What is Cricopharyngeal Spasm?
Cricopharyngeal Spasm occurs when there is narrowing at the upper esophageal sphincter when there is incomplete or partial closing and opening of the sphincter. This is usually caused due to problems with pharyngoesophageal coordination or decreased muscular compliance in the upper esophageal sphincter. The cricopharyngeal muscle is located on top of the esophagus. The primary function of this muscle is to open and close the esophagus when the food enters it.[1,2,3]
Cricopharyngeal Spasm normally is a benign condition and is not a cause for concern but sometimes it can create a sense of discomfort and panic. The primary symptom of Cricopharyngeal Spasm includes a feeling of a lump in the throat. This is medically termed as globus pharyngeus. The frontline treatment for Cricopharyngeal Spasm includes muscle relaxants that reduce the spasms and make swallowing that much easier.[1,2,3]
What are the Symptoms of Cricopharyngeal Spasm?
How severe the symptoms of Cricopharyngeal Spasm will be depends on the extent of the narrowing of the upper esophageal sphincter. The symptoms will be felt more in people who are overly sensitive. A person with Cricopharyngeal Spasm will also often have episodes of choking and gagging when eating foods or drinking liquids. This result in people getting anxious and even may panic.
It has also been seen that symptoms in people with Cricopharyngeal Spasm tend to worsen under stress and towards the end of a long day at work. This results in insomnia in some cases especially when they develop a feeling that they might have a choking episode in their sleep. The primary difference between Cricopharyngeal Spasm and other conditions with similar symptoms is that swallowing is not affected in people with Cricopharyngeal Spasm even though people may feel that their swallowing is restricted.
Additional symptoms of Cricopharyngeal Spasm include a feeling of mucous being stuck in the throat which the person is not able to cough out or swallow. People may have a choking sensation in the throat. A person with Cricopharyngeal Spasm may also complain of a feeling as if somebody is strangulating him. Sometimes, the neck also swells up. These symptoms fade away when the person is eating or drinking and tend to worsen with stress or exposure to environmental allergens.
How is Cricopharyngeal Spasm Treated?
The severity of the symptoms decides the treatment course of action for people with Cricopharyngeal Spasm. If the symptoms are severe and disabling then the following medications are found to be quite effective. These medications include Botox injections to relieve the spasms. Muscle relaxants are also found to be extremely beneficial to treat Cricopharyngeal Spasm. Since acid reflux is also one of the causes for Cricopharyngeal Spasm, medications to treat reflux also treat the symptoms of Cricopharyngeal Spasm.
Additionally, to improve the functioning of the upper esophageal sphincter physical therapy with focus on neck strengthening exercises is also found to be quite beneficial. The anxiety and panic caused by the symptoms of Cricopharyngeal Spasm, people may benefit from psychological counseling can be benefitted from.
There are also some home remedies that can be optimally utilized to treat the symptoms of Cricopharyngeal Spasm. These include relaxation and distraction techniques to take the mind away from the sensation of the lump in the throat. In most cases, this is enough to get rid of the symptoms of Cricopharyngeal Spasm. It is also beneficial to drink a glass of warm water or eat a snack when a person feels symptoms of Cricopharyngeal Spasm to get rid of the sensations.
Gentle massage of the neck and throat are also quite effective in calming down the symptoms of Cricopharyngeal Spasm. Additionally, ginseng, peppermint, and lemon teas have been found to be effective in treating the symptoms of Cricopharyngeal Spasm. Reassurance that Cricopharyngeal Spasm is not a serious condition also works quite well as people tend to be less anxious when knowing that their symptoms are caused by nothing to be worried about.
Very rarely, surgery may have to be done for people with Cricopharyngeal Spasm. This is done when a specific cause of the condition is identified and the symptoms do not improve for more than six months. Surgery is also recommended for people who develop swallowing problems due to Cricopharyngeal Spasm. The procedure done for this condition is called Cricopharyngeal myotomy. The surgery involves making an incision and getting into the Cricopharyngeal muscle so as to decrease its ability to contract.
This procedure is normally done using an endoscope. This significantly improves the symptoms and the ability to swallow in a person with Cricopharyngeal Spasm. This has been seen in estimates in about 60-70% of cases.
How Can Cricopharyngeal Spasm Be Prevented?
Since the primary contributing factors for Cricopharyngeal Spasm are still not known, it is quite a challenge to find ways to prevent it. However, it has been seen that symptoms tend to get worse with stress and anxiety and thus it is advised to cope with stress and anxiety by healthful means to prevent Cricopharyngeal Spasm. This can be done through regular exercise, doing yoga, meditation, and reducing alcohol consumption.
If Cricopharyngeal Spasm is in some way related to other medical conditions like acid reflux then the best way to prevent it is to address the underlying cause and once treated the symptoms of Cricopharyngeal Spasm normally go away.
In conclusion, Cricopharyngeal Spasm is a benign condition in which the upper esophageal sphincter gets narrowed resulting in problems with opening and closing of the sphincter. Normally, swallowing is not affected by Cricopharyngeal Spasm but in some rare cases people do complain of dysphagia. The symptoms of Cricopharyngeal Spasm tend to get worse with periods of stress and anxiety or exposure to certain environmental allergens.[1,2,3]
In majority of the cases the symptoms of Cricopharyngeal Spasm resolve once the underlying issue is addressed or with stress and anxiety management. The symptoms of Cricopharyngeal Spasm usually last for a period of a few days to weeks. However, in some cases it may also last for a few months depending on how the underlying cause is being managed. People who are overly sensitive and prone to anxiety have more severe and long lasting symptoms of Cricopharyngeal Spasm.[1,2,3]