Acupuncture for Intractable Oesophageal Spasm

Objective: To review a case of intractable oesophageal spasm treated with acupuncture alone.

Case: A 22 year-old Caucasian right-handed female presented to the head and neck surgery clinic with a two year history of dysphagia. The patient had difficulty swallowing solids and liquids and therefore received an extensive work-up, including two upper gastrointestinal endoscopies with oesophageal biopsies, as well as a barium swallow. Biopsy results revealed no evidence of Crohn's oesophagitis or eosinophilic oesophagitis, and only mild evidence of gastro-oesophageal reflux disease. A barium swallow showed diffuse moderate oesophageal spasm. The patient was treated with multiple modalities, including anti-reflux medication, swallowing therapy and endoscopic oesophageal dilation, without any benefit. Although the reflux was controlled, the dysphagia persisted. The patient was therefore referred to the senior author for other modalities of treatment.

Methods: The patient was evaluated for diffuse oesophageal spasm and treated with acupuncture alone. Acupuncture points included auricular points for the oesophagus and gastric antrum in the right ear, Shenmen in the left ear, and Baihui DU-20 on the scalp.

Results: The patient's symptoms of dysphagia completely resolved within 24 hours. She was able to swallow both solids and liquids normally, without any further medical intervention. The patient returned to clinic approximately every three months for further acupuncture treatment, whenever her symptoms recurred. Conclusion: Acupuncture may be a viable alternative for select patients who fail to respond to conventional treatment for diffuse oesophageal spasm.