I frequently have severe esophageal spasms that send me to the emergency room. Is there a treatment, besides botox, that can help reduce the number of spasms?

HI Mer-

My son is 13 and use to have the spasms really really bad! We tried nitroglycerin tabelets and they done nothing.James use to be able to guzzle ice cold water and that would make them go away almost instantly.Some other achalasians try milk,icecream,even eating crunchycereal and that helps these go away. After a while the icewater stopped working and the DR gave him nifediphine tablets.Now when he feels one coming on he takes one and it knocks them out usually just a few minutes.If its really bad it makes it very tolerable and almost gone.They have been a life saver for him.He use to lay in the floor and scream sometimes too the ER.

Try some of the ideas here next time and see if they work,if not talk with your DR and ask for a rx for them.Best of luck , let me now how it goes


Hi - I have tried a variety of things over the years. I've tried both nitro tabs and niphedepine and while they both worked, they can also have very severe side effects. Be careful of the drop in blood pressure - no one told me about it and mine dropped so low it put me into shock!

You can also experiment with a bunch of different things - some work well for one and others work better - it seems to be a very individual thing. One key element is to catch it ASAP!! If I can catch a spasm really early - usually just chugging water helps. I also like to use vanilla yogurt - the custard kind - if I'm at home. At work and in my car I keep saltines or shredded wheat - they seem to also work well.

As far as medication, the only thing that has worked well on me without the nasty side effects is amitryptaline. It increases the seratonin levels in your blood and seems to really help prevent the spasms from starting. I've had A for well over 25 years but I've only been taking the amitryptaline for about 6-8 months and it has made a serious improvement. Now - I'm not aware of ANY thing that will make your spasms go away completely - these are all just things that help.

 As with anything else, good eating habits and good sleep, low stress, etc. also help.

good luck!

Happy Swallowing!

-Michelle in NC

Hi, again. I am going nuts. I went to the ER 3 days in a row because of the esophageal spasms. On a daily basis I take Cardizem LA, Protonix, and Zantac. I use the nitro pills when I first feel a spasm start, but lately it’s not affecting them at all. When I get the spasms I can’t eat or drink anything cuz it makes the spasm worse. I’ve had a Heller Myotomy and numerous dilations and my doc doesn’t think it would be safe to dilate it anymore due to the increased risk of perforating the esophageal wall.
I’m just getting really tired. When I go to the ER they give me IV injections of Glucagon, Phenergan, and Ativan. And then I’m out of it for the next 12 hours. Yuck. Does anyone else out there have really severe spasms fairly often? How are you coping? I’m getting pretty scared. The spasms are happening more often and the severity is worsening. I can’t go through all the crud again if my esophagus closes again. I just can’t.
Thanks for “listening”.

Next time ask them about a “Pink Lady.” It numbs, soothes, and calms the esophagus from the inside. It is known as the “GI cocktail”, the Pink Lady is a mixture of liquid antacid and viscous lidocaine, and may also include an anticholinergic agent.The lidocaine numbs. The antacid sooths and if included the anticholinergic calms contractions. Depending on what causes your spasms this could stop them. No guarantee.


So my theory is “panning” out that stress is most likely related to what has happened. I happen to work at a University Hospital and am going to visit one of the GI docs and pick his brain for some information!

Thanks for letting me know what you knew all along!


I think you responded to incorrect e-mail. I never was in ER nor had esophageal spasms. But thanks for the info.


Tell me something, I have this theory but it’s only theory. I will assume you work. How is your job? Do you find yourself under a lot of pressure be it real or imagined. I was under pretty severe pressure for about 7 yrs when my mom & dad did their thing and died and I was laid off & rehired into a field I don’t care much for. Now that I am down the road a piece and calming down, I found that those 7 years did my body more damage then if a truck ran me over! I too get stressed out from work and have the ability to retire but need the money (like everyone else). I am just wondering (theory wise) if something like yoga, relaxation techniques, would help us.

