Sometimes when I eat, particularly rice, my esophagus seems to cramp just like a skeletal muscle would. I have to wait it out, maybe five minutes, until I feel it relax, before I can continue eating. I don't choke, but the food just stays there until the "cramp" is over. And it really does hurt. Any suggestions?

B.D.

The cramping pain you are describing may be due to an esophageal motility disorder -- what many physicians would call esophageal spasm. In fact, there are several motility abnormalities (different patterns of abnormal contraction of the esophagus) that may cause this type of pain. You may have inflammation of the esophageal lining from an infection, or perhaps an ulcer from a pill that got stuck. There is a remote possibility your esophagus is partially obstructed (blocked) from a stricture (a narrowing), or you may have a diverticulum (a pouch) in which rice or other food is getting stuck.

A gastroenterologist can give you tests to find out exactly what's happening. You might have a barium X-ray, in which you drink a liquid containing a substance visible on X-rays, and a series of X-rays are done to show its movement through your esophagus. You might have endoscopy, in which a specialist uses a viewing device to look inside your esophagus. Or you might need a test called esophageal manometry that measures contractions of the esophagus; this involves placing a small tube through the nose into the esophagus to record contractions as you swallow water.