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 – I have never been diagnosed with this officially, but I am pretty sure I have experienced it because GERD has very similar symptoms and I do have GERD caused by a hiatal hernia. The pain comes n so suddenly and feels like a heart attack. I have discovered that sipping some water eases the pain within mere minutes, so I always have a bottle or glass of water near me at all times. Not eating (not even a small snack)) or drinking anything (except for the sips of water durin an attack or when taking medication) after 7:00 p.m. and having the top of my bed raised in risers really helps too.

I had no idea what Jackhammer or Nutcracker Esophagus Syndrome was until I read your post and googled it!
https://www.verywellhealth.com/what-is-jackhammer-esophagus-1191896

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@rashida

@blackoutthesun – I have never been diagnosed with this officially, but I am pretty sure I have experienced it because GERD has very similar symptoms and I do have GERD caused by a hiatal hernia. The pain comes n so suddenly and feels like a heart attack. I have discovered that sipping some water eases the pain within mere minutes, so I always have a bottle or glass of water near me at all times. Not eating (not even a small snack)) or drinking anything (except for the sips of water durin an attack or when taking medication) after 7:00 p.m. and having the top of my bed raised in risers really helps too.

I had no idea what Jackhammer or Nutcracker Esophagus Syndrome was until I read your post and googled it!
https://www.verywellhealth.com/what-is-jackhammer-esophagus-1191896

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Hello @rashida

I noticed you are interested in learning more about nutcracker esophagus. It sounds as if you have found some helpful things to do when you have an episode such as the sips of water and raising the head of your bed. Do you take any meds as well?

Have these symptoms been going on for a long time and have you talked with a doctor about it?

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@hopeful33250

Hello @rashida

I noticed you are interested in learning more about nutcracker esophagus. It sounds as if you have found some helpful things to do when you have an episode such as the sips of water and raising the head of your bed. Do you take any meds as well?

Have these symptoms been going on for a long time and have you talked with a doctor about it?

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@hopeful33250 – yes, I take 1 Lanzoprazole (generic Prevacid) at bedtime. I used to take it in the morning but I found it helped more at bedtime so I switched from morning to bedtime.

I have had this problem for several years, and yes, I am under doctor’s supervision. The sips of water and raising the head of the bed is just something I experimented with, it worked, so I continue to do that. I have an endoscopy every five years or so (along with a colonoscopy) to check for Barrett’s esophagus. So far, so good! 🙂

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I was diagnosed with jackhammer esophagus a year ago. Was misdiagnosed as gets for many years. I couldn’t eat without throwing up and always felt like I was having a heart attack. There are a few treatment options available for this one is a Botox injection in the esophagus which relaxes the muscle. I had this and it worked temporarily. Unfortunately it doesn’t last and have to have injections every couple months and eventually it won’t work. 6 weeks ago I had a surgery called a P.O.E.M procedure. They actually go in with a scope and cut the muscle. I can now eat food without it coming back up or getting stuck. The procedure has a really high success rate but finding a dr that will do the procedure is a little challenging as this is a fairly new procedure. Hope this helps

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@miller82602

I was diagnosed with jackhammer esophagus a year ago. Was misdiagnosed as gets for many years. I couldn’t eat without throwing up and always felt like I was having a heart attack. There are a few treatment options available for this one is a Botox injection in the esophagus which relaxes the muscle. I had this and it worked temporarily. Unfortunately it doesn’t last and have to have injections every couple months and eventually it won’t work. 6 weeks ago I had a surgery called a P.O.E.M procedure. They actually go in with a scope and cut the muscle. I can now eat food without it coming back up or getting stuck. The procedure has a really high success rate but finding a dr that will do the procedure is a little challenging as this is a fairly new procedure. Hope this helps

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Hello @miller82602

I appreciate your discussing your experience with the POEM surgery as it relates to jackhammer esophagus. It sounds as if you were really helped by this procedure.

You mentioned that it was difficult to find a doctor to perform POEM. Would you share how you went about finding a specialist for this procedure?

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@miller82602

I was diagnosed with jackhammer esophagus a year ago. Was misdiagnosed as gets for many years. I couldn’t eat without throwing up and always felt like I was having a heart attack. There are a few treatment options available for this one is a Botox injection in the esophagus which relaxes the muscle. I had this and it worked temporarily. Unfortunately it doesn’t last and have to have injections every couple months and eventually it won’t work. 6 weeks ago I had a surgery called a P.O.E.M procedure. They actually go in with a scope and cut the muscle. I can now eat food without it coming back up or getting stuck. The procedure has a really high success rate but finding a dr that will do the procedure is a little challenging as this is a fairly new procedure. Hope this helps

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How did you come to a diagnosis and what are the symptoms? I do at times have a bit of difficulty swallowing and pressure in my throat. It feels as if there is a lump occasionally after taking meds or eating. This can continue to indigestion and discomfort in my chest. Does that sound familiar?

