Is this pain an oesophageal spasm, acid reflux, or a combination of both?

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I've had Achalasia for almost 10 years now, and I am trying to get some questions answered.  Anyway, I am wondering about this pain that I get maybe every two weeks or so.  It is a very severe pain.  I feel it all over my chest, and sometimes in my neck and head.  When I first started experiencing this pain, I would drink a couple glasses of water and it would go away.  Now, it is harder to get it to go away.  Water does help but only temporarily.  I've started to eat full packages of saltine crackers when this happens, and I feel like that helps.  It still takes a while to go away though.

Anyway, I don't know if this is a muscle spasm or a very very severe acid reflux, or maybe a combination of the both.  Do you guys have any insights on this? Also what do you take when you have muscle spasms and/or acid reflux?

Thanks!  

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  • Posted

    Aaron,

    As soon as you feel the pains starting drink very cold whole milk. Drink until the pain completely stops. Usually it takes a whole glass. This should work.

    Good Luck.

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    • Posted

      Glad to hear another person uses milk too...it determines whether I have a good day or bad for me.
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    • Posted

      Thanks for the suggestion, Robert! I am glad milk works for you!  I have tried drinking milk, and I drink a lot of milk on a daily basis, but I sometimes feel like having milk, especially in the morning w/ cereal, can cause these episodes.  I will try again though, with different types of milk and different quantities.

      Thanks!

      Aaron

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  • Posted

    That is a very good question..it is so hard to distinguish what is what for me often with nurses and doctors.

    If you are not asleep..I would contribute chest pains from the sphincter not allowing food and lquid to go past it...the build up occurs in your esophegoues and presses up against your heart to create angina chest pains/spasms is my issue.

    It gets worse depending on how much the sphincter tightens and lack of water causes mine to be worse...so I ice my chest and hydrate with fluids even though it does not stay down.

    I also try to walk it off ..but be very careful..your heart really is having difficulty because of the pressure of swollen sphincter with debris in it.

    But when you are asleep..I have had acid reflux go all the way to upper sphincter located below mouth..it made it impossible for me to swallow or breath for about 1 minute was very scary.

    I also get acid reflux while sleeping that sends food and liquids into my lungs causing me to pass out if not quick enough. Usually I wake up covered and then try to get iot all out of my lungs by cough or vomit.

    Sleeping upright..not eating 3 hours before bedtime helps with this type of acid reflux.

    Not sure what causes others spasm/pains for sure..I do not buy that everything is acid reflux like most doctors say...

    I have lived with this my entire life and know the difference between acid reflux burn and an angina heart attack from debris in my esophageos.

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    • Posted

      Thanks for your suggestions aqua-man! I don't think my chest pain is the same as your angina chest pains/spasms, because, generally, large quantities of food don't get stuck above my LOS (luckily!).  I will ice my chest next time this happens though, and see if that works.  I have never done that.

      Thanks!

      Aaron

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  • Posted

    Hi Aaron.  I had esophageal spasms for many years prior to having swallowing difficulties, regurgitation, and the diagnosis of Achalasia.  In the beginning, I was told it was due to acid reflux and I made adjustments in my life that only seemed to help marginally.  At a later point, I experimented with taking PPI's twice a day for a month.  I had the spasms just as frequently as I had been before taking the PPI's so I stopped taking them.  Then I had an endoscopy that showed there was no indication of reflux damage.  This has led me to believe that they are not caused by acid reflux.  However, I also have noticed that sometimes they occur when I bend over or move quickly, which makes me reconsider acid reflux as a possiblilty.  I've wondered if there could be a small amount of reflux that triggers the spasm at times but that perhaps food particles or something else triggers them as well.  Some say that stress can play a role.  I wonder about adrenaline or something like that but don't know enough about biology to know if that would make sense.  I've also considered it being related to trapped air, akin to hiccups.  (which may be why drinking water can help as it does with hiccups.)  Anyway, I think that it's, unfortunately, a bit of a mystery.  At this point, drinking water works for me.  I've also started to drink water first thing in the morning when I wake up in case it has to do with dehydration. (We get dehydrated over night) And I've started the Autoimmune Paleo diet.  Eliminating grains may also have been helpful to me because I haven't had a spasm in two weeks ( I was getting them every three days).  Now, I've gone for weeks before like this, so it could be sheer coincidence.  But I'm into trying everything to try to solve this painful mystery!
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    • Posted

      Hi Amy.  Thanks for the response! I can relate with a lot that you shared.  I used to take a ppi too (prevacid.) I took it for a couple years and then stopped taking it because it seem to help with my spasms, also.  I didn't take it for about 5 years, and now I've started to take omeprozale because I have an irritation in my throat.

      I have also noticed that sometimes when I bend over, it triggers the spasm.  I've thought that it could be related to trapped air too, because sometimes carbonated drinks seem to trigger it. 

      Hmmm I eat a lot of grains.  Has your Autoimmune Paleo diet still been working for you?

      Thanks!

      Aaron

       

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  • Posted

    If it is reflux, then logically, gaviscon should be able to make a fairly quick impact.

    If it is muscular spasms, there is medication like buscopan that can sometimes help.

    I suppose it could be both if the spasm is holding the lower oesophageal sphincter open rather than it being clamped shut.

