Esophageal Disease

What is Hypercontractile Esophagus?

Hypercontractile esophagus is a rare type of esophageal motility disorder that is characterized by abnormally strong contractions in the esophagus during swallowing.


Your health is important. Don’t delay care.

To schedule an in-person or virtual consultation with a UH digestive health specialist, call 1-866-UH4-CARE.

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Also known as nutcracker or jackhammer esophagus, the esophageal spasms or contractions associated with this condition can cause the following symptoms:

  • Pain when swallowing
  • Difficulty swallowing
  • Chest pain
  • GERD symptoms like heartburn
  • Dry cough

The exact cause of hypercontractile esophagus is not known but research has shown that it is more likely to occur in people who:

  • Are female
  • Are over 50 years of age
  • Have frequent heartburn
  • Have been diagnosed with GERD

Expert Diagnosis and Treatment for Hypercontractile Esophagus

If you are experiencing any of the symptoms listed above, it is important to see a UH digestive health specialist for an accurate diagnosis so that the appropriate treatment can begin. Before your first appointment, it may be helpful to keep a food diary that notes when the spasms occur and if they seem to be related to certain foods.

After completing a physical exam and taking a medical history, your doctor may order one or more of the following diagnostic tests:

If your test results suggest you may have hypercontractile esophagus, your treatment plan may include:

  • Breathing exercises and techniques to relax your esophagus
  • Avoiding foods and/or drinks that bring on symptoms
  • Medications such as calcium channel blockers or proton pump inhibitors (PPI)
  • Botulinum toxin injections (Botox) to relax your esophagus muscles
  • Peroral Endoscopic Myotomy or POEM. The POEM procedure only recently became available in the United States and there are very few centers with more than 10 years of experience in this advanced endoscopic technique. University Hospitals Digestive Health Institute is proud to offer patients this procedure. Jeffrey Marks, MD, general surgeon and Director of Surgical Endoscopy at UH Cleveland Medical Center further explains the procedure in this video.

Your health is important. Don’t delay care.

To schedule an in-person or virtual consultation with a UH digestive health specialist, call 1-866-UH4-CARE.