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I asked my gastroenterologist about this one. The missing nerve endings in the oesophagus and at the LES are not the same ones that control the muscles in the LES itself. The 'default' condition of the LES is to keep it shut, so as to prevent acid reflux. The spasms occur when the LES cannot control how 'shut' it is, and just keeps pulling itself together until 'something' intervenes. In my case, nifedipine, being a smooth muscle relaxant, excludes the calcium which gives the sphincter its 'power', making it go limp. This 'intervention' eases the spasm.

What I can't understand is that it doesn't work for everybody, when the physiology of the condition is common to all of us.

Terry Hickmott

Chester, UK

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Terry, Thanks for the education. I had wondered about how it happened. The "why" part seems to vary from

one person to another, and differing circumstances.

When I get the spasms (most usually at night), I drink

something cold. It used to be milk, but now that I don't

consume dairy products, it's whatever is in the fridge. So, is calcium the preferred remedy? Or did you mean

calcium accerbates the spasm?

If the cold drink doesn't give me immediate relief, I switch

to hot water or hot herbal tea. If that doesn't work, I go for the drugs: alcohol or the awful tasting Nyquil. Those are known to work and/or knock

me out.

I too had tried Procardia, but the headache it gave afterwards

was not worth it for me.

in Oregon

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Forget the cups!!! Try carrying a bottle of water, AND an empty water bottle. That way, you can at least cap it off!!!

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Hi Sue, welcome to the group. I'm glad you found us.

I can contribute to your one question about whether I get spasms more severely with Mr. Monthly (aka Aunt Flo, "the curse", Red day, etc). My answer is no. I had a hysterectomy two years ago. I still get spasms.

Boy, don't we (women) wish the two were related? Then

we'd only get them once a month... and menopause would

would be a sweet occasion!

in Oregon

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Hi Sue

I never thought of plastic cups but I always make sure my handbag contains a carrier bag (without air holes) for accidents!

Thinking about your comment about the monthly curse, I find that I am able to swallow a little more during mine. Odd isn't it how we all differ and suffer different symptoms of the disease.

Take care

Lynn (UK)

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Hi Sue and welcome to the group. I am also relatively new to the

Board. I found your comment about the cups quite amusing. I

actually never leave home without a stash of ziploc bags. My husband

just shakes his head, but is now coming to terms with it. I also

have trouble understanding the use of bread for relief. This has

always been one of the worst foods for me. Dry cereal, heavier

types, can sometimes bring me some relief, but bread has always been

out of the question. I long for a piece of pizza. It will be one of

the first foods I attempt once I find some relief. I have recently

been in for my first dilatation. Unfortunately, I was not one of the

lucky ones who had instant relief. I am going in again this coming

Monday where they will attempt a larger balloon. I didn't find the

first procedure to be too bothersome. It was a little uncomfortable

when the balloon was being blown up, but that was short-lived. As

someond else mentioned, it doesn't differ a whole lot from a standard

endoscopy...just an extra tube or two. :) I was also very

apprehensive before going in for my first dilatation, not knowing

what to expect. When I was walking out of the hospital about 4 hours

later, I wished I hadn't spent so much energy concerning myself with

the procedure. Take care and the best of luck to you!

(Ottawa, Canada)

> YES, I NEVER GO ANYWHERE WITHOUT A BOTTLE OF HOT WATER IN THE

PURSE,

> AND OF COURSE MY STASH OF DISPOSABLE CUPS FOR THE CONSTANT

> REGURGITATION...DOES EVERYONE ELSE HERE KEEP CUPS IN THE PURSE,

CAR,

> WHEREVER YOU GO, OR IS IT JUST ME?? AS FOR BREAD OR COOKIES, I

NEVER

> FOUND THAT A RELIEF, BREAD WAS ONE OF THE FIRST PROBLEM FOODS I HAD.

> WHENEVER I SEE SOME STRANGER HOLDING A CUP, I JUST WANT TO RUN UP

TO

> THEM AND SAY " ?ACHALASIA? " BUT THEY MIGHT THINK I AM SOME KIND OF A

> NUT! hahaha

>

> ALSO, THIS IS A QUESTION FOR THE LADIES ONLY, SO MEN OF THE LIST,

BE

> WARNED...

> I ALWAYS SEEM TO GET THE SPASMS MORE SEVERLY WHEN IT IS TIME FOR

> MY " MONTHLY " (BLUSH-BLUSH)...DOES THIS HAPPEN TO ANY OF YOU?

> SORRY GUYS, BUT I WARNED YOU FIRST...LOL

>

> I KNOW I AM POSTING ALOT, AND LONG POSTS TOO, BUT FINDING THIS SITE

> TODAY HAS ME EXCITED TO FIND OTHERS WITH THE SAME PROBLEM. PLEASE

> FORGIVE THIS NEWBIE TO THE LIST...I'LL GET OVER THIS SOON.

