Esophagus problems

Dear Ask The Doctor: Late last year, I began having symptoms of dysphagia with my reflux, which over the months escalated to a lump in my throat and slow-moving food. I went to a GI in early March and he performed an esophagoscopy. Results showed a small hiatal hernia and small Schatzki's ring. He dilated the ring and said most of my symptoms were probably due to anxiety and stress. I was taking 15mg Prevacid once a day and that seemed to help, but after a while I started to feel a pressure in my head and throat and intense anxiety. I stopped taking Prevacid a few weeks ago and the pressure went away and anxiety subsided. I now take Pepcid once a day, which helps the reflux. However, over the passed few weeks I have felt a soreness in my chest cavity after I eat. It almost feels like a pulled muscle and sometimes a slight burning. Upon physical examination, I discovered the soreness is around the chest cavity and also just below under the ribs. I think the discomfort is in my esophagus. I also notice that when I eat a lot of simple carbs and starch or greasy foods, the food seems to move slower down my esophagus. My diet has been altered to eat better foods such as whole grains and complex carbs, lots of veggies and foods with fiber and protein. I'm also trying to eat slower and take smaller bites. However, I'm still having discomfort after having a day of heavy foods, like an Easter meal. Could I possibly having muscle spasms in my esophagus? Could it be the Schatzki's ring constricting? Or is there something more serious? Should I be concerned? I can't keep going back to the doctor for more tests or to have him tell me its just anxiety.

Dear Laura: I understand your concern about your esophageal discomfort. It might be due to anxiety but there are also other possibilities to rule out, according to the characteristics the likelihood of spasms in your esophagus are one of them. Esophageal spasms can lead to chronic swallowing problems and pain. These are uncoordinated series of muscle contractions that prevent food from traveling properly from your esophagus to your stomach. These spasms can be very painful. Chest pain is a common symptom of esophageal spasm.Certain kinds of foods can activate these spasms but since you have a history of GERD this could be considered the trigger in your case. I suggest you to re evaluate your esophageal reflux and rule out this possibility, certain medication like muscle relaxants and calcium channel blockers could help you with your symptoms. I wish you a prompt recovery.