Does anyone here have or heard of nutcracker esophagus?

Posted by blackoutthesun @blackoutthesun, Dec 5, 2017

I was diagnosed in 2011 with Nutcracker esophagus, apparently it's very very rare no one seems to know how to treat it. It's causing major motility problems in my upper body/ arms hands, it's very painful and it is debilitating please help

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@blackoutthesun Oh, my goodness! This is one I thought I did not have, but after looking up the definition and notations, I am not so sure. I sometimes feel as if my esophagus is trying to squeeze the food back out, especially if it is an acid-type food such as salsa, Tabasco sauce, etc.Or if it is very cold, or hot. Mayo has told me I have esophageal spasms, but did not mention the "nutcracker" bit. Google says: "This condition may be called diffuse esophageal spasm, or DES. These spasms can prevent food from reaching the stomach. When this happens, the food gets stuck in the esophagus. Sometimes the squeezing moves down the esophagus in a coordinated way, but it is very strong. This can be called nutcracker esophagus." There are several more notations in various formats. All of them say it is a side effect of GERD, which I have, or Barrett's Esophagus, which I have also, or hiatal hernia. I suspect that a bland diet of small bites of easily-digested food, very well-chewed, would be as good as anything. Probably eating such a diet over a period of about 6-8 meals per day would be the most effective treatment. Limit salt, strong spices, acid food, etc. Have you had your eosinophils checked? I am guessing that an over-abundance of eosinophils would cause nutcracker. I know it causes a lot of my esophagus problems. Now, this is just a quick guess on my part right now, but thanks for making me think about it. And if you are already doing these things, just ignore me. But thanks again.

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I was diagnosed with esophogeal spasms which sounds a little different. I experienced very severe chest pains that subsided once I was put on acid reflux medication, buscopan and taken off Prednisone. In my case, my gastroenterologist suggested that the spasms could have been brought on by the severe trauma to my back (from a fall on black ice) or from swallowing many pills daily (why does Prednisone only come in 5mg. doses?) or a combination of both.

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Hello @blackoutthesun and welcome to Mayo Connect! We appreciate your post and we look forward to getting to know you.

This sounds like a very uncomfortable problem you are having. Has your physician offered any help to you through medications or procedures?

You mention problems with your arms and hands - are you referring to pain or something else?

Teresa

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@hopeful33250

Hello @blackoutthesun and welcome to Mayo Connect! We appreciate your post and we look forward to getting to know you.

This sounds like a very uncomfortable problem you are having. Has your physician offered any help to you through medications or procedures?

You mention problems with your arms and hands - are you referring to pain or something else?

Teresa

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Hi Teresa and thank you! The motility issues basically my esophagus is very inflamed which causes pain numbness tingling throughout my arms and hands. I have to be very careful as far as using the upper body for example I pulled some weeds and grass a few months ago and afterwards I had bruises on my fingers and bad pain/ inflammation in hands arms chest upper back. I cannot do simple tasks sometimes such as washing dishes, driving, opening jars, grocery shopping (pushing the cart) or anything that involves fine detail. I'm an artist and have had to stop drawing due to the inflammation and pain it causes in my thoracic area chest and hands.

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@hopeful33250

Hello @blackoutthesun and welcome to Mayo Connect! We appreciate your post and we look forward to getting to know you.

This sounds like a very uncomfortable problem you are having. Has your physician offered any help to you through medications or procedures?

You mention problems with your arms and hands - are you referring to pain or something else?

Teresa

Jump to this post

@blackoutthesun

It sounds as if this condition is limiting you in a lot of ways. I'm really sorry that your art is affected by this problem - that must be very disheartening to you. Have you found any treatments to be effective? I'm thinking of things like diet and/or meds.

Teresa

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Hello @blackoutthesun and welcome to Mayo Clinic Connect. Sorry to hear you are having those issues, it sounds very painful. @hopeful33250 (Teresa) has been waving flags in your behalf to find someone that knows about your condition. I hope I am not exposing something that I shouldn't but I just wanted you to know how some of these caring people work on the connect.
I do not know about this condition but saw Teresa's flag and found some information. You will need to look closely or do a quick find for "nutcracker" in this document. You may have already seen this but I will throw it out there for you to look at. Again, it sound very painful but it looks like it it treatable. Let us know what you think.It does sound a lot like what @kimh and @oldkarl was describing, https://www.mayoclinic.org/diseases-conditions/esophageal-spasms/symptoms-causes/syc-20372250