> SUE

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Hi Sue,

Welcome to the group! It's very exciting to find so many others who

also share this lovely affliction. I laughed and I cried. It was

very emotional for me.

I've had " A " for almost 8 years now. The first 2-3 years were the

worst for me.I couldn't go anywhere without burping up white foam.

I'd be out shopping and suddenly I'd have a mouthful. I kept my cup

out in the car and usually didn't get much shopping done. I hated

that foam. I don't get it much anymore.(whoops, here comes a

mouthful... I shouldn't have said that). I had lap surgery last May.

I never had any dilatations so I can't share any experiences about

that with you. My GI doc didn't want me to go that route. My surgery

was 5 hours long because my esophagus perforated due to all the scar

tissue. I was in the hospital for a week. My Dr. was wonderful. He

repaired the perforation without having to open me up and the

perforation healed quickly. Sorry you had so many problems with your

gall bladder surgery. Hopefully you will be able to drink your warm

water again soon. Warm tea is what worked for me. I never made a

connection with the spasms and the monthly thing. I just used to get

spasms all the time. They would start in my chest and radiate up

into my neck and make my teeth ache. If I burped (belched), the pain

went away, so I always assumed, and still do assume that the pain is

related to having air trapped in my stomach. Mylanta or Maalox

always work for me.

Wishing you a successful dilatation, and

I wish you, and the rest of our " Achalasia Family " a Happy Healthy

New Year!

Sandi in No Cal

---

In achalasia , " crownroyalyorkies

<crownroyalyorkies@y...> " <crownroyalyorkies@y...> wrote:

> YES, I NEVER GO ANYWHERE WITHOUT A BOTTLE OF HOT WATER IN THE

PURSE,

> AND OF COURSE MY STASH OF DISPOSABLE CUPS FOR THE CONSTANT

> REGURGITATION...DOES EVERYONE ELSE HERE KEEP CUPS IN THE PURSE,

CAR,

> WHEREVER YOU GO, OR IS IT JUST ME?? AS FOR BREAD OR COOKIES, I

NEVER

> FOUND THAT A RELIEF, BREAD WAS ONE OF THE FIRST PROBLEM FOODS I

HAD.

> WHENEVER I SEE SOME STRANGER HOLDING A CUP, I JUST WANT TO RUN UP

TO

> THEM AND SAY " ?ACHALASIA? " BUT THEY MIGHT THINK I AM SOME KIND OF

A

> NUT! hahaha

>

> ALSO, THIS IS A QUESTION FOR THE LADIES ONLY, SO MEN OF THE LIST,

BE

> WARNED...

> I ALWAYS SEEM TO GET THE SPASMS MORE SEVERLY WHEN IT IS TIME FOR

> MY " MONTHLY " (BLUSH-BLUSH)...DOES THIS HAPPEN TO ANY OF YOU?

> SORRY GUYS, BUT I WARNED YOU FIRST...LOL

>

> I KNOW I AM POSTING ALOT, AND LONG POSTS TOO, BUT FINDING THIS

SITE

> TODAY HAS ME EXCITED TO FIND OTHERS WITH THE SAME PROBLEM. PLEASE

> FORGIVE THIS NEWBIE TO THE LIST...I'LL GET OVER THIS SOON.

> SUE

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,

I get muscle spasms too. Unfortunately, stretching sometimes seems to

trigger them, but not stretching isn't good either. For some reason, the

one move that doesn't set them off is swinging my arm in a large circle

forward a few times then backwards a few times. That's weird I know.

I find that calcium with magnesium helps. When I first went on prednisone

it helped but then wore off. Doing a yoga video for senior citizens (I'm

40, and not a senior citizen but it's the same principles as for people with

arthritis) helps. Turrning the shower to a real warm temperature and

letting it beat on my back for a while helps.

, there are excellent medications for AS now. Someone just being

diagnosed now should do better than people have in the past. I'm on Enbrel,

a new medication given by injection that is very effective for AS. Make

sure you have a doctor who's really current and really knows how to treat AS

and be aggressive and persistent about getting the newest, most effective

treatments.

Good luck and let us know how you're doing.

God Bless,

Janet in SF

Reactive Arthritis since 1973; diagnosed 1997

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, your Doctor should have some medications that will help with the

muscle spasms. It is best if you let him/her know about them. In the

meantime, ask your pharmacist about what muscle relaxants they have on hand

that do not require a prescription. There are several non prescription drugs

available. Also ask your Rheumatologist about gentle stretching, HOWEVER, do

not attempt stretching yourself if you have AS. AS patients should only do

stretching exercises under the direction of a rheumatologist and a

physiotherapist after x-rays have been taken and analyzed. You can easily

make things worse by following a stretching class or regime designed for

non-AS patients. The same goes for physical exercise, gentle exercise under

the direction of a physiotherapist will help, but too much exercise will do

you more harm than good. Sorry but this is a harsh reality for AS patients.

