The spasms tend to last for a long time and can make it hard to swallow.
Some health professionals believe thatgastroesophagealreflux disease (GERD)triggers jackhammer esophagus.
The actual incidence of jackhammer esophagus is unknown.
Science Photo Library / Getty Images
It may radiate to your back.
Seek emergency medical care if you experience heart attack symptoms such as chest pain.
Diagnosing Jackhammer Esophagus
Diagnosing jackhammer esophagus can be difficult.
The condition may initially be misdiagnosed as another illness that causes similar symptoms.
Your healthcare provider will consider your health history and reported symptoms and conduct a physical exam.
Other tests may be used to rule out overlapping conditions.
Providers typically utilize a bang out of manometry called high-resolution manometry.
Peristalsis is the movement of the smooth muscle in the esophagus.
Distal latency is nerve conduction.
A normal esophageal contraction is considered between 4508,000 mmHg-s-cm.
Barium Swallow
Abarium swallowis a special key in of X-ray test, also called bariumesophagography.
It is often used in addition to upper endoscopy to look for obstructive lesions.
Upper Endoscopy
Anupper endoscopy called anesophagogastroduodenoscopy(EGD) visualizes the upper gastrointestinal (GI) tract.
Some use the terms interchangeably.
However, the term “nutcracker esophagus” is no longer used.
Treating Jackhammer Esophagus
There are several treatment options for jackhammer esophagus.
The cause of jackhammer esophagus is poorly understood, making finding an effective treatment challenging.
Sometimes, a healthcare provider will recommend a wait-and-see approach to treating jackhammer esophagus.
Examples include:
You may find a combination of lifestyle modifications along with other interventions most helpful.
Controlling GERD
Gastroesophageal reflux disease (GERD) often presents with jackhammer esophagus.
Thus, one treatment option is usingproton pump inhibitorsto reduce the amount of stomach acid produced.
Calcium Channel Blockers and Nitrates
Calcium channel blockersand nitrates relax smooth muscle.
A provider may also prescribe phosphodiesterase-5 inhibitors, another medication that can relax smooth muscle.
Additional Medications and Supplements
Low-dose antidepressants can effectively reduce chest pain.
However, it is less invasive and has a lower risk than esophageal dilation and surgery.
Botox is injected by endoscopy into the lower esophageal sphincter to decrease contractions.
Botulinum injections are effective.
However, most patients will require repeat injections in six to 24 months to maintain their effectiveness.
Esophageal Dilation
Esophageal dilation involves inflating a special balloon in the lower esophageal sphincter to disrupt it.
It is done endoscopically and may need to be repeated to be effective.
Other Esophageal Procedures
Another treatment option isperoral endoscopic myotomy(POEM).
Including the lower esophageal sphincter seems to be the most effective in symptom resolution.
In this procedure, your healthcare provider willuse an endoscopeand go through your mouth to access your esophagus.
The provider will then cut through the muscles to loosen them.
Summary
Jackhammer esophagus is a condition that causes too-strong esophageal contractions.
It can cause several uncomfortable symptoms, including chest pain and swallowing difficulties.
High-resolution manometry measures the strength of esophageal contractions.
It is used in conjunction with additional tests to rule out other conditions and aid in diagnosis.
National Organization for Rare Diseases.Jackhammer esophagus.
Achem SR, Vazquez-Elizondo G, Fass R.Jackhammer esophagus: current concepts and dilemmas.J Clin Gastroenterol.
2021;55(5):369-379.
Hong YS, Min YW, Rhee PL.Two Distinct Types of Hypercontractile Esophagus: Classic and Spastic Jackhammer.Gut Liver.
2015;27(2):160-174.
Wilkinson JM, Halland M.Esophageal motility disorders.American Family Physician.
2020;102(5):291-296.
2020;26(2):224-231.
Sirinawasatien A, Sakulthongthawin P.Manometrically jackhammer esophagus with fluoroscopically/endoscopically distal esophageal spasm: a case report.BMC Gastroenterology.
2017;30(3):1-5.
2016;4(5):E585-E588.