Let me know what your thoughts are. I also wonder if you had better management of your meds so that if a spasm started you could take something at home to help head it off. Maybe something to ask your GI doc or 2nd opinion.

Don’t give up, take control!!!


Hello, MomKBurns.

First, this message is being sent to the Achalasia Community Forum. It will be posted there in the forum, but it will also be sent to everyone that is set to receive new messages in that forum in their email, basically everyone in the CarePlace Achalasia Community. You can tell it was sent to everyone in the forum by the CarePlace signature section which will will have the first line saying “notan ostrich posted the message below in the Achalasia Community Forum.”

MomKBurns wrote:

… I was under pretty severe pressure forabout 7 yrs …

Many people with achalasia believe that stress played a part in developing it and that it makes it worse. Stress changes the levels of chemicals in the body and has an impact on the immune, and neurological systems. Both of those system directly impact the GI tract. In achalasia there is evidence that chronic inflammation of the esophagus by the immune system plays a part in damaging neurons there. Exactly why and how it happens is a matter of research. Anyway, many will tell you they feel better and have less problems with swallowing and spasms when under less stress, so things that help with stress may help with achalasia.


Dear Mer,
yes, the spasmns are the most severe pain I ever had. But there might be stuff you can do:

  1. prevention:
  • I tend to get spasmns if my stomach is overly acidic, so I take tums regularly, especially before laying down. Also at the first hint of heartburn or spasmn I take a tums or two with cold water. Sips of ice cold water sometimes stops them. Also saltine crackers help if taken immediately.
  • I also get spasmns after eating gassy food or if I feel bloated. If I feel gassy or bloated I take some Gas-Ex to prevent the spasmns.
  • I am lactose intolerant. Milk products tripper indigestion and spasmns for me.
  • I have several food allergies which trigger indigestion and spasmns.
  • an empty = acidic stomach triggers spasmns for me, so I’ll eat frequent small meals, and a couple of crackers with a tums before going to bed.

find out what triggers YOUR spasmns, everyone is different: do they happen at certain times of the day or night? After certain foods, after spicy food? At the end of a stressful day? Do they happen more on an empty stomach, or after a meal?
Is alcohol triggering it? Gassy drinks like sodas, beer?
Is a lot of coffee or black tee making it worse?

Make sure you rule out lactose intolerance.
Make sure you have no food allergies (only a certified allerologist can perform the tests to find out).

Look back at fairly spasmn free times: what was different?

Stress during the day definately aggrevates my spasmns. If this is the case, find some things that help you destress (much easier said than done, but there are lots of resources out there, books, tapes, websites).

  1. head the early warning signs:
  • act right away. A hint of sour stomach, a tingle of a heartburn, a bloated feeling could develop into a full grown monster. Get off the phone, leave the meeting, pull the car over. Squelch it immedately. Try different things (see posts) and see what works for you. I have always tums, water and crackers with me (at work, in my car, at my bed).
  1. during a spasmn episode:
  • a cocktail of tums, gas-ex and motrin sometimes help to tame a spasmn
  • sometimes pepto-bismol helps (read medication labels to prevent harmful interactions: e.g. never take pepto-bismol with aspirin)
  • try different suggestions: sip ice-old water, or warm water, or cold milk, icecream. Try crackers, bread or plain pasta; try something syrupy and mild like a cool yogurt, or maybe some warm broth. You are already miserable, so just try different stuff, you might be surprised what helps.
    Also what helped last time, might not help so much this time. So keep trying and adjusting.
  • try to stay as calm and as relaxed as possible. Change into comfortable clothes, Know what relaxes and calm you.
  1. after an episode:
    You made it! The spasmns are very stressful and painful episodes, so take good care of yourself afterwords. Catch up on lost rest when you can. Treat yourself to something nice and relaxing.

  2. prevent the next episode:
    look back on what could have triggered this one. Maybe keep a dairy or put a note in your calender:

  • what could have triggered it?
  • what helped during the episode?
  • what can you do to prevent the next one?