Fortunately there are many physiotherapists who will be able to give you a

program specifically designed for AS patients in order to maintain strength

and flexibility. Hope this helps, Matt

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dearest krae , yes muscle spasms have been a big problem for me .

usually they are at their worst a night . Especially

when im trying to fall asleep and my neck and sh

oulders are totally inflexible and painfull . the best help for this

problem that i have found is 5mg. Valium. i had tried all muscle

relaxants without much success ............ they all managed to make

look like im totally loaded , even if im as straight as the day i was

born !!!!!. i have been accused of public drunkene ss and aressted and

humiliated in front of my children !!!! ..... all due to taking my

medicationin an effort to try and lead a normal life

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> What do your spasms feel like? What makes them worse or better? I

> think I get them with stress and hot liquids (tea or coffee, even

> decaff)but I can't be sure what I'm feeling.

> Thanks,

> I

Spasms feel like I imagine it would feel to have a very sharp knife

thrust through the back of my neck and have it come out the front of

my throat. I usually know one is coming by a feeling of intense

reflux in the back of my throat at the base of my tongue that keeps

getting worse until I have to make a mad dash for ice water and

Nitro. Occasionally stretching my neck helps, but not often. The ice

water/Nitro combo works well, but it still takes a couple of minutes,

which can seem an eternity when the spasm is intense. I've never

noticed one thing or another triggering one, although I do hear that

sometimes. Mine occur usually in the middle of the night when I've

been quiet and asleep for hours with no provocation at all.

Does anyone else have a problem with residual pain after the spasm is

over? I still have chest discomfort and a feeling of pressure hours

after having a particularly bad spasm. Sound familiar to anyone?

Sharon

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Sharon, I get residual pain after my spasms like you explain. The

chest pain that feels like someone is pressing hard down on my chest

occurs a lot as well, and not JUST after a spasm for me, more like

all the time. In addition, my spasms mainly occur at night like you

said, but after I lay down for a while, but before I fall asleep

usually. Do you have any idea for the cause of these pains?

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No , I don't know why we have that annoying chest pain. I wish I

did though. Maybe then a solution could be found for the problem.

I've had mine since 5:00 this morning and it feels just as you

said.....like someone pressing down on my chest.

Sharon

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I get those spasms, and when I do I take some antacid and ibuprofen and they go away within an hour.

I am not sure this is the most healthy thing to do, but it works. One time at the ER they gave me some mylanta or maalox with a topical painkiller in it and that worked good too. I thought i was having a heart attack, and then of course got all panicky and hyperventilated (panic attack).

That pain was one of the first things besides the food feeling stuck that made me go get checked in the first place.

I also always have water with me, sometimes just drinking helps.

Whatever I say I do is well past post-op and I am into the lifetime maintenance, had my surgery in 1985.

dawn

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Mark wrote:

> No doctor has ever talked to me about spasms. I have what I call

> " spells " when nothing will go down into my stomach. I've also

> experienced extreme pain just above my sternum that would put me on

> my knees. After the extreme pain incident, I experience numerous

> days of not being able to intake anything and constant heartburn.

> Are these experiences spasms?

Without knowing more about the nature of your extreme pain, I can't say

for sure, but I'd guess that the " on your knees " incident was likely a

NCCP (non cardiac chest pain) or what is often called a " spasm pain " [NCCP

is the medical term}.

The location can vary among different people. My first ones (back when I

didn't know that what I had was achalasia) were mistaken for gas. I ate

three rolls of Tums in one evening and kept waiting for relief! I

remember holding onto the counter in the kitchen to keep from falling over

and just howling at the intensity of the pain. Sometimes it will run up

the front or sides of my neck. Sometimes it's in a shoulder. I can often

feel it in the roof of my mouth, through the back of my tongue, and down

the sides of my throat (where the tonsils will be) all the way down the

sternum.

I'm curious about your statement that you have periods of constant

heartburn. Do you call it that b/c of pain in your chest, because you

have " stuff " (undigested food, saliva, white foam/mucus) that comes up

into your mouth, or because you have actual stomach acid that comes up

into your mouth? Lots of achalasia patients are initially told they have

" acid reflux " or GERD b/c if you don't look closely at the symptoms, it

can sound like reflux -- pain in the sternum area, washing icky stuff up

into the mouth, etc.

