Cricopharyngeal Spasm

Cricopharyngeal spasm

Cricopharyngeal spasm is usually defined by patients as a lump in the throat which is said to be the primary source of discomfort. Technically, the condition is identified as synonymous to functional dysphagia (difficulty in swallowing), spasmodic stenosis or hysterical dysphagia. This medical condition primarily affects the cricopharyngeus muscle, the upper esophageal sphincter and an essential part of the digestive system. Once this condition is experienced by clients, concluding it as a tumor or a cancerous lump is a common mistake. This should not be confused with cancerous lumps, as malignant tumors are frequently undiscoverable unless it has developed into a very large, visible lump.

During cricopharyngeal spasm, patients experience discomfort from the accumulation of food and fluid in the sphincter during or after the act of ingestion. Physiologically, the sphincter is responsible for food and water intake by relaxing and opening for esophageal passage. The mentioned buildup is frequently found at the back of the throat, that’s why most patients complain of the “lump feeling” in the throat. This should not be a cause of an alarm as this is rather harmless, unless it becomes a source of extreme discomfort.

Cricopharyngeus muscle Anatomy

Cricopharyngeus muscle

Picture : Cricopharyngeus muscle

Image source : http://static.mda.org

How does one develop cricopharyngeal spasm?

Anatomically, the muscle involved in cricpopharyngeal spasm is found in the esophagus. As mentioned, this contracts when unused but then relaxes as one swallows food to give way for food digestion. As the ingestion process is done, the sphincter closes to avoid food or fluid regurgitation from the stomach. Instead of the normal contraction and relaxation of the cricopharyngeus muscle, a spasm occurs triggering the symptoms. Stress and anxiety are the two primary factors that cause this condition.

What are the manifestations of cricopharyngeal spasm?

This condition is considered a syndrome, which means a number of accompanying symptoms are complained by patients. This syndrome is considered self-limiting while others experience the condition in a chronic state. The following are the presenting symptoms of cricopharyngeal spasm:

  • Lump feeling at the back of the throat. Sometimes, patients complain of the feeling of being strangled. Some believe there is swelling in the throat. Feelings of tightness on the throat is also another complain by sufferers.
  • Pain is tolerable but significant discomfort from the lump sensation is a common manifestation. The discomfort may come and go but can also progress unfavorably as the day goes on. There are instances where the sensation is worse in the morning that may gradually increase in intensity.
  • Difficulty in swallowing. The affected shall feel uncomfortable when one swallows food. In separate cases, others may be even unable to swallow his or her saliva.
  • Feelings of distress. This can be considered as the cause or the precipitating factor for cricopharyngeal spasm. However, patients suffering from this condition are somehow observed to be suffering from stress.

What should one do when cricopharyngeal spasm is being experienced?

First thing to consider is one’s emotions during an episode of cricopharyngeal spasm. The patient should be accompanied, in a calm state and should not be panicking. The lump feeling behind the throat should be further investigated by checking oneself for food choking or the like. As most patients are unsure of the cause and answer behind the discomfort, seeking medical assistance should be done. But one should always remember that stressing out on the discomfort can only aggravate the spasm.

In order to attain a proper diagnosis, a physical examination is done to check for any visible structure that may be causing for the lump sensation. However, there are instances where a doctor would like to make sure that a tumor is not causing the discomfort. Esophageal endoscopy has been done and as well as imaging examinations (CT scan, MRI scan and X-ray). Other doctors would only consider it as a waste of time and money for such procedures, but are somehow still practiced for precaution.

The doctor shall recommend a muscle relaxant after being examined. This can help relieve the pain and decrease any amount of anxiety if there is any. Valium or Ativan is the usually prescribed medication for cricopharyngeal spasm.

For home management, placing of a heated pad (for a few minutes) on the throat can help reduce the discomfort and can induce muscle relaxation. This should be inquired first from the physician, as considerations should be reviewed. It is advised for patients to drink warm fluids to relieve discomfort. The doctor would most likely recommend for stress relief activities that can help reduce the presenting symptoms. Considering meditation can assist in attaining relief from cricopharyngeal spasm. Trying to live in a stress-free life and environment can avoid future episodes of cricopharyngeal spasm.

If the symptoms persist and if the problem has been a chronic one, the doctor may recommend injection of Botox. But this is only necessary when a dysfunction is identified. The effect of Botox is to reduce the over- contraction of muscles. In severe cases, a surgical intervention may be performed to correct the muscle dysfunction. This is to help in the reconstruction of the affected muscles that cause the problem.

Is there a recommended diet for cricopharyngeal spasm?

This medical condition should be treated accordingly to relieve the discomfort. However, there is no specific diet plan required to avoid the spasm. It is only suggested that one should avoid ingesting food or drink when it is observed to be a difficult task. One should not aggravate the situation by forcing food and should consider a doctor’s advice when it persists.

In order to have no future episode of cricopharyngeal spasm, patients must not rush a meal and should chew food properly and thoroughly before swallowing. Seeking medical advice is still a must to make sure and identify that there’s no underlying condition causing such manifestations. Remember that one can get better from cricopharyngeal spasm as soon as attention and management is done. A number of patients would attain full recovery after several weeks while others would need months in order to get better.

Treating this type of disease cannot be done alone. Though there are many self help book that can be a source, always trust the advice of a doctor.

References

http://en.wikipedia.org/wiki/Cricopharyngeal_spasm

http://www.voicedoctor.net/therapy/lump

http://voices.yahoo.com/cricopharyngeal-spasms-feel-like-lump-sensation-5143501.html

http://www.livestrong.com/article/322239-diet-for-cricopharyngeal-spasms/



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