BFS: Cricopharyngeal Spasm Explained

Diego4Life

Well-known member
As the swallowing thing keeps coming up, I will give you my view on what I suspect is happening to many of us with BFS and is really the most likely explanation.

Cricopharyngeal spasm

This is caused by spasm of the cricopharyngeus muscle; The esophagus has two valves. When we swallow they relax. Once the food has past through, the valves contract again to prevent reflux of stomach contents.

What can happen is the valve can go into a spasm causing a feeling of a lump in the throat, difficulty swallowing, throat tighness, some people describe that the feel like they have a golf ball in their throat.

The condition is self limiting and usually goes away on its own. It can last from a few days to a few months. The most common cause of this condition is STRESS and ANXIETY.

The kind of swallowing problems associated with serious neurological diseases are not like this. I am not going to describe them because people will start imaging they have them!

Matt, you have seen a neuro, you have had a normal EMG and exam. The one thing all the neuros agree on and all the studies back up is that if you have a normal EMG then you cannot have ALS.

The symptoms you describe sound unpleasent and somewhat familiar to a lot of us. The one thing you can take from this forum is that you can have some really awful neurological symptoms and they do not have to be an indication of anything serious. I have had horrible symptoms for 10 years.

It does sound to me like anxiety is a major factor in your life and this could be causing some or even all of your symptoms. The affects of stress on our bodies lasts months after the stressor has bee eliminated. For example my university did a study into the affects of stress on the immune system. Without going into loads of boring data, they concluded that once the stressor was removed from a person's life, the affects on the immune system continued for a minimum of 8 weeks!

What I'm saying is that even though you have been told that you do not have a serious disease, the affects from worrying about it are still affecting your body and will continue to do so for some time. This is why when people are given the all clear, they still feel awful and symptoms will continue feeding their anxiety more because they think the doctors have missed something!

You may also have back problems? Have you seen a chiropractor? Leg weakness can be caused by nerve root compression, especially if there are some sensory symptoms as well.
 
Blondie, Mark, and Diego4Life,

Thanks for your responses. It helps to receive some reassurance. I'm hopeful this is largely a stress response. Checking some blood work, it looks like there are some possible indicators of the influence of stress on my body (low lymphocytes, high neutrofils). I'm hoping to be able to be present to provide reassurance for others if I can get a stronger sense that anxiety is a primary or sole culprit for my symptoms.

Thanks again,
Matt
 
Yes, bulbar onset is picked up on EMG.

Also, everything I have read about bulbar onset is that it is more rapid. I read about one guy with bulbar onset and within 3 months he couldn't speak. You would notice weekly or even daily progression.
 
Thanks again for your all's responses. As I tell others, if I were an outside observer listening to my story, the first thing I'd attribute a great many of these symptoms to is stress. I've been evaluated by multiple doc's, three of whom have told me this isn't ALS. With normal EMGs and evals, I should be fine. There's only one problem - I keep experiencing new symptoms. Of course, I should be able to ease my mind with the understanding that bulbar ALS is the most rare and it would be even more rare for it to present with limb weakness (the latter of which has been checked out by an EMG).

Yet, like some others on this site, I suffer from a condition called "yeah, but..."

For example: I have several symptoms of the Cricopharyngeal spasm Diego4Life described, but I also have difficulty with: the initial swallow, have to clear my throat frequently, feel a pulsating sensation in my tongue, have neck pain, and become hoarse very quickly. And this does seem to be progressing daily.

I've searched through the archives and did some tongue exercises. Thankfully I passed them. I even found a new self-test: the pill swallow. I chose a few of my vitamins to see if I could swallow them without anything to drink. Went two for three.

Again, thank you all for your responses. It helps to see such responses in this community.
 
Matt,

Check out this site. I mentioned the prospect of reflux before on another thread.



I suffered with hoarseness, chronic throat clearing, laryngitis, esophageal cramps, asthma and post-nasal drip. After gettin on a regime of acid reducing medication these symptoms have vanished. I am not a doctor and I am not dx you but I think it is well worth a look. Get your doc to give you a PPI ( proton pump inhibitor) like nexium and see what happens.

If you have reflux, which I suspect you do, and then you couple this with anxiety, it is a coctail for fear. You feel that symptoms are getting worse and that would also be consistent with GERD. I'll bet that you'll feel better in a week, and then you will only be posting here about your twitching. I am excited for you because I am anticipating a major hurdle that you are about to leap over.

Cheers,
Basso
 
Basso,

First of all, I love your messages. You seem to keep things in great perspective - a trait which I can't claim myself these days!

Second, I should have replied to your other message. I read what you said and had a prescription of nexium refilled. My GP had prescribed it in February when I was having some stomach pain. I've taken it the last few days and am hoping to see some improvement. No matter, I certainly read your reply and was excited at the prospect of this being something as treatable as GERD.

Thanks,
Matt
 
Hey Matt,

I just remembered why I stopped taking a PPI and went with the weaker acid reducer Ranitidine. I started taking Pantaloc which is like Nexium, it addressed my GERD issues but I felt extremely irritable: like I wanted to jump out of my skin. I mention this because when one is sensitive, like I believe many BFSrs are, this can exacerbate anxiety. I have used Ranitidine for about a year and I haven't noticed any side-effects. When I began twitching I thought that maybe the medication was to blame, and so I stopped taking it for about 2 weeks. The twitching continued unabated.

I mentioned the irritability to the gastro and he just looked at with me a bemused expression. He also hadn't heard about reflux affecting the voice, which I found astonishing because it is well documented. Often when a motivated person has a certain condition they learn as much, or more than your average doctor about the condition. One only needs to look at this site to know that that is true. (Yes I do know that there are really good Docs out there) Anyway, I digress.

I only wanted to say that if the PPI seems untenable then over-the counter Ranitidine may work as well. I take 75mg 3 times-a-day rather than the 150mg twice-a-day. Just some thoughts. Good luck.

Cheers,
Basso
 

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