It's important to distinguish if you have REAL stomach acid coming up or

just nasty-tasting undigested food. Doctors don't sound like they're

doing a very good job of making that distinction, and since the general

public isn't aware that undigested food that decays in the esophagus can

become acidic as it rots, then the automatic assumption is that anyone who

has icky stuff wash up into their mouth *must* have GERD. Also, acid that

attacks the cells of the esophagus can lead to a condition called

Barrett's Esophagus (you can read more about that in the Links section,

too.)

Hope this helps.

Debbi in Michigan

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Hi! I had surgery in July and started having spasms in Nov. My GI has

put me on Bentyl. It has seemed to help. Ask your doctor.

Patty in Houston

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Patty,

It's interesting that your GI put you on Bentyl for spasm pains. I have been taking bentyl for years for IBS symtoms.

Hope it is helpful.

Jan in Northern KY

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Hey Kris,

I know exactly what type of pain you are typing up...My GI doctor

equated achalasia spasm pain to a heart attack...I was given

different spasm medicines, but none worked on me....They even tried

Valium to try to relax my esophagus, but that just put me to

sleep...and I would awake back with the chest pain radiating to my

back..It felt like someone was stabbing me....

Two things helped my pain, first was a balm called " Tiger

Balm " ...They sell it at Asian stores or Indian stores...It is an

ointment that will help relax the area where you have pain...In

addition, I would keep a heating pad on my back and stomach and

often still do---This did not take away the pain--but made it a bit

more bearable....

In the hospital once I was given Nubane--or Newbane--not sure how

you spell it..--once when I was in excrutiating pain--and it helped

me tremendously--

My pain is so bad, that I have to take Meperidine--Demerol with my

meals to ease the pain...But it barely works on me, because I have

been on it for a longggg time now...I hate taking painkillers, but I

would be in so much pain if I didn't....

I hope you feel better and find something that will help with your

pain...but I would strongly recommend heat and the Tiger Balm--both

will truely help you. =)

> Hi everyone. I had signed on to this group a long time ago. It

is

> comforting to know you are all out there to understand and give

> advice. Anyways, these non cardiac chest pains are AWFUL. I start

to

> think " THIS IS A HEART ATTACK! Take me to the ER " And I beg for

> mercy from God.

>

> My doctor has tried the nitro and the anti spasm meds. So far,

> neither have worked. I had received an e-mail from a girl when I

> first signed up. She said to try a low dose anti depressant or

try

> to get the doctor to give me something for the pain. Has anyone

> tried either of these?

>

> I try to figure out why this hits me. Did I eat too much? Is

there

> food breaking down in there? Am I stressed?

>

> I have found that the less I eat, the better I feel. As far as

the

> myotomy, I would recommend it to anyone. It has saved me. But

does

> anyone have any more advice or experiances with this chest pain?

> Kris in Kansas

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> > Hi everyone. I had signed on to this group a long time ago. It

> is

> > comforting to know you are all out there to understand and give

> > advice. Anyways, these non cardiac chest pains are AWFUL. I start

> to

> > think " THIS IS A HEART ATTACK! Take me to the ER " And I beg for

> > mercy from God.

> >

> > My doctor has tried the nitro and the anti spasm meds. So far,

> > neither have worked. I had received an e-mail from a girl when I

> > first signed up. She said to try a low dose anti depressant or

> try

> > to get the doctor to give me something for the pain. Has anyone

> > tried either of these?

> >

> > I try to figure out why this hits me. Did I eat too much? Is

> there

> > food breaking down in there? Am I stressed?

> >

> > I have found that the less I eat, the better I feel. As far as

> the

> > myotomy, I would recommend it to anyone. It has saved me. But

> does

> > anyone have any more advice or experiances with this chest pain?

> > Kris in Kansas

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-HI . Sometimes I think I must be the only one in the WORLD

with this pain. And somehow, it is comforting to know someone

UNDERSTANDS! Thank you for the advice. Tiger Balm-I will try it. I

have tried the heating pad and agree that it does help. I wonder if

anyone knows WHY these spasms occur? Do you ever get really sick and

have to throw up when this hits you?

Kris

-- In achalasia , " huggie192002 " <huggie192002@y...>

wrote:

> Hey Kris,

> I know exactly what type of pain you are typing up...My GI doctor

> equated achalasia spasm pain to a heart attack...I was given

> different spasm medicines, but none worked on me....They even tried

> Valium to try to relax my esophagus, but that just put me to

> sleep...and I would awake back with the chest pain radiating to my

> back..It felt like someone was stabbing me....

> Two things helped my pain, first was a balm called " Tiger

> Balm " ...They sell it at Asian stores or Indian stores...It is an

> ointment that will help relax the area where you have pain...In

> addition, I would keep a heating pad on my back and stomach and

> often still do---This did not take away the pain--but made it a bit

> more bearable....

