Esophageal Dysmotility?

[sugarbugar]

Hi Everyone!  I haven't written in awhile.  I have a few questions I am hoping someone can help me with.  I had a CT Scan done for my lungs but it also showed Esophageal Dysmotility and Mild Pericardial Thickening.  Can either or both of these cause intermittent chest pain?  The pain is kind of a squeezing and release feeling, then it hurts for awhile and goes away.  I went to my regular GP but of course he just blamed my pain on Sjogren's with out looking into anything. Does anyone know what these two things are?  I am calling my Dr. tomorrow at National Jewish to find out more but in the mean time any help would be appreciated!! 

[lynnmarie219]

Boy, I sure don't know and wouldn't want to venture to guess. Have you called your doc by now? What did he/she think about it?

[dmouse]

Yes, it can cause chest discomfort. It can be one of the early symptoms and can radiate to the jaw, arms, neck or back as well. Sometimes the dysmotility can cause esophageal spasms, or even heartburn that is felt as chest pain. But, word to the wise, any chest pain should be investigated by a doctor to rule out a heart attack as heart attacks do mimic esophageal dysmotility...
Best of luck and hope you find relief!

[Daisy1234]

First please get any chest pain checked out to ensure that you are getting the appropriate medical treatment for your problem.  In my case I have primary and severe SJS with extraglandular features.  My SJS has spread into my gastro tract and I do have esophageal dysmotility and severe esophageal and stomach spasms as well as other issues.

I started getting some what I would now term small discomfort in the chest areas, but now the spasms are a 10 on the pain scale and include projectile vomiting along with other not so nice symptoms.  I too was misdiagnosed initially by my GP (I have a new one now) who sent me to a surgeon who yanked out my gallbladder.  The pain never went away and just increased in fact, because the problem was never with my gallbladder but was my esophagus. 

Now I see a gastroenterologist regularly, and get at least 2 endoscopies a year with botox injections in both my esophagus and stomach as well as taking a slew of medications. This treatment has been very helpful to me.  I also keep a nitro-lingual pump spray with me at all times since it stops severe esophageal spasms in mid stream, but unfortunately leaves you with a migraine. 

[livewssj]

I am 43 years old recently diagnosed with ssj. I have had a esophagus motility disorder since I was 26. All of my symptoms have been for years.
 

[sugarbugar]

Thanks for all the info everyone!  I did end up in the ER the night I posted this due to heart palpitations.  This isn't uncommon for me but they were hitting really hard and fast.  The crazy thing is, once they pumped me with fluids I was fine.  My heart rate went from 115 down to 62, BP went from 115/62 to 90/43 and my heart started beating regular.  I honestly think it might have been dehydration I just didn't know I was dehydrated because I drink so much water.
Good news is, pain, palps etc. are not a heart attack and I don't have fluid around my heart.  However, the ER DR. did say if they don't get my peracarditis under control it can cause fluid around the heart and a host of other problems.
As for the Esophagus, I have an Esophogram coming up. 
Daisy~ You mentioned medicines etc. how do these help?  I still don't understand what dysmotility is.  I don't really have heart burn or anything but my stomach and intestines feel like my food isn't digesting correctly at times and I get discomfort.  I'm sorry you have so many problems with it.  I too am learning I have severe SJS and it's attacking me every where literally! 

[anita]

Sugarbugar,

Esophageal spasms can mimic heart attack just like others have said and cardiac issues should always be investigated first.  I have just gone through this with severe chest pain for a couple months and the first thing the GI said (I went to him first thinking maybe the hiatal hernia was acting up) was to get my butt to the cardio.  Stress echo was abnormal (heart wall problems and reduced blood flow) but heart cath showed arteries only 40% clogged. I just had the manometry test (for esophageal motility) done this past week at Hopkins and don't know the results yet.  however, I am on nitroglycerin for the time being until more is know for both GI and cardio.  Bottom line, get with a cardiologist to check the chest pain thoroughly (not just for palpitations), then follow-up with GI.  Just so you know, Sjogren's can cause inflammation of the blood vessels and thus early atherosclerosis.

I do have one question for you.  Esophageal "dysmotility" is a problem with "movement" of the esophagus...how on earth does a CT scan (still images) show any kind of "motility problem?  Did they tell you how they came about this finding?  I was told the manometry (also referred to as Esophageal motility test) is the only way to diagnose esophageal spasms.  It was a very uncomfortable test and I surely would have opted for a CT scan.  Even gastric dysmotility (gastroparesis) cannot be diagnosed by CT; only with an gastric empty test which shows the movement (of lack there of).  I would love to know how they saw this on your scan.

Good luck, Anita

[Daisy1234]

Hey Sugarbugar:

Some of the medications I take help the esophagus to move the food along thru the digestive tract.  Sometimes I feel really full because the food hasn't gone thru the normal digestive process and is stuck somewhere.  Other meds I take help the esophagus to minimize spasming and the stomach to empty.  Also the gastro problem extends to my colon and intestines as well as I have issues with cronic constipation as well.  I do follow a high fiber diet as well as drink 12 to 14 glasses of water daily.

This all started with some (as I previously termed) milder pain in my chest and has over the last 8 years become progressively worse.  But the  botox injections that I get twice a year in my esophagus and stomach help the most of everything i have tried to stop the violent spasms.

[anita]

Daisy,

What meds do you take for the gastroparesis and spasms?  I have taken domperidone for years and find it to be quite helpful.  I just started on nitroglycerin for the spasms and he said he would use a longer acting nitrate next.  Unfortunately, I have severe autonomic dysfunction that causes significant BP problems of which nitro can exasperate.  I'd be interested in what meds you use to help.  I also agree with you about the dysmotility throughout the colon.  I too suffer with chronic constipation...the entire GI system isn't moving like it should.

Do you notice an immediate difference after the botox injections?   

[Suzy]

Sugarbugar,

Thanks for posting this. Exact same thing happened to me in a few months ago - ER with chest pain and heart rate of 150. They gave me fluids, too, and it eventually went away but I still feel very mild chest pain on occasion. Follow-up echo was clear. This thread is interesting because I developed a sore throat and difficulty swallowing (esp food) last week, and it doesn't seem to be illness-related. Trying not to jump to conclusions and hoping it will go away!

Let us know how your esophogram goes.

Suzy