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@oldkarl

@blackoutthesun Oh, my goodness! This is one I thought I did not have, but after looking up the definition and notations, I am not so sure. I sometimes feel as if my esophagus is trying to squeeze the food back out, especially if it is an acid-type food such as salsa, Tabasco sauce, etc.Or if it is very cold, or hot. Mayo has told me I have esophageal spasms, but did not mention the "nutcracker" bit. Google says: "This condition may be called diffuse esophageal spasm, or DES. These spasms can prevent food from reaching the stomach. When this happens, the food gets stuck in the esophagus. Sometimes the squeezing moves down the esophagus in a coordinated way, but it is very strong. This can be called nutcracker esophagus." There are several more notations in various formats. All of them say it is a side effect of GERD, which I have, or Barrett's Esophagus, which I have also, or hiatal hernia. I suspect that a bland diet of small bites of easily-digested food, very well-chewed, would be as good as anything. Probably eating such a diet over a period of about 6-8 meals per day would be the most effective treatment. Limit salt, strong spices, acid food, etc. Have you had your eosinophils checked? I am guessing that an over-abundance of eosinophils would cause nutcracker. I know it causes a lot of my esophagus problems. Now, this is just a quick guess on my part right now, but thanks for making me think about it. And if you are already doing these things, just ignore me. But thanks again.

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And besides the small bites, drink water with food to help it go down.

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I have had food get stuck in my esophagus and cause severe pain. Usually it will be pieces of chicken. When I finally get it down, usually by drinking enough water to move it on, the pain is gone. If I take too many of my pills at once, they can get stuck in my esophagus. I have felt that these things occur after I have had an acid reflux episode and it feels like my esophagus is swollen for a while from the acid reflux. Most of the time, my esophagus can handle the chicken and the pills.

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I have been diagnosed with "hypersensitive esophagus". This means that anything can cause my esophagus to get irritated- anxiety, lack of sleep, wrong foods, allergies, sinus drainage. This phenomana was not apparent to me prior to the nissen fundoplication and very large hiatal hernia repair. The AMA treatment for this is hypnotism and antidepressants. Hypnotism did not work for me. Atavan- 4 times a day @1mg/ use does help me sleep and reduces the "heartburn like" symptoms. Antacids do not work any more because the nissen fundoplication has stopped the acid reflux. i have not heard of nutcracker esophagus. Perhaps you may want to go to a hypnotherapist to see if post hypnotic commands might help alleviate your painful condition. Have you tried Cannibinoid oil sublingually? This is legal in all 50 states,because it is from hemp. I'll attempt to do some research on this and feedbaclk anything i can find out. I do have rheumatoid arthritis also. The CBD oil sublingually did help body pain somewhat, but does not help my "hypersensitive esophagus". I can still drive and do little things. I know as an artist you must be able to concentrate, so this is difficult for you. Perhaps there are enough of us to find help for these very unusual esophagus conditions. My esophagus is delaying me in getting the spurs removed form my neck to eliminate my neck and face pain . One other thing; have you tried lyrica, gabapentin, neurontin? these are all powerfull
nerve pain supressors. Lyrica has helped me with neck and back pain, but after 2 uses i got very bad body itch.... good luck and better health to you!...kozlo52

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I was recently diagnosed with Esophagitis Eosinophilic, esophagus damage due to allergies. I've had trouble with allergies since early childhood but when I started getting really sick at age 16 no one could figure it out. I don't know if an esophageal manometry was invented yet, this was the mid 80's. Also I was pushed out of a moving car at age 1, luckily while turning a corner, I suffered minor head trauma and was sent home. A psych doctor ask few years ago if I had head trauma as a baby because I also had a grand mal seizure in my mid-twenties. I know now I have orthostatic hypotension and I was sick of getting the extreme dizziness / headrush upon standing so I decided to not sit back down and see what happened, I should have sat back down! I had no insurance at the time and was young stupid, didn't go to the ER, once I got down on the floor the tremors stopped but after that neurologically I was much worse for several months. In 98 when the 2 protruding discs were found and I got the fibro diagnosis, I was put on a regimen of pills and was told all of my upper body problems were fibromyalgia! Finally in 2010 an MRI of my neck revealed 2 bulging discs and 3 slightly protruding. I also have scoliosis that was not discovered until a year ago from an accident when I was 17. I believe cervical stenosis, possibly congenital, caused my allergies to be worse. I suffered emotional trauma as well after being adopted at age 8. Pent up adrenaline, lack of communication, led to extreme anxiety, sleep problems, etc etc etc. I just bought some raw all allergy blend honey from local farmers, I live in Central Florida lots of allergens here. I'm also buying bee pollen to experiment with. I'm currently taking prednisone and Protonix waiting to see my GI doc next week! I hope this helps you or anyone suffering from this excruciating painful so-called rare disease!

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