> In the hospital once I was given Nubane--or Newbane--not sure how

> you spell it..--once when I was in excrutiating pain--and it helped

> me tremendously--

> My pain is so bad, that I have to take Meperidine--Demerol with my

> meals to ease the pain...But it barely works on me, because I have

> been on it for a longggg time now...I hate taking painkillers, but

I

> would be in so much pain if I didn't....

> I hope you feel better and find something that will help with your

> pain...but I would strongly recommend heat and the Tiger Balm--both

> will truely help you. =)

>

>

>

>

>

>

> > Hi everyone. I had signed on to this group a long time ago. It

> is

> > comforting to know you are all out there to understand and give

> > advice. Anyways, these non cardiac chest pains are AWFUL. I

start

> to

> > think " THIS IS A HEART ATTACK! Take me to the ER " And I beg for

> > mercy from God.

> >

> > My doctor has tried the nitro and the anti spasm meds. So far,

> > neither have worked. I had received an e-mail from a girl when I

> > first signed up. She said to try a low dose anti depressant or

> try

> > to get the doctor to give me something for the pain. Has anyone

> > tried either of these?

> >

> > I try to figure out why this hits me. Did I eat too much? Is

> there

> > food breaking down in there? Am I stressed?

> >

> > I have found that the less I eat, the better I feel. As far as

> the

> > myotomy, I would recommend it to anyone. It has saved me. But

> does

> > anyone have any more advice or experiances with this chest pain?

> > Kris in Kansas

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Evita -- have you read my big-long-spasm-post?I'll copy/paste it below for you -- I hope it helps!

As for gastric banding or gastric bypass surgery, any reputable surgeon here (USA) would refuse to perform it on an achalasia patient because of our pre-existing peristalsis problems. The liability is just too high if there should happen to be complications. (Don't know if the same medical liability legal issues would apply in Belgium.) One of the requirements is supposed to be that the patient not have any pre-existing conditions which impede the digestion process.

Debbi in Michigan

------------------------------------------

Chest pains, heartburn, acid reflux, spasm pains, NCCPs.... what the heck is all of this stuff anyway????

(aka: Debbi's Dissertation on Dysfunctional Dysphagia Diagnoses)

Here's some info I've put together on differences between "heartburn" and the "chest pains/spasm pains" that are related to achalasia. The official medical term that I've found for the "spasm pain" is "NCCP" or Non Cardiac Chest Pain. There are multiple terms used for "heartburn" including: acid indigestion, acid reflux, GERD/GORD, etc.

In my pre-achalasia days, I would have "indigestion/heartburn" once in a while (after a particularly large, fatty, acidic meal, etc.), maybe once or twice a year. I would have that nasty acid taste in my mouth when I burped, and a hot/burning sensation in the area of my breastbone. While not particularly comfortable, it wasn't an excruciating, debilitating pain, and taking some Tums or other antacid would neutralize it and both the taste and the discomfort would go away.

When I had my first NCCP, I had been having problems swallowing for a few years but hadn't yet been diagnosed with anything, and I had no clue that the pain was related to my swallowing problems. I thought the pain was some gawd-awful gas pains -- felt like something was stabbing me from the inside out! The pain seemed to start in the ribs and almost squeeze my chest with searing pain that seemed to shoot up into my neck, too. (note: everyone can experience NCCPs in varying degrees and in various parts of the body, including stomach, chest, shoulders, neck, back, jaw, tongue, teeth, and roof of the mouth.) I lived alone at the time, and I drove to a convenience store and bought three rolls of Rolaids and ate two whole rolls. That didn't have any effect at all, and it took a couple hours for the pain to go away.

Another time, I have a distinct memory of standing in the kitchen holding onto the countertop and just WAILING at the top of my lungs because it hurt so bad, and my knees buckling from the pain. My wailing turned into one big repetitious prayer: "Please, Lord, Please, Lord, Make It Stop, Lord, I Can't Take It Anymore, Lord, Please, Lord, I Need You To Please Help Me!" over and over and over again while sobbing. This was almost a decade ago and I don't know how long it went on, but I'm thinking that it was well over an hour of that constant wailing. Boy, those were the days, huh? ;o)

For people whose doctors believe that NCCPs are an "atypical" (not normal) symptom for achalasia patients, point them in the direction of this informal poll here on our group: achalasia/surveys?id=1037310

The poll is now closed, so who knows how many more would be added to it if it were still accepting votes. If you scroll down to the end, 38 people reported that they have these "spasms", and 5 people reported that they don't have spasms. So out of 43 people who answered the poll, 88% have spasms and 12% don't have spasms. Doesn't sound like a "rare" or "atypical" symptom, does it?

