Certain types of food have a tendency to provoke distal esophageal spasm in many patients with gastro-esophageal reflux disease (GERD), without accompanying more typical GERD-symptoms (e.g. heartburn, acid regurgitation). My empirical experience is that rice is a particularly nasty culprit. Does anyone else have seen this causal relationship? What would be the pathologic mechanism?
I stopped eating rice years ago for this reason and will follow this question. I hope someone can give a good answer! Good luck!
Definitively no. ¨Nutckacker¨esophagus (NE) is a well known motor disorder of the esophagus with very clear manometrical diagnostic criteria. Pathophysiology is not certainly known (however rice is not among the factors of imputation). It is observed in patients with psychological disorders and big stress. The path physiology of ¨nutcracker¨ esophagus may be related to abnormalities in neurotransmitters or other mediators in the distal esophagus. Abnormalities in nitric oxide levels, which have been seen in achalasia, are postulated as the primary abnormality. It is clinically manifested by esophageal spasms that produce chest pain.
Some food may produce impairment of peristaltic waves of the esophagus. And maybe spasms. But not a specific motor disorder as NE
These patients should reflux can lead to eating rice. I do not know the mechanism.
I must apologize for that my phrasing may have lead to some misunderstanding. I hope the following will clarify:
Of course, rice does not cause the underlying motor disorder!
What I and others , such as Kathleen Bailey above, have experienced, is that for patients who are prone to have intermittent attacks of spasm in the distal esophagus, rice can be a particularly nasty provocateur.
My clinical impression is that daily intake of a proton pump inhibitor (eg omeprazole 20 mg) resolves or at least mitigates the agonizing tendency. To me, a positive "PPI-test" strongly indicates that the the symptom is related to gastro-esophageal reflux (GERD).
But my question remains: Why does rice catalyze this mechanism? What could be the patho-physiologic mechanism?
I quite agree with Diego Garcia-Compean, that`s a well known motor disorder of the esophagus with very clear manometrical diagnostic criteria but Pathophysiologically, could be linked to chronic Gastro Esophageal Reflux Disease(GERD) complication and manometric correlation between relative Inferior Esophageal Sphincter(IES) pressure; probably interpreted as relative Low-IES pressure as Esophagitis and relative High-IES as Respiratory syndrome.
I started having this problem since a year ago. It seems to be more with basmati rice and not that much with parboiled rice! this is my casual observation. I will have more encounters to confirm it. Thanks
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