It's not clear what causes esophageal spasms. However, they appear to be related to abnormal functioning of nerves that control the muscles you use when you swallow. A healthy esophagus normally moves food into your stomach through a series of coordinated muscle contractions. Esophageal spasms make it difficult for the muscles in the walls of your lower esophagus to coordinate in order to move food to your stomach. There are two types of esophageal spasms:Oct. 21, 2015- Occasional contractions (diffuse esophageal spasms). This type of spasm may be painful and is often accompanied by regurgitation of food or liquids.- Painfully strong contractions (nutcracker esophagus). Although painful, this type of spasm — also referred to as jackhammer esophagus — may not cause regurgitation of food or liquids.- Feldman M, et al. Esophageal neuromuscular function and motility disorders. In: Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. http://www.clinicalkey.com. Accessed July 30, 2015.- Castell DO. Esophageal motility disorders: Clinical manifestations, diagnosis and management. www.uptodate.com/home. Accessed July 30, 2015.- Ravi K, et al. Diagnosis and medical management of esophageal dysmotility. Techniques in Gastrointestinal Endoscopy. 2015;17:62.- Cameron JL. Disorders of esophageal motility. In: Current Surgical Therapy. 11th ed. Philadelphia, Pa.: Saunders Elsevier; 2014. http://www.clinicalkey.com. Accessed July 30, 2015.- Weijenborg PW, et al. Effects of antidepressants in patients with functional esophageal disorders or gastroesophageal reflux disease: A systematic review. Clinical Gastroenterology and Hepatology. 2015;13:251.- Coss-Adame E, et al. Treatment of esophageal (noncardiac) chest pain: An expert review. Clinical Gastroenterology and Hepatology. 2014;12:1224.- Castell DO. Chest pain of esophageal origin. www.uptodate.com/home. Accessed July 30, 2015.- Vanuytsel T, et al. Botulinum toxin reduces dysphagia in patients with nonachalasia primary esophageal motility disorders. Clinical Gastroenterology and Hepatology. 2013;11:1115.- Picco MF (expert opinion). Mayo Clinic, Jacksonville, Fla. Sept. 10, 2015.- Khashab MA, et al. International multicenter experience with peroral endoscopic myotomy for the treatment of spastic esophageal disorders refractory to medical therapy. Gastrointestinal Endoscopy. 2015;81:1170.