In another poll ( achalasia/surveys?id=1011383 ) of people who went to the Emergency Room due to extreme chest pains, 2 were given intravenous Valium, 3 were given Demorol or other narcotic injection, and 7 were given no treatment whatsoever.... isn't that sad? 58% of the people who were in such severe pain that they went to the E.R. were given NO TREATMENT at all!!! That is SO unnecessary!!!!

Here's some info that I copied from an old post of mine -- if your doctor will bother to do some simple web searches, he'll see that calcium channel blockers, nitroglycerine, and anti-depressants are all documented ways to treat NCCP in people with esophageal disorders! Maybe if you print it out and show it to him, he'll be willing to offer you some help in dealing with this.

=============================================

Here's some basic info that I've posted in the past -- different things work for different people, so it's basically just an experiment to find what works for your own particular situation.

Here are some different coping methods to try:

-- Swallowing something warm or something cold (in my case, I chug warm --not hot-- water as fast as I can).

-- CCB medication (calcium channel blockers) -- when I'm having NCCPs, I prick the shell of a nifedipine capsule and squirt it under my tongue. It absorbs into the bloodstream under the tongue (this is called a "sub-lingual" medication, meaning under-tongue) and relaxes smooth muscle tissue (which is what the esophagus is made up of). You can also just swallow the capsule, but since we have trouble swallowing in the first place, I've found the under-the-tongue method works best (then you just swallow when you've held it there as long as you can and your saliva requires a swallow). Unfortunately, it can also lower your blood pressure (usually only a problem if you already have low BP to begin with) and cause a headache afterwards -- some people experience this, some don't. CCB's can also be tried in the "slow release" formula as a preventative to having NCCPs start in the first place.

-- Nitroglycerin medication -- works in much the same way as the CCB mentioned above, and can also be taken sublingually for fast relief.

-- Certain anti-depressant and anti-convulsant medications -- some people don't have NCCPs when on these types of medications, believed to be a function of the medicine's effect on serotonin in the brain (antidepressants such as Nortryptaline, Amitryptaline, Imipramine and Trazodone have been studied; Neurontin is being studied in a similar way for "phantom limb pain" in amputees, etc.) People in the group have had luck with Paxil, Ativan, Nortryptaline, etc. The dosage needed in this case is generally lower than the dosage that is normally used to treat depression.

-- L'Argnine supplements -- some people have found these relieve NCCP symptoms.

-- If symptoms are debilitating and none of the methods above help, you may need a narcotic pain reliever, but definitely try all the options above first, b/c if you're on narcotics you can't drive, work, etc., and the vast majority of people can find relief in a way that doesn't involve narcotics.

=============================================

In the last few years I've taken three different drugs that affect serotonin (one of which isn't considered to be an anti-depressant medication, but which does have a serotonin effect nonetheless); any time I was on one of those drugs, my NCCPs have either disappeared entirely, or been nearly eliminated. And each time I discontinued a serotonin-effect drug, the NCCPs started up again within a month's time. One member here who was in the E.R. repeatedly for debilitating NCCPs finally had a doctor prescribe a low-dose daily antidepressant; her NCCPs have been eliminated.... no more pain, no more narcotics, no more trips to the hospital.

There are soooooooooooo many things that can be done to reduce NCCPs, but doctors don't even bother to TRY to find a solution for us. I say let THEM curl up in a fetal position making plea-bargain deals with their Maker at 3:00 in the morning just ONCE, and you can bet your booty that they'll find a solution REAL fast!!! :oP

------------------------------------------

Been having them a lot lately ... Really hurts, and it doesn't go away after drinking hot tea, ice cold water, eating something and stuff ...Do you guys think this is worth while a visit to the doctor?I'm currently trying to get pregnant, I just hope that the doctor is not planning on doing things that might interfere with our plans.Do the pains get worst during pregnancy? And does eating stay the same, or does it become more difficult? I suppose a baby pushing against your stomach does not do you any good, especially when you already have a problem eating ...And can someone tell me if the spasms are food-related? I know it are spasms of the muscles around the oesophagus, but are these triggered because you eat a certain substance that causes it?Lately, I've been keeping a list of things that I ate right before I started having pains. If I follow this list, I can't eat anything anymore!I'm so lost ... don't know what to do anymore ... My doctor keeps referring me to the specialist, but I'm not even sure if he can do someting about it ...And another question ... Don't know how to explain this in English, but I'll give it a go. Because I weigh way too much (I've gained everything) that I lost while being so sick :-(, I'm thinking about having a procedure, where they put a ring around your stomach, that you can not eat a lot anymore, and can not eat certain things (depends from person to person, but mostly it's things like steak, spaghetti and white bread) Is that wise to do this, in the position that I am (the disorder that will never go away)? I don't even know if I qualify, my BMI is not high enough ...What do you guys think?Evita in Belgium

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Welcome to the group, Kelley!I have a post about spasms/NCCPs/"heartburn" that I copy/paste here from time to time when the subject comes up. Unfortunately there isn't any "one" fix for the problem, but hopefully you'll find something in here that helps in your particular case! (And many if not most of us notice more symptoms when under stress -- it isn't just you!)Debbi in Michigan

=============================================================================

Chest pains, heartburn, acid reflux, spasm pains, NCCPs.... what the heck is all of this stuff anyway????

