Muscular Spasm in oesophagus

[LittledoIknow]

Hi,

Looking for a bit of help and advice about a particularly concerning condition.

I hold a class 1 medical and have never had any major problems, but during the last 3 years I have had occasional problems when eating.

The symptoms are that during a meal I will swallow and very occasionally will suffer from what can only be described as cramp or muscular spasm in my oesophagus. The pain feels like someone is crushing my neck and extends all the way down to just behind my sternum. It usually lasts about 30 seconds to a minute but is absolute agony and as a result is totally debilitating. It leaves me unable to talk, and act normally and I certainly couldn't maintain control of an aircraft during this. Hence I don't eat when flying.

I had an attack 2 days ago and my work colleagues (not currently in a flying job) nearly called an ambulance they were so concerned. Even when the pain stops it takes a good 3 to 4 minutes to recover.

As yet this has only happened when eating, and after the event I can continue eating normally although mentally it does scare me to do so because I worry it will re-trigger the attack with the associated pain.

Does anyone know what this is because it certainly isn't heartburn?

More importantly, what are the possible ramifications on my Class 1? As yet my GP and AME are unaware.

Thanks in advance

ldik

[Sim Dude]

go to a doctor go today go now

i had difficulty swallowing then i got lucky and suffered internal bleeding (blood out of mouth) which put me in hosptal and they took a look, it saved my life.

thats the first i heard of esophagul cancer of which the first symptom is difficulty swallowing (which i had) and more advanced symptoms are pains in the chest (which i did not have), do an internet search on esophagul cancerl symptoms i think you will see stuff you reconise

i no longer have an oesphagus since they removed it along with the cancer (touch wood)

not many survive but i am still here as are a (very) few others but to have any chance at all you MUST see a DOC and he should insist on an endoscope with biopsy

it may not be you, but if it is, the medical is the LEAST of your worries your life is in serious danger right here, right now.

if all i have done is scare you consider that a good result. IF the Doc says it is not esophagul cancer.

however if you do have this particular nasty, and want to email some one who has been thier and got the scars to prove it feel free to email me privately.

i am just about back to normal and fully functioning. but you MUST see the Doc to have any chance at all

I think you know that, i am not a Doc but i have been where you might well be right now

Good Luck

[NWSRG]

I have suffered from a similar complaint myself...

The explanation that I recieved (after an endoscope down my throat, and a number of barium X-rays) is that this is a simple random muscular contraction. Some people can develop a small pocket in their throat...as you eat, this can cause a temporary blockage in the throat, sometimes only eased by regurgitation of said food! I find that even sudden temperature changes (drinking a very cold drink along with hot food) can cause the onset of this spasm...

Good news is that it is totally harmless (although disconcerting and embarassing in company, and it can be painful in the short-term)...I also find that sitting with a very straight back and holding your breath during the 'attack' can open the throat and allow safe onward travel of the food in question!

Not sure if this is what you are suffering, but it sounds very similar to my experience...

[LittledoIknow]

Now I am more than a little concerned.

A brief rumage on the old internet comes up with quite a wide variety of possible ailments, several of which seem to fit the bill.

What I didn't mention is that these pains only occur rarely, probably about once per month.

Looks like a trip to the doc then.

Thanks all,
ldik

[Loose rivets]

You may dismiss this instantly, but are the spasms confined to dining after an aperitif?

A very few people suffer an extreme spasm some minutes after drinking sherry!

It can be very, very painful, and often has them leaving a resturant before their meal is complete.

[Milt]

Could be Achalasia.

My fix for difficulty swallowing was a Fundoplication (spelling?) of the upper stomach sphincter. It worked.

[LittledoIknow]

Loose Rivets,

Sorry but no sherry is involved.

I should add by the way, I am a relatively fit 6'3 16 stone 31 year old.

Milt,

Looking at info on the web, it is unlikely to be Achalasia. I have never had any regurgitation, or symptoms similar to heartburn, ie. acid returning up the windpipe.

My symtoms at the moment are restricted to the severe pain of the spasms.

Work permitting, should be going to doc Thursday or Friday this week. A thorough internet search has found "Nutcracker Oesophagus", I kid you not which describes my symptoms perfectly.

Ldik

[Flyin'Dutch']

Oesophageal spasm are not uncommon and more likely to be the cause of these symptoms than oesophageal cancer at 31.

However to come to a proper diagnosis and treatment plan it is necessary for you to go and see your doctor to get it looked into, so make an appointment now.

I think you answered the question to the fitness to fly yourself.

[LittledoIknow]

At the moment, it would appear to be oesophageal spasm, and fortunately not as serious as cancer.

My doctor has prescribed me 2 courses of drugs to regulate the motability of the oesopahgus in the mean time and after a month or so I will need to go and see him again. Edited - the drugs are Metroclopramide and Pantoprazole.

My AME as of yet is unaware or all of this. How much will this relatively minor condition affect my class 1?

Many thanks
LDIK

[Captain Airclues]

LittledoIknow

You MUST tell your AME (JAR-FCL 1.040). You might get away without being found out, but you are flying illegally and there could be serious consequences if you were to have an incident.
I have always found that AME's can be very helpful and supportive if you are straight with them. Don't forget the legal declaration that you sign when you have your Class 1.

Edit;

A quick Google search found the following warning (amongst others) for Metoclopramide "This medicine may cause some people to become dizzy, lightheaded, drowsy, or less alert than they are normally".

Airclues