Esophageal Spasms

Your healthcare provider will perform a physical exam to evaluate your symptoms. If you have chest pain, your provider may order tests, such as an electrocardiogram (EKG), to rule out heart disease.

Once they’ve ruled out heart disease, they’ll likely perform tests to rule out more common conditions that may be causing your symptoms. These include:

• Upper endoscopy: For this test, your provider will insert a narrow tube called an endoscope into your esophagus. The endoscope has a light and a tiny camera at one end so your provider can view the inside of your esophagus. This test helps your provider see if you have structural irregularities causing your chest pain or trouble swallowing.
• Esophagram (barium swallow): This test requires you to swallow a solution containing barium. Your provider will view X-rays that show the barium moving down your esophagus. It can help a provider rule out other causes of your symptoms, like a stricture (narrowing).

Tests used to diagnose esophageal spasms specifically include:

• Esophageal manometry: This test measures pressure waves inside your esophagus when you swallow. It’s the gold-standard (most used and reliable) test to diagnose esophageal spasms. An unusually large number of simultaneous contractions in your lower esophagus is a major indicator of spasms.
• Functional lumen imaging probe (FLIP): FLIP is a newer test that can provide information about movement within your esophagus. This includes your esophageal wall’s ability to respond to pressure changes.

What can mimic esophageal spasms?

Esophageal spasms can be tricky to diagnose since several conditions cause the telltale symptoms: chest pain and trouble swallowing.

Once your provider determines your issue isn’t heart-related, they’ll rule out more common digestive system conditions with similar symptoms. These may include:

• GERD (which often happens alongside esophageal spasms).
• Esophageal strictures.
• Hiatal hernia.