(aka: Debbi's Dissertation on Dysfunctional Dysphagia Diagnoses)

Here's some info I've put together on differences between "heartburn" and the "chest pains/spasm pains" that are related to achalasia. The official medical term that I've found for the "spasm pain" is "NCCP" or Non Cardiac Chest Pain. There are multiple terms used for "heartburn" including: acid indigestion, acid reflux, GERD/GORD, etc.

In my pre-achalasia days, I would have "indigestion/heartburn" once in a while (after a particularly large, fatty, acidic meal, etc.), maybe once or twice a year. I would have that nasty acid taste in my mouth when I burped, and a hot/burning sensation in the area of my breastbone. While not particularly comfortable, it wasn't an excruciating, debilitating pain, and taking some Tums or other antacid would neutralize it and both the taste and the discomfort would go away.

When I had my first NCCP, I had been having problems swallowing for a few years but hadn't yet been diagnosed with anything, and I had no clue that the pain was related to my swallowing problems. I thought the pain was some gawd-awful gas pains -- felt like something was stabbing me from the inside out! The pain seemed to start in the ribs and almost squeeze my chest with searing pain that seemed to shoot up into my neck, too. (note: everyone can experience NCCPs in varying degrees and in various parts of the body, including stomach, chest, shoulders, neck, back, jaw, tongue, teeth, and roof of the mouth.) I lived alone at the time, and I drove to a convenience store and bought three rolls of Rolaids and ate two whole rolls. That didn't have any effect at all, and it took a couple hours for the pain to go away.

Another time, I have a distinct memory of standing in the kitchen holding onto the countertop and just WAILING at the top of my lungs because it hurt so bad, and my knees buckling from the pain. My wailing turned into one big repetitious prayer: "Please, Lord, Please, Lord, Make It Stop, Lord, I Can't Take It Anymore, Lord, Please, Lord, I Need You To Please Help Me!" over and over and over again while sobbing. This was almost a decade ago and I don't know how long it went on, but I'm thinking that it was well over an hour of that constant wailing. Boy, those were the days, huh? ;o)

For people whose doctors believe that NCCPs are an "atypical" (not normal) symptom for achalasia patients, point them in the direction of this informal poll here on our group: achalasia/surveys?id=1037310

The poll is now closed, so who knows how many more would be added to it if it were still accepting votes. If you scroll down to the end, 38 people reported that they have these "spasms", and 5 people reported that they don't have spasms. So out of 43 people who answered the poll, 88% have spasms and 12% don't have spasms. Doesn't sound like a "rare" or "atypical" symptom, does it?

In another poll ( achalasia/surveys?id=1011383 ), out of the people who went to the Emergency Room due to extreme chest pains, 2 were given intravenous Valium, 3 were given Demerol or other narcotic injection, and 7 were given no treatment whatsoever.... isn't that sad? 58% of the people who were in such severe pain that they went to the E.R. for relief were given NO TREATMENT at all!!! That is SO unnecessary!!!!

Here's some info that I copied from an old post of mine -- if your doctor will bother to do some simple web searches, he'll see that calcium channel blockers, nitroglycerine, and anti-depressants are all documented ways to treat NCCP in people with esophageal disorders! Maybe if you print it out and show it to him, he'll be willing to offer you some help in dealing with this.

=============================================

Here's some basic info that I've posted in the past -- different things work for different people, so it's basically just an experiment to find what works for your own particular situation.

Here are some different coping methods to try:

-- Swallowing something warm or something cold (in my case, I chug warm --not hot-- water as fast as I can).

-- CCB medication (calcium channel blockers) -- when I'm having NCCPs, I prick the shell of a nifedipine capsule and squirt it under my tongue. It absorbs into the bloodstream under the tongue (this is called a "sub-lingual" medication, meaning under-tongue) and relaxes smooth muscle tissue (which is what the esophagus is made up of). You can also just swallow the capsule, but since we have trouble swallowing in the first place, I've found the under-the-tongue method works best (then you just swallow when you've held it there as long as you can and your saliva requires a swallow). Unfortunately, it can also lower your blood pressure (usually only a problem if you already have low BP to begin with) and cause a headache afterwards -- some people experience this, some don't. CCB's can also be tried in the "slow release" formula as a preventative to having NCCPs start in the first place.

