Common diagnostic tests for cardiospasm are esophageal manometry and barium swallow test.
Barium swallow. The patient has to swallow a barium solution and the movement of fluid will be recorded with fluoroscopy.
If the person suffers from cardiospasm, narrowed gastro-esophageal junction will be seen a rat’s tail or bird’s beak appearance.
Esophageal manometry. A thin tube will be inserted through the nostrils and the patient has to swallow many times. This test estimates the amount of muscle movements in the various points of the esophagus while swallowing.
This shows the failure of the lower esophageal sphincter to relax during swallowing and the absence of functional peristalsis in the smooth muscle fibers.
Biopsy. It is not performed typically for diagnosing cardiospasm. This procedure involves the removal of small portion of tissue during endoscopy.
Patients have to chew more, eat slowly, and drink more water while they eat. It is recommended not to eat before bedtime.
Avoiding foods that trigger reflux and taking proton pump inhibitors will help in reducing the regurgitation.
Medicines like calcium channel blockers (nifedipine) and nitrates (isosorbide dinitrate and nitroglycerin) that can decrease LES pressure are helpful.
Botulinum toxin (Botox) can be injected into the LES to paralyze the muscles keeping it closed.
In this method the muscle fibers are expanded and slightly torn by the strong inflation of a balloon inserted inside the LES.
Pneumatic dilatation is highly effective on people who are aged above 40. For younger patients, the results are short-lived.
This laparoscopic surgery is the most effective and about 90% of cardiospasm patients are benefitted by this treatment.
The procedure involves a small cut on the outer layer of esophagus above the LES and extends up to stomach.
Per-oral endoscopic myotomy or POEM is an advanced minimally invasive endoscopic surgery that is similar to the Heller myotomy.