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@carolinesearch

How did you come to a diagnosis and what are the symptoms? I do at times have a bit of difficulty swallowing and pressure in my throat. It feels as if there is a lump occasionally after taking meds or eating. This can continue to indigestion and discomfort in my chest. Does that sound familiar?

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The symptoms you are having are exactly what I was dealing with lump in the throat chest pain that felt like a heart attack 24/7. Food getting stuck. The test they did was a Manometry. Horrible test but it measures your esophagus muscles when you swallow water. Had it done twice with the same results.

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Thank you for your response. It's good to know someone can relate, although not good that we are experiencing this situation. Hope you soon have good health and all that goes with it.

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Have Achalasia and x-ray showed esophagus abnormality. Had ballon stretching endoscopy and it has worked very well so far—two years. A digestive specialist performed procedure. Also met with registered dietician who suggested a semi soft diet which has also helped. My suggestion is to find a
digestive specialist at a major hospital center such as Mayo and have yourself tested. Manometry is the gold standard test from what I've been told.
It's not pleasant but it doesn't take very long. Also had upper endoscopy done by digestive specialist. This is slightly different than procedure performed by GI doctor. Good luck and hope you feel better.

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It's helpful to read other's comments on this condition. I've had trouble swallowing foods and liquids (and now even my saliva) for well over 15 years now. Food would get stuck in my esophagus and was VERY painful until the muscles finally pushed it down. Many times I had to vomit to get the food out. My problems got increasingly worse the past several months so my small-town nurse practitioner referred me to (a non-Mayo) gastroenterologist. In the past 6 weeks the doctor had me get a barium swallow test, a high-resolution manometry/motility study (I agree with a poster above, not a pleasant test at all), and an endoscopy (of which the doctor performed a balloon dilation during that procedure). He has diagnosed me with Dysphagia, Schatzki's Ring, GERD (of which I take Pantropazole), a floating hiatal hernia, mild reflux esophagitis, and the 'biggie' of Hypercontractile Esophagus (also called Jackhammer/Nutcracker Esophagus). Besides the GERD med, he started me out with taking 2 peppermint Altoids 10 minutes before eating. They did nothing. Now he has me on Diltiazem to see if that med will smooth out my esophagus' muscles. I've been on it a week and no change whatsoever. I also have terrible backaches (and have for as long as I've had the problems with swallowing food and now liquids) and my local pharmacist told me that the nerves in the muscles of my esophagus radiate out the pain I'm having to the nerves in my back muscles and thus gives me the terrible backaches (makes sense to me). Having difficulty even swallowing my saliva has started the past couple of weeks. At the end of my 30 days of the Diltiazem I'm going to ask my current gastroenterologist to refer me to Mayo (where I have been many times in the past 17 years for other problems). This Hypercontractile Esophagus condition is quite wearing on me (I also have severe Fibromyalgia and CFS/ME) and I also take Trazodone at night so that I can get some sleep. I also have an electronic bed that I raise the head up on it each night and that helps a bit with the GERD. I've been following a GERD diet the past several weeks and have taken out acidic, fried, (most) processed foods and only drink water and skim milk. I eat very small bites and chew until its pulverized (it feels like!) and sip water while eating. I eat several times during the day and not put all of my food into the normal 3 main meals/day. It's been very challenging to find foods that I can eat (or not eat) and I'm still figuring out what foods do or don't work best for me. I was interested in the person who had the P.O.E.M. surgery and your comment that it's difficult to find a surgeon who does it. Did you have it done at Mayo? I am hoping to get myself referred to Mayo because they are closest in distance to me (versus another big medical center in the country) and I've read that Mayo has an "Esophageal Clinic" within the gastroenterology department and was hoping they would have expertise in my condition (which I've been told it's a major, but rare, esophageal condition – I'm convinced my current (non-Mayo) gastroenterologist does not have much, expertise in my particular rare condition). Thank you all for your responses.

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My story is similar. Had an endoscopy in 2019 that according to the Gastroenterologist was normal. I was suffering from acid reflux a lot. Fast forward to Jan 2022 when I had another endoscopy. Was diagnosed with GERD, sliding Hiatal hernia, and poor swallowing capacity. My esophagus is wide open. Taking PPI's and following the book "The acid watcher's diet". Did a Manometer test that diagnosed me with nutcracker esophagus. Although I've only had food stuck once in a while and always been able to get the food down, I know there will probably come a time when it's not working. Discussed surgery options with the doctor and am not overjoyed. Only one surgeon in my area performs the Linx which is the one I'm leaning to. It would be nice to hear from people who have had that surgery. In the meantime, I have ordered a device from Sweden (I'm Swedish) that is suppose to strengthen the muscles of the esophagus. It's a small plastic tool that you put in front of your teeth and pull, doing that 3 times a day. It takes a long time to feel the results (3 to 6months) and since it's patented, it's expensive. But reading the reviews, I'm optimistic that it will at least make it better. My doctor poo-pooed it of course! Iqoro.com

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@maureercria

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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Chewing is very important. Of, course swallowing fewer pills at once is a fix. Chewing is what keeps people from choking to death, what helps digestion immensely, and very helpful in weight loss.

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