-- Nitroglycerin medication -- works in much the same way as the CCB mentioned above, and can also be taken sublingually for fast relief.

-- Certain anti-depressant and anti-convulsant medications -- some people don't have NCCPs when on these types of medications, believed to be a function of the medicine's effect on serotonin in the brain (antidepressants such as Nortryptaline, Amitryptaline, Imipramine and Trazodone have been studied; Neurontin is being studied in a similar way for "phantom limb pain" in amputees, etc.) People in the group have had luck with Paxil, Ativan, Nortryptaline, etc. The dosage needed in this case is generally lower than the dosage that is normally used to treat depression.

-- L'Argnine supplements -- some people have found these relieve NCCP symptoms.

-- If symptoms are debilitating and none of the methods above help, you may need a narcotic pain reliever, but definitely try all the options above first, b/c if you're on narcotics you can't drive, work, etc., and the vast majority of people can find relief in a way that doesn't involve narcotics.

=============================================

In the last few years I've taken three different drugs that affect serotonin (two were antidepressants, and one isn't considered to be an anti-depressant medication but does have an effect on serotonin); any time I was on one of those drugs, my NCCPs have either disappeared entirely, or been nearly eliminated and greatly reduced in severity. And each time I discontinued a serotonin-effect drug, the NCCPs started up again within a month's time. One member here who was in the E.R. repeatedly for debilitating NCCPs finally had a doctor prescribe a low-dose daily antidepressant; her NCCPs have been eliminated.... no more pain, no more narcotics, no more trips to the hospital.

There are soooooooooooo many things that can be done to reduce NCCPs, but doctors don't even bother to TRY to find a solution for us. I say let THEM curl up in a fetal position making plea-bargain deals with their Maker at 3:00 in the morning just ONCE, and you can bet your booty that they'll find a solution REAL fast!!!

Debbi in Michigan

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Hi Kelley,

I just had the heller done 2 weeks ago,

and have been having spasms regularly since. What has so far 90% of the

time for me is to drink a glass of really cold water, or milk, as soon as I

feel them coming on. Sometimes that by itself helps. If it doesn’t

right away, then I try to eat something dry and crunchy like graham crackers

(any crackers work, but graham ones taste better!). My surgeon told me to

try extra strength Gaviscon. He says it should help some for spasms, as

well as heartburn, but I have not tried that yet. Good luck Kelley.

Chilliwack, BC

·

<I was wondering if anyone had any surefire way to relieve

spasms>.

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>

> I was wondering if anyone had any surefire way to relieve spasms.

Thanks,

> Kelley

Hi Kelley - I can only share what works for me. I've been post op for

more than 15 years so I've had some time to experiment. I will add a

clause though: what works for me may not for you and vice versa.

There are several other posts - including pepto debs detailed post

about medications etc. that you should look over. This post will only

be my own experiences.

A magnesium supplement does not relieve spasms but seems to help

reduce them, I haven't tried the large doses of Vit. B yet, I'm

waiting for my pregnancy to end before I try anything new.

I take ginger quite a bit and that seems to be a good preventative.

You can buy it in capsule form and I take one every evening before

bed. It's also really easy to keep in my purse so I pop one whenever

I feel spasms coming on. Together will a large drink of water it

seems to help alot. If you have access to hot water you can also make

ginger tea, the hot water works very well - I guess from relaxing the

muscles. Vanilla yogurt works well for easing the pain, usually

within a minute or two.

If I feel especially stressed, I drink Camomile tea at night before I

go to sleep to help me relax. I also have a prescription for Ativan

and will take that if the spasms or my stress level is bad so I can

get a good nights sleep.

I also completely gave up caffeine years ago - figured I didn't need

the stimulation - that was a huge help.

Unfortunately, not one single 'fix' but hopefully you can take some

of these ideas and experiment and find what works for you.

good luck, happy swallowing!!

-

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Wow!!! Two

weeks post-op and you are eating crackers?? Wow! I must say I am quite jealous.

I do not think I will be eating crackers till 1 month post-op at least.

, 6 days

post-op Heller Myotomy

RE: Spasms

Hi Kelley,

I just had the heller

done 2 weeks ago, and have been having spasms regularly since. What has

so far 90% of the time for me is to drink a glass of really cold water, or

milk, as soon as I feel them coming on. Sometimes that by itself helps.

If it doesn’t right away, then I try to eat something dry and crunchy

like graham crackers (any crackers work, but graham ones taste better!).

My surgeon told me to try extra strength Gaviscon. He says it should help

some for spasms, as well as heartburn, but I have not tried that yet.

Good luck Kelley.

Chilliwack, BC

·

<I was wondering if anyone had any surefire way to relieve

spasms>.

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