Cricopharyngeal spasm

Cricopharyngeal spasms occur in the cricopharyngeus muscle of the pharynx. These spasms are frequently misunderstood by the patient to be cancer due to the 'lump in the throat' feeling (Globus pharyngis) that is symptomatic of this syndrome. In practice, real lumps in the throat, such as a cancer, are generally not felt until they impede ingestion of food. This is one of the reasons that a cancer can get so big before it is discovered. However, a cricopharyngeal spasm is a harmless, if uncomfortable, self-limiting disorder and will resolve itself over a period of time.

Physiology

There are two valves in the oesophagus. They are normally contracted and they relax when you swallow so that food can pass through them going to the stomach. They then squeeze closed again to prevent regurgitation of the stomach contents. If this normal contraction becomes a spasm, these symptoms start. [1]

Symptoms

  • Sensation of a 'lump' in the back of the throat
  • Throat feels swollen
  • Discomfort - Lump can often feel quite big and pain is occasional
  • Symptoms normally worse in the evening
  • Stress aggravates the symptoms
  • Saliva is difficult to swallow, yet food is easy to swallow - eating, in fact, often makes the tightness go away for a time
  • 'Lump' sensation comes and goes from day to day
  • Symptoms can persist for very long periods, often several months.
  • The symptoms can be mimicked by pushing on the cartilage in the neck, just below the Adam's apple

Causes

Stress and Anxiety. Other causes are not yet clear. In some cases, eating certain foods may bring on acute spasms, in susceptible individuals. Peanuts, pumpkin seeds and other nuts may trigger these spasms.

Cures

No real 'cure' exists, the sufferer must simply wait for it to fix itself. A number of treatments will make it much less noticeable;

  • Muscle Relaxants
    • Lorazepam (Ativan), diazepam (Valium) and other benzodiazepines relax the smooth muscle in the throat, slowing or halting contractions. In some people, benzodiazepines may have addictive properties.
  • Reduce Stress
    • High stress levels make these spasms more noticeable
    • It is advisable to take note of when your symptoms are at their worst
  • Warm Fluids
    • Consider a cup of warm tea when the lump is bothersome.

References

External links

  • James P. Thomas, MD
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