That’s all I got. With the very best wishes, TanTan7007

That’s the whole thing. I never have spasms. I never knew what I had until a barium swallow to check on a hiatal hernia showed my esophagus and it didn’t look like a tube at all. It looked like bat wings up and down the esophagus. By the time I had the manometer, I was scared to death. So spasms don’t scare me as I never have them. Once in a great while I find food that wants to “sit in my throat” and I end up vomiting it out rather than trying to keep it down.

I too have severe allergies to food along with airborne allergies. I have to be very careful about foods as I am allergic to: milk, wheat, eggs, brewer’s yeast, cranberries, coffee, cheese, beets, bananas just to mention a few. So I know what you mean about avoiding those and you feel much better. It may be why I never had a spasm as I have “followed the instructions.” Oh, that goes for alcohol, too. I don’t drink or smoke and due to PCOS (polycystic ovarian syndrome), I am classified diabetic, I don’t eat the bad things. But, I still am overweight. So, this diagnosis has be befuddled. I understand that usually, you lose weight. What’s up with this picture?

Thanks for any help.


MomK - I was wondering if you wouldn’t mind starting a new topic on stress related to achalasia. I think intertwining this with the spasm topic is getting a little confusing. They are both very good and interesting topics. Thanks!

I will leave these questions for the Medical community and see what they say.

Take care,

try taking peppermint tea or sucking on peppermints it helps. Try that before bed.


None of my Doctors could understand why I was getting frequent spasms. Everytime I got a spasm I would have to call out sick from work. I was getting spasms as frequent as two times a week. I called out so much from work that I was forced to quit my career as a corrections officer. None of my doctors believed me when I woud call the during a spasm and ask them to write me a Dr. Note for work. “A” has really affected my life.

Carbonated beverages ( pepsi, ginger ale, anything with carbonation) works for me

Guess what? I'm having an episode right now. I am 17 years old and I have been dealing with spasms for about 10 years. At first, after me surgery, my parents and my brilliant doctors hooked me up to a heart monitor for 3 months, but then my mom discovered what they actually were. The infamous spasms of Achalasia. My soulution messes things up sometimes but it works without fail. When you feel spasms coming on, run to the medicine cabinet and knock yourself out with the maximum dosage of nighttime tylenol, or bendryl. Any sort of muscle relaxer will do, and you may be able to get one perscribed.

Personally, none of that other stuff works for me. I've tried it all. I hope this helps! These stupid things are the bane of my existence, and they are probably your's too. Well, I feel my medicine kicking in. Starting to get tired after over an hour of pacing a crying and dying. Good luck!


Please explain what you mean by spasms.

i have spasms without fail at around 3.00am every night (except if i have been drinking a lot). i take a banana to bed and eat it and that stops it.

I am going to chip in my two cents and always always do your own research.

I am currently undergoing tests to diagnose weather or not I have EOE or Achalasia. I have had the "Spasms" for almost a year now. When they first started they were the only symptom I had so I thought it was related to my neck. At the time I was undergoing chiropractic treatment for 2 herniation in my lower spine. The first few times I had the Angina like spasms I really thought I was having a heart attack. I quickly started to experiment on my self to find a way to stop them from happening. In my case (PLEASE TALK TO SOMEONE BEFORE TRYING THIS) I would have to "pop" my neck. I would have a pain at C1 right at the base of my skull. I would turn my head until it "popped" then I would take a drink of water. The pain would stop immediately! But only the combination of the two actions. Popping my neck alone would not stop it neither would drinking water. After a few weeks I began having issues with swallowing and I have a lot of the symptoms for both EOE and Achalasia. I have had my first Endoscopy and I am waiting for test results from my biopsy. I am scheduled to have a test for Achalasia in early August. I still get the Angina like pain frequently but the same method still applies to stop it. As a side note, I have had an MRI of my spine and neck. I do have 2 herniation there as well with minor impact to my spinal chord. The doctors do not believe it is related, but I find it odd that I can stop the pain by adjusting my self. It does not however help with eating. I am down 60Lbs from Feb of this year. We will see how it goes.