Cricopharyngeal spasm – symptoms & complications

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Cricopharyngeal Spasm

This is a type of muscle spasm which happens in the throat. It is also known as UES (upper esophageal sphincter). The cricopharyngeal muscle is located at the top part of the esophagus. This is a ring of muscle which encircles the upper end of the esophagus. The esophagus is part of the digestive system which helps to digest food and it can prevent acids from creeping up from the stomach. It is normal for the cricopharyngeal muscle to contract because this can help the esophagus to moderate food and liquid intake [1]. When the cricopharyngeal muscle contracts too much, then the cricopharyngeal spasm happens. It is known as a hypercontraction state. The affected person can feel the hyper – contraction or hypertonic state. While you can still swallow food and drinks, then spasms can make your throat to feel uncomfortable. The cricopharyngeal spasm is not a significant medical concern. This condition can cause some discomfort during the periods when the esophagus is in a relaxed state, such as between meals. But if you have persistent discomfort caused by cricopharyngeal spasms, then you should talk with your doctor as soon as possible. If the symptoms of cricopharyngeal spasm persist even while you are drinking and eating, then these symptoms are likely to be related to another cause. You need to talk with your doctor to get a proper diagnosis.

Symptoms

When you have a cricopharyngeal spasm, then you still will be able to eat and drink. The discomfort is highest between meals and beverages. Here are some symptoms of cricopharyngeal spasm [2,3]:

  • A lump that you can’t swallow or spit out
  • A sensation of a large object being stuck in your throat
  • Discomfort – a lump can often feel quite big and the pain is occasional
  • Feeling like something is tightening around your throat
  • Choking sensations
  • Stress which is aggravating the symptoms

When you have a cricopharyngeal spasm, then the saliva is difficult to swallow and the food is easy to swallow. When you are eating, then it makes the tightness to go away for a time.

  • Throat feels swollen
  • The lump sensation comes and goes from day to day

The symptoms of cricopharyngeal spasm can be mimicked by pushing on cartilage in the neck, just below the Adam’s apple

  • The symptoms of cricopharyngeal spasm normally worse in the evening
  • The symptoms of cricopharyngeal spasm persist for a very long time, often several months

When you are eating foods or when you drink liquids, then the symptoms of cricopharyngeal spasm disappear. This is happening because the related muscles are relaxed to help you drink and eat. The symptoms of this condition tend to get worse throughout the day. The anxiety about having cricopharyngeal spasm can aggravate the symptoms. You need to talk with your doctor if you have some of the above-mentioned symptoms of cricopharyngeal spasm because he or she will give you the proper diagnosis and treatment.

Causes

These spasms happen within circoid cartilage in the throat. It is located right at the top of the esophagus and at the bottom of the pharynx. The cricopharyngeal spasm is responsible for preventing anything, like the air reaching from the esophagus in between drinks and meals. The cricopharyngeal spasm is constantly contracting to prevent the airflow and stomach acids from reaching the esophagus. There are some cases in which this natural protective measure can get off balance and the UES is contracting more than it is supposed to and this is resulting in notable spasms.

Complications

There are rare cases when there are complications from the cricopharyngeal spasm. If you are experiencing other symptoms (not the common symptoms of cricopharyngeal spasm) such as chest pain or swallowing difficulties, then you can have an associated condition. Here are some possible associated conditions:

  • Brain damage from related injuries or stroke [4]
  • Neurological disorders, such as Parkinson’s disease
  • Other types of esophageal strictures caused by swelling, such as noncancerous growths
  • GERD (gastroesophageal reflux disease) or stricture (esophageal damage) cause by persistent heartburn [5]
  • Heartburn
  • Dysphagia (difficulty swallowing)

References:

[1] Malm C, Souza EM, Ferian PE, et al. Canine cricopharyngeal achalasia: Case report. Arquivo Brasileiro de Medicina Veterinária e Zootecnia. 2011;63(1):56-60.

[2] Jain V, Bhatnagar V. Cricopharyngeal myotomy for the treatment of cricopharyngeal achalasia. Journal of Pediatric Surgery. 2009;44(8):1656-8.

[3] Bua BA, Olsson R, Westin U, et al. Treatment of cricopharyngeal dysfunction: a comparative pilot study. BMC Research Notes. 2015;8:301.

[4] Sebastian S, Nair PG, Thomas P, Tyagi AK. Oropharyngeal dysphagia: Neurogenic etiology and manifestation. Indian Journal of Otolaryngology and Head & Neck Surgery. 2015;67(Suppl1):119-23.

[5] Mosca F, Rossillo V, Leone CA. Manifestations of gastro-pharyngo-laryngeal reflux disease. ACTA Otorhinolaryngologica Italica. 2006;26(5):247–51.

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