Esophageal Spasm and RLS

For everything and anything else not covered in the other RLS sections.
stjohnh
Posts: 1284
Joined: Sun Feb 14, 2016 3:13 pm
Location: Palo Alto, California

Re: Esophageal Spasm and RLS

Post by stjohnh »

LSM wrote:
Mon Feb 01, 2021 2:55 am
What do you do for the esophageal spasms? They put me on TCAs for the pain but I heard that’s bad if you have RLS.
Get off the TCA (Tricyclic Antidepressant) if you can, they definitly make RLS symptoms worse.

I have now have had 3 courses of IV iron, I am 7 months from the last one, my iron is dropping, and my chest pains are getting more severe, more frequent, and again occuring with less relation to swallowing. I've had a slow progression and now food and liquid gets "stopped up" in my lower esophagus a couple of times a year. By that I mean, I swallow, get a little pain, swallow again and pain worsens. I stop swallowing and 1-2 min later start coughing and get the urge to vomit. I regurgitate what is in my esophagus, spit it out, and am better. I know it is not "vomiting" because there is no acid taste or bile taste like comes from an intestinal virus or eating bad food.

Anyway, I started looking on the internet for a forum like this for esophageal spasm to find out what others are doing. Guess what!! Peppermint oil works!! There have been anecdotal reports of it working for years, but in 2019, a study was done which proved peppermint oil helps those with esophageal spasm. I've only been using it a week or so, and the improvement is dramatic. I was getting fairly severe chest pains more than 10 times a day, now getting a couple of mild chest pains a day and I can eat what I want again. Chicken for some reason has had a much greater liklihood of getting "stuck" than anything else.

I am still working on the best dose and route to take it. I am currently taking 250mg 4 times daily, as 8 drops put into a gelatin capsule. But have also tried 10 drops in 1/2 cup of water and gulped down prior to eating, this works well also, but I don't like the flavor. Peppermint oil tastes about like a peppermint candy, but MUCH MUCH stronger, not good at all. The oil is sold on Amazon and also available on amazon as capsules (though most have only 50mg peppermint oil) and enteric coated capsules (for people with IBS-irritable bowel syndrome). A nice side effect, my breath smells like peppermint a lot. LOL.

Esophageal spasm is still a big black hole as far as scientific understanding goes. I still think it has a basis in iron metabolism, though there is also evidence that nitric oxide plays a role as well. Some other similarities to RLS: More frequent in women, more frequent episodes in the evening, some familial pattern, more frequent in people with low ferritin, and cause is unknown. The most reliable prescription med used is nitroglycerine under the tongue, works fairly well, but lots of people get severe headache from it. Other meds are used but none are very reliable. Surgery is used in severe cases.

For those reading this, be aware that the chest pains are VERY similar to pain from heart problems, and heart disease as a cause of substernal chest paind is MUCH more common than esophageal spasm, so if you are getting chest pains you should see a doctor to make sure pains are not from heart trouble.
Blessings,
Holland

Rustsmith
Moderator
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Joined: Sat Sep 28, 2013 9:31 pm
Location: Colorado Springs, Colorado

Re: Esophageal Spasm and RLS

Post by Rustsmith »

Holland, how are the symptoms of esophageal spasm different from those of GERD or hiatal hernia?
Steve

https://www.mayoclinicproceedings.org/a ... 0/fulltext
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

stjohnh
Posts: 1284
Joined: Sun Feb 14, 2016 3:13 pm
Location: Palo Alto, California

Re: Esophageal Spasm and RLS

Post by stjohnh »

Rustsmith wrote:
Mon Feb 01, 2021 7:17 pm
Holland, how are the symptoms of esophageal spasm different from those of GERD or hiatal hernia?
GERD ("reflux" "heartburn" GastroEsophageal Reflux Disease) pain is much more common in overweight people, pain is usually in the lower sternum or epigastric area, is worsened by acid foods, lasts 1/2 hour to several hours, is much better with antacids (Maalox, Mylanta, etc) or acid reducers (Zantac, Tagamet, Prilosec, etc) and is commonly worsened by big meals or lying down.

Hiatal Hernia usually doesn't cause pain and if if does the pain is similar to GERD.

Of note, none of these (Esophageal spasm, GERD, hiatal hernia) is typically worsened by exercise, while heart pain is frequently worsened by exercise. Heart pain and esophageal spasm pain typically last 30sec to a few minutes. Heart pain and esophageal spasm pain is typically sub-sternal, sometimes with radiation to the left shoulder or jaw. Esophageal spasm pain is typically initiated by swallowing food (though for me, when my iron is low, it will occur with no apparent cause).

Also note, heart disease and GERD are common, esophageal spasm is uncommon.
Blessings,
Holland

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