Nutcracker Esophagus
Overview
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.
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.
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.
Treatment
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.
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