Cricopharyngeal Spasm

A cricopharyngeal spasm refers to a spasm which affects the cricopharyngeus muscle. It occurs due to improper functioning of the topmost valve above the esophagus, which subsequently causes swallowing problems. The condition can be easily detected as the patient suffers from chronic sensations of a lumpy presence in the throat. Most affected individuals have reported that they can easily swallow food, but face difficulties in swallowing saliva.

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There is no particular diet that patients may follow so as to resolve the cricopharyngeal spasms. However, eating different kinds of foods can reduce the tight feeling in the throat and alleviate swallowing problems. Cricopharyngeal spasm is a self-limiting condition, but the associated symptoms can persists for many months. Taking measures to control stress and anxiety, such as breathing and relaxation therapy, during this period can help alleviate the symptoms and eventually cure the disorder. It will also help prevent a recurrence. Prolonged instances of cricopharyngeal spasm need to be checked by a doctor.

Symptoms of cricopharyngeal spasm

Some of the signs and symptoms of cricopharyngeal spasm are listed below:

  • The most common symptom of cricopharyngeal spasm is the sensation of having a lump or a foreign body in the throat. The lump may feel like a golf ball or phlegm. In some cases, the sensation may stop after eating. However, such alleviation of symptoms is only temporary.
    • This sensation may not be felt continuously; it may come and go through the day and often worsen as the day ends. The lumpy sensation in throat may become very severe at night. The spasm may not occur every day, or it may occur for several days at a stretch, and even persist for many months.
    • The patient may feel as if he/she is being strangled or there may be sensations of neck constriction or choking.
    • The throat may feel inflamed or swollen
    • Patients may inadvertently and unconsciously keep trying in vain to remove the lump in throat.
    • The lump is said to be usually present at the cricoid cartilage’s level.
  • The patient may experience difficulties in swallowing saliva. However, intake and swallowing of food and water occurs smoothly without any problems. In fact, drinking water and eating food can sometimes result in short-term abatement of the symptoms.
  • Sometimes, the lumpy feeling may be accompanied by pain, which in turn can be sporadic or constant.
  • Anxiety, stress, and emotional upheavals can worsen cricopharyngeal spasm symptoms.

Causes of cricopharyngeal spasm

The esophagus is a hollow tubular structure that extends from the throat and travels downwards till the stomach. The esophagus features 2 valves on its uppermost section. These valves relax so that liquids and food from the mouth can pass down from the throat into the esophagus and then down to the stomach. Later the valves contract to prevent the backward flow of stomach contents into the mouth. Any disruptions to this normal rhythm of relaxation and contraction of the valves can cause the valves to malfunction, resulting in swallowing difficulties. The disruptions to the normal valve rhythm are often caused due to increased stress and anxiety.

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Cricopharyngeal spasm and the accompanying symptoms of swallowing difficulties and discomfort are more prevalent when there are problems in the relaxation aspect of the valves. Reduced relaxation of the valves can cause the food particles to back up in the throat, thereby causing the distinctive sensations of ‘lump in throat.’

Some of the most common causes of valve dysfunction and subsequent occurrence of cricopharyngeal spasm are listed below:

  • Increased amounts of anxiety
  • Elevated levels of stress
  • Negative and positive emotions
  • Intake of certain foods can also trigger an episode or episodes of cricopharyngeal spasms. Peanuts, pumpkin seeds, and other types of nuts are known to cause the spasms, especially in people who are more susceptible to developing the condition.
  • Sometimes anxiety, stress, and emotions may not directly cause cricopharyngeal spasms. However, the condition can worsen with the onset of stress, emotional problems, or anxiety.

Treatment of cricopharyngeal spasm

As cricopharyngeal spasm is a self-limited condition that resolves on its own, most cases do not need medical treatment. If treatment is required then it will differ as per varied individual factors such as the stress levels, the duration and frequency of the spams, age, and medical history, etc. After such data is gathered, the physician can chalk out a treatment plan.

Some of the common treatment options that can help alleviate the symptoms of cricopharyngeal spasm are listed below:

  • Severe cases characterized by persistent discomfort in the throat can be managed via use of prescription muscle relaxants such as benzodiazepines. These drugs help in relaxing the constricted muscles which are causing the spasms as well as reduce the frequency of the spams. It is advised to take the muscle relaxants only when a spasm starts. This is because the drugs are very addictive. Doctors may sometimes opt for a different class if a specific class causes side effects.
    • Neck relaxation exercises and other kinds of physical therapy by a physiotherapist can also help relax the throat muscles.
    • If the muscle relaxants do not help alleviate the symptoms, then the condition may be caused due to increased stress of anxiety. The drug dosage is subsequently discontinued and stress alleviation is looked into.
  • A physician will identify the triggers and causes of stress and suggest measures on how to decrease it. Patients may be asked to keep a diary so as to note down the times at which a spasm occurs. This will help identify and track down the triggers.
  • Heat applications such as use of a heating pad or warm compresses on the throat can also help relax the muscles and ease the discomfort associated with cricopharyngeal spasm. Ensure that the warm compresses or heating pads are placed on the throat for only 2 to 3 minutes.
    • Intake of warm fluids may also be helpful for some patients. It will not only lower the intensity of the symptoms but also keep the throat in a hydrated state.
  • Local anesthetic injections can help find short-term relief from the cricopharyngeal spasms. Some patients, especially those suffering for a prolonged period, may benefit via use of botulinum toxin injections.
  • Chronic cases of cricopharyngeal spasm that occur due to muscle damage or muscle ailments may need to be surgically treated, via surgical reconstruction or repair.

 

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