Medication for esophageal spasms?

[Bobby]

Ever since I had severe gas bloat a little over a week ago, I have been getting weird spasms at the base of my esophagus (at least I think that is what they are). After meals I am fine. However, a few hours after my meals, if I push my stomach out a little I will get a pressure feeling about 4 inches above my navel (I'm assuming that this is around the base of the esophagus at the stomach valve...within the wrap). If I push a little more, a feeling (spasm) will move up from that point along my esophagus. It will sometimes stop mid-esophagus or will occasionally cause a spasm that moves all the way up to the top of my esophagus (bringing air noises with it :) ). These spasms have subsided a little since the day I had gas bloat, but not much. I know what you're thinking...just don't push out my stomach. At times it is hard to keep these spasms from happening (I need to keep constant tension on my abs to prevent them). And they occur much more often and are much harder to control while seated (I sit most of the day at work).

A few weeks earlier I had extreme esophageal spasms up and down my esophagus following another occasion of gas bloat. I have been taking Allegra-D and these had since subsided. I had assumed that these severe spasms were occuring due to post-nasal-drip (causing more resistance pushing food through the wrap)...they went away a day after starting the Allegra-D. I am still taking an Allegra-D tablet every 12 hours.

My surgeon had originally given me Lorazepam (Ativan) for anxiety on one occasion where I was panicked following surgery. I have found that if I take 0.5mg of this drug, I don't have any side-effects and within an hour these feelings (spasms) in my upper abdomen go away. I can usually get by with one dose a day.

After my first episode of esophageal spasms, my doctor gave me Trazadone (an anti-depressent). I never started this medication for fear of side effects and addiction/dependency. I have a good knowledge of the effects of some anti-depressents and don't want to go down that road if possible. However, I was looking at the datasheet for Lorazepam and it also concerns me. I'm not taking much, but it looks like it may lead to dependency.

Sorry for running on, but here are my questions:

Are there any over-the-counter medications or natural remendies for esophageal spasms? What have others on this board used, and what has the least side-effects and drug interactions? Has anyone used Lorazepam (Ativan) for a long period of time? I think all I really need is a very mild smooth muscle relaxant. These new spasms also seem to get worse when I have more stress (probably why the Lorazepam works).

After researching on the web a little, it looks like the main medications prescribed for esophageal spasms are nitroglycerin and calcium channel blockers. I found a few sites that say that the amino acid Arginine may help. Any comments are appreciated. Thanks.

[Bobby]

I guess it may have been more appropriate to post this thread in the Medication Forum, but thought it belonged here because my problems are related to my fundo surgery.

[TomCarv]

Hi Bobby,

I think I have a thought for you, this is just a thought, so don't panic on me. It is possible, I doubt it, but it is possible that during your Fundo, you may have had some Vagus Nerve Damage. It is also possible that during the Gas/Bloat that the Vagus got irritated. If you want to read the Vagus Nerve Damage Fundo Thread, that may give you some ideas you may want to bring up with your Surgeon. Relax, don't stress about it, just a thought!! :)

Prayers,

Tom

[robertw]

I also had many problems after my fundo with gas bloat just at night 2 hours after going to sleep terrible burning
I tried Ativan but it totally spaced me out unfortunately I have to take something, what I take now is elavil it makes me sleep and reduces acid and non addictive I don’t like taking it but its the only way I can get any sleep
I sometimes take nexium when I get woken up then it works for me
If I take the nexium before bed I still get woken up
Will be seeing sergeon Feb 6 but I dont think he will help

[Bobby]

Tom,

Thanks for the possible insight. My doctor actually told me when I talked with him the morning after surgery that he located the Vagus Nerve right away and isolated it. I'll talk to him about it when I see him next (Wednesday after next).

It's very possible that the gas bloat incident(s) irritated the Vagus Nerve. A couple days after the gas bloat I had a funny feeling (which could have been my esophagus spasming) inside around the diaphram area. I went for a stroll and as I was walking the feeling would disappear and immediately I'd get the pain in my left shoulder. Then the shoulder pain would disappear and I'd get that esophagus pain again. I thought it might have to do with the Vagus Nerve.

The weird thing is that I have had some soreness in the center of my top abdomenal muscles since the gas bloat..right around or above the wrap area (small hernia possibly???). It seems to get a little better day by day. When I push my stomach out it seems to trigger things. Maybe the Vagus Nerve comes into play somehow when I do this. I'm sure that they're esophageal spasms because yesterday they were continually moving up from the wrap area all the way to the top of my esophagus (over and over again...they don't hurt...they're just annoying). At first I was concerned it was gas/acid leaking through the wrap which was causing these (because it feels like it), but I don't hear any noises (bubbling) when the spasms reach the top of the esophagus (only if I swallow some air...then they bring it back up). And the fact I can't burp tells me that nothing is leaking past the wrap. But just like clock work, about 1 hour after I take 0.5mg of Lorazepam they disappear. I can then go between 6 hours to the rest of the day without them reappearing. And every morning they start up again about 1-2 hours after breakfast.

I'll read the thread on Vagus Nerve damage. Thanks for your help. I talked with my friend (who is a retired nurse) and she felt that 0.5mg a day of Lorazepam is a very small dose and shouldn't cause any addiction...but I still don't like the fact that it can cause dependency. Also, the longer I take it I think I'll need more to sustain the same level of comfort (I think the drug works like that). I'm going to talk to my surgeon and ask his advice on the matter. I hope things have been going well with you. You've been very helpful and it is much appreciated. Take care.

Bobby

[Bobby]

Robert,

Thanks for the reply. Yeah, if I take 1mg of Ativan (Lorazepam) I get tired and spacey also. But 0.5mg doesn't give me any side effects (pretty weird). I initially used it to get some sleep when I was panicked a few weeks after surgery.

I'll research Elavil. If it is non-addictive and helps reduce the spasms, I'm all for it. My doctor gave me a prescription of Reglan to help with the gas bloat (I guess it helps move things along in the stomach)...but I'm not going to get it filled because I'm getting along fine now by using Beano, Gas-X and by just gauging my meals a little better. Also, the possible side-effects for Reglan don't look all that great either. I should just be like 99% of the people out there and not look at the drug datasheet...because I never want to take the drugs because of the side-effects and interactions with other drugs. But. then again, if I took all the drugs my doctors have dished me out over the last few months, I think I'd be a head case right now ;) ... even more than I already am :)

I hope you find some relief for your troubles. Thanks for the suggestion. I'm going to research Elavil right now.

[GW]

No......I'm not going to recommend snake oil or anything weird. However, I found that when I had those horrible heart attack-like spasms that would sometimes even throw me into a panic attack I could take a plain ol' Benedryl tablet and hop in a very warm tub (bubbles and rubber ducky optional :)) put on some music or meditate/pray that it was within just a few minutes the spasms and the panic would cease.

Also, I'd look into some really, really good vitamin Bs out there. They are supplements that have a natural way of allowing the body to manage the stress from something as disturbing as esophageal spasms.

[Bobby]

GW,

Benedryl...I'll have to try that. That's a good idea about Vitamin B also. It's funny how the body reacts to stress, no matter how little there is. I think you're right though, it definitely helps esophageal spasms (at least the type I'm getting) when I relax. I could see how a nice hot bath and a little praying could calm things down.

On a sidenote, I'm starting to think that the Allegra-D I'm taking is a double edge sword...I think the medication might be making me a little more anxious than usual and this might be contributing to the spasms also. But then without it the post-nasal-drip made things so much worse.

Thanks for the suggestions (and the humor :) ) Take care.