Nutcracker Esophagus

Nutcracker esophagus is an abnormality in which swallowing contractions are too powerful. In up to half of patients, this condition is caused by gastroesophageal reflux.

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Symptoms

Symptoms include:

Chest pain - Experienced by most patients with nutcracker esophagus, chest pain may feel the same as the pain produced by a heart attack.

Dsyphagia - This is characterized by the sensation of food getting stuck under the breast bone.

Heartburn - This is a burning sensation under the breastbone.

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Diagnosis

In confirming this condition, a doctor will do certain tests, including:

Esophageal manometry. This test identifies the excessively powerful swallowing contractions.

Upper GI endoscopy. This test is almost always done if a patient describes food sticking in the esophagus after swallowing to make sure that no abnormal growths or scars in the esophagus are causing this symptom.

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Treatments

Among the options for helping people with nutcracker esophagus are:

  • Anti-reflux therapy. This is usually tried first since many patients with nutcracker esophagus have GERD.
  • Drugs, such as nitrates or calcium channel blockers. These help relax the muscles of the esophagus and stomach. They do relieve some patients, but overall they are not very effective.
  • Tricyclic antidepressants. These drugs work by lowering the sensation of pain for some patients.