or congealing and not progressing into the stomach. I know that this will only affect a small minority of people in this community, but it is something that causes great problems, so we would be most grateful for people's contributions.

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Hi I had a hellors myotomy operation in 2012 for achalasia,thank god it worked as I was throwing up food .I have a small amount of barrets also.Im a type 1 diabetic,have addisons disease,vasculitis ,aps hughes syndrome aswell as vitiligo.Was wondering if achalasia is an autoimmune illness as my other illnesses are.?

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I had a total gastrectomy 5 years ago and have suffered with spasms for some time that are just like having a heart attack and at times are extremely painful whereas I am doubled up. Achalasia has never been mentioned by my medical people just say it is a spasm and normal basically. Will investigate further and mention to them for some feedback thanks as I can get them after during and sometimes a long time after eating. I regurgitate food quite regularly as well after between 2 to 4 mouthfuls it all comes back up and normally after that I can eat the rest but sometimes cant continue eating.

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It might be the result of the nerve system being altered by the surgery, perhaps? 'Normal' is not quite the word (for most people at any rate) but it might be that they meant that it was a recognised potential side effect from surgery that inevitably has to cut some of the vagus nerve system. So it probably does not count as achalasia as such. I am not sure what they can do about it, but I think it would be worth exploring exactly why your problem is occurring.

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Thanks Alan I will follow up when next see my Upper GI Specialist Nurse although as I said have mentioned it numerous times before with no real explanation. The vagus nerve was cut so maybe this is why, will see and hopefully get a better explanation. Rob

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This is a separate issue from the 'annual cancer check up'. I know you will feel really grateful that the cancer side of things has gone so well, but this other aspect is an effect from your treatment that someone should be able to think really carefully about to try and get it resolved because it is a significant quality of life issue.

So I think I would try and get a specialist opinion on exactly what is occurring and why, and I think I would mention the possibility of a second opinion to try and get it resolved - or at least establish that even the best specialists cannot offer an answer.

I think it would be worth trying some medication if the throat numbing medicine does not seem to work. There are various things like Buscopan and/or smooth muscle relaxants that might be worth a try; and others that help with the blood flow to the nerve endings. But it really all depends on what is the cause. It might be a reaction from scar tissue from the surgery, for instance. I know there are some people who take certain sorts of cannabis to help with spasms (and, indeed Viagra). I am sure that the doctors would blanch at the thought of allowing you to do that, but it might just concentrate minds and spice up the conversation in the clinic!

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Thanks Alan

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Hi Evans

Doctors have not yet buttoned down the reasons for oesophageal spasms - some argue it's lack of blood reaching vital areas, some neurological. Don't forget a number of nerves and blood vessels have been cut from this area.

A spasm can occur at any time but often when trying to swallow. The motility mechanism which most people take for granted can get out of synch (achalasia) or in my case (post cancer op/gastrectomy), where I have no motility, the oesophagus can just close up or get blocked.

I've tried a variety of remedies, none work in all cases.

Increased omeprazole dosage (temp)

Switching to lanoprazole

Peppermint oil

Rennies (or equivalent) post spasm

Vomitting (to open the pipe from the opp end)

When the spasm occurs it is impossible to get food (or even liquids) down but the muscles (in my case) reset themselves after approx 4 hours and a rest.

I would go back to your doctor. They are aware of these symptoms and I'm currently being introduced to a drug that relaxes localised muscles which may or may not work.

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I am not sure that anyone knows for sure, but the general speculation is about possible contributory factors being viral infections, the varicella zoster virus (linked with chicken pox and shingles), measles, a possible genetic predisposition, associated motility problems or, as you have mentioned, an autoimmune process. I have also heard about the issue of blood supply being relevant to some people.

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Another excellent poll Alan. All very useful and interesting results appearing.

Also useful to bridge the gap between the two conditions and NB we can still get spasms even without achalasia

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Thanks Alan & David for your responses, I have been regurgitating food, not every time I eat, for some time now and the latest prescription I am trying is Antacid & Oxetacaine Suspension that numbs the throat, strange feeling and not sure can get used to using it. Have had swallowing problems since the op 5 years ago with food and liquids that lead to the spasm's. Will certainly follow up further but as the vagus nerve was cut that changes everything nerve end wise etc and guess the issues are something one has to live with, you do get used to them and now on an annual review so cant be bad. Rob

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Hello Alan,

I am new to Healthunlocked. I have not had a diagnosis but the symptoms you describe are exactly my experience for the past 4 weeks. It started with difficulty swallowing solid foods about 6 moths ago . I’ve had a barium swallow which shows a slowing of swallowing when lying down. I’ve then been able to eat some things & not others & all the time taking PPIs and Gaviscon advance at night. My GP didn’t even get sent the results of the BS. Anyway I was referred for an endoscopy as my symptoms worsened ( I had gone from smooth food to liquids to now barely anything in the day ) !!

Reading a lot of posts it does scare me that I may never be able to eat & drink normally again. Yes I know I have to try to be positive as far as possible. I was unable to tolerate the endoscopy and staff tried twice ( I have had them years previously ) so I have an Appt with gastro at hospital on 25 th April. My daughter is getting married in Spain in June and this has set me back !! I don’t think I could cope with dilatation etc so I’m very worried indeed.

Thanks for the site though and information available.

Shebes66

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Try and keep your nutrition levels up by having soft /liquid food, and try to relax as much as you can, using any relaxation techniques that work for you. I hope the gastroenterology appointment goes well, and that they give you a good diagnosis.

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I hope this may be of some interest. I was diagnosed with achalasia in 1998 following a year of regurgitating food and losing 50lbs. I was finally admitted to hospital when I could no longer swallow even water and had the diagnosis after a barium meal and a pressure test.

I had the first spasm after returning to the ward following a balloon dilatation. I thought something had gone horribly wrong with the procedure as I had never had pain like it. The doctor told me to drink water, which I did, and the pain subsided after a few minutes. I regularly have the spasms which reduce me to tears, but the water does help and I never go anywhere without at least one bottle. I can eat almost anything I want but never late in the evening, and I can't lie flat because of the risk of stuff coming up into the oesophagus, and I find I often have a spasm if I lie on my right side, other than that they are quite unpredictable. I have never thought they are linked to the food I eat or when I try to swallow.

I had 2 MRI scans last year , nothing to do with achalasia, and found it hard to explain the difficulty I would have lying flat and that if I had a spasm I would have to sit up and drink water. I am now about to have radiotherapy and have had to explain again about the spasms. I think a card to hand to people explaining the condition would be helpful as very few people have heard of achalasia and have no conception of the pain it causes.

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I am sure you are right about lying flat and warning medical staff about it. It might be possible for a MedicAlert bracelet to help, perhaps? I believe the OPA would give more information about when their members have used them.

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Coughing all day and most of the night bringing up sticky mucus especially after food and drink not much sleep l have Achalasia

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I also have achalasia, and coughing at night is annoying, in addition to the mucus. I recently tried a cough drop in frustration, and it did help. During the day sucking on a hard candy, like Werthers helps with mucus, too, for me.

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