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    • Posted

      Thanks for the response, Alan! I have never tried gaviscon.  I have recently taken tums whenever my symptoms occur, and tums seem to help, but I discovered over the course of a couple of weeks that tums have a constipating effect on me.  Does gaviscon also constipate?

      Thanks!

      Aaron

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  • Posted

    Aaron, hi I am Jamie from the states, thanks for having me be a part of this discussion. Your spams are directly part of the achalasia. I have A111 with spasms! It feels like you are having a heart attack huh? They are painful but what I do is try and meditate or relax as much as possible. I have noticed the more I get panicky the worse they can be. I am glad that the milk works for a lot of you but there are some people that can't get anything down. This is a progressive disease I know you know that and I hope that in the UK that you have informed Doctors. I have spent endless time researching this and reaching out to others that are with this disease a different levels. I have seen some of us go through the worst and have to have the esophagus replaced and come out on top as a well balanced body builder with a great attitude. Others not so much! What I see about your group is openness and greatful for info. Keep your throat warm, drink room temp water and plenty of it and find a healthy diet. Leg me know how you are doing ok? You friend Jamie 
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    • Posted

      HI Jamie..I am also from the states and glad you brought up milk.

      I also have difficulties getting it down.

      Sometimes I do what I call"binge eating" eating anything and everything that my mind says looks good.

      Sometimes my best weapons are chocolate pudding with whip cream to open sphincter to allow milk to go in..

      It might not all stay down..but I equate it to dinosaurs using rocks to digest food in their stomachs..pudding is basically crushed bones..is lubricates the throat and helps digest food downward towards sphincter..and then chase it with a shot glass of milk...repeat until success.

      As far as trash eating..soup is cheapest..I make a mean spinach cheese soup..make sure you have the soup hot enough boiling point before adding cheese is secret.

      Anyone else have had to improve their cooking abilities and have great things that work for them?

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    • Posted

      Hi Jamie.  Thanks for the response! When this happens, I tend to relax just because I don't feel like doing anything else, and I definitely agree that activity makes it worse.  I will try meditation as well! 

      I can get milk down, but it doesn't seem to make symptoms any better.

      Oh I am from the states too.  I've found that it is hard to find well-informed doctors here, as it is a rare and hence still mysterious disease.  I feel like often I am teaching doctors about the disease more than they are teaching me.  However, I feel confident that the doctors I've consulted are some of the best in the world (at MassGen, and NY Presbyterian.) 

      Thanks and good luck!

      Aaron

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  • Posted

    sameeeeee problem aaron. i had achalasia since 5 years, I get the same kind of pain once in two weeks, when i drink a glass of water i goes away, but there are days when the pain doesnt reduce for the whole day. i feel its a clear acid reflux. i stopped having oranges and all citric stuff. i suggest u to have 1/2 litre water in the mornings, and no spicy stuff encouraged. AND I RECENTLY STARTED HAVING COOL ICECREAM WHEN I GET UNCONTROLLABLE THE PAIN AROUND THE CHEST, IT WORKS smile  try it. 
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    • Posted

      Thanks for sharing, Dimpi! haha ice-cream is the cure for everything.  I confess that I am sometimes guilty of not staying hydrated, and I have to remember to stay hydrated.  And I don't eat most citrus or spicy stuff, but it is hard to tell if those things actually cause me trouble because sometimes I think I have trouble with them and sometimes I don't.

      Thanks!

      Aaron

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  • Posted

    Hi Aaron, I get this all the time. I too have had achalasia for 10 years. I had a Heller Myotomy with a partial fundoplication soon after i was FINALLY diagnosed. I have had the pains the whole time but they seem to have gotten worse and more frequent over time. As a former paramedic that was familiar with heart attack symptoms I can only compare the pain to a heart attack (symptomwise, not from experience). The pain is sometimes my whole chest, one side, or right in middle and often radiates into my left or right jaw. I have NO idea why and none of the doctors can be sure. After staying away from GI docs due to frustration in their lack of knowledge masked by arrogance, I finally, after 5 years went back. Same thing so far but at least this one is going to refer me to Dr Richter at USF in Tampa, Florida USA who is known to be an expert in achalasia and the esphogus. Luckily this is only a 2 1/2 hour drive for me once an appointment is made. I don't know what will become of it and don't expect much, I am trying to avoid another manometry as I would rather have chest pains forever than experience that horror again right now as well as medications daily. I take 10 mg nifedipine when I get the pains and often pop the capsule for a quicker effect. It works but leaves me with red feet and a lingering headache. Sometimes just the water works, and sometimes I use pepto or mylanta in case the pain is from old food fermenting in my esophogus. Since I don't know what it is I use the above methods until it goes away. I have come to tolerate some major pain but worry that someday what I am having will be a real heart attack and not just a chest pain episode. If I ever find out what it is or if the specialist of specialists helps me I will share with everyone!

    Michelle

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    • Posted

      I chickened out. They asked me to come up there and do the manometry. I cant do it. The thought of that tube in my nose and the banana flavored numbing agent (that doesn't work anyway) puts me into esophageal spasms just thinking about it. It will have to get REALLY bad before I put myself through that again sad
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