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Smooth Muscle Spasms

I have smooth muscle spasms in my gut, mostly in the diaphragm area, though they often spread up my chest, and sometimes affect my lower abdomen.   A colonoscopy has shown no organic disease in the colon, and u/sound scans and MRI scans have ruled out any disease in other abdominal organs.

The spasms have a severe effect on my breathing, making me constantly breathless, and I am woken several times a night struggling to breathe.

I have been prescribed several drugs in the past, at different times, to treat the problem. None of them helped, partly because of the side effects I experienced .  The drugs were a small dose of  benzodiazipine, which made me too tired to do anything all day. Later I tried a very small dose of Amitryptiline, but it  made me too agitated to continue with it, and did little to relieve my symptoms.

I do not suffer from diarrhoea or constipation.  But when I tried taking one of the smooth muscle relaxant drugs (cannot remember the name of it) it gave me terrible constipation, which was a nightmare to resolve.   There is just no point in me taking a drug that makes my quality of life worse than it already is.  Can anyone recommend a drug that might relax the muscle spasms, without giving me constipation or other intolerable side effects?  

Thank you.  
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Avatar universal
Sounds very similar to symptoms I have had in the past and occasionally still get.  My condition was caused by the vagus nerve being "turned on", being in "flight or fight".  I didn't feel stressed but I had had bunion surgery many years ago and I cannot take pain meds so had to endure the pain postop which was no fun.  I think that's when the vagus nerve got "turned on" because there was a lot of stress at that time. The spasms started after that.  What has helped me the most has been something called Network Spinal Analysis, which is a form of chiropractic but without the cracking to correct the subluxations.  It has helped me immensely.  I don't believe in taking drugs because they all have side effects.  I as well am celiac and find that if I am exposed to gluten, my spasms return, so I do feel that the colon is involved but the network has been a lifesaver for me.
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Hi there, glad to hear you've found a solution that's worked well for you :)

My health problems are in fact all linked (as it turns out) to the Bronchiectasis (a type of COPD) and severe asthma I suffer from. :(  

I also have quite bad scar tissue in the bottom lobe of my left lung and so my lungs do not have the elasticity of normal lungs. This gives me muscular pains if I am physically active, even walking at more than an ambling pace.

I do suffer from muscular cramp a lot, in many areas of my body, but this is a symptom of the lung disease in my case.

So far my arteries and my heart are OK thank goodness! ;)
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Hi Jenni. I have similar issues to yours. It has been getting worse with age. I finally found out that my conditions are caused by arterial spasms. The solution (so far) has been the nitro glycerine patch.
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Hi, I sympathise with your search for answers, as I have been through the same kind of search and as you say, it's very frustrating.

My doctor referred me to an excellent  dietitian to help resolve my allergies, and I must say it has made a big difference.

The life changing difference was she put me on the low FODMAPs diet (FODMAP stands for Fermentable Oligo-  Di- and Mono-Saccharides and Polyols).  At last all my allergies made sense, instead of being an unconnected bunch of odd things!

http://fodmapsdiet.com/

In addition because I have chronic abdominal inflammation I have problems eating bulky foods or big meals, as food cannot get through my gut easily and causes blockages. So the dietitian advised small regular meals (up to 5 a day) of foods low in fiber. This has also been a big help.

best wishes,
jenni
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Avatar universal
I have been dxed with several different autoimmune disorders throughout my life, since I was 17. My Dad saw first symptoms of food intolerances when I was a child. I started having symptoms of autoimmunity when I was 14. The autoimmune is not consistent in diagnoses, tending to attack several different parts of my body and though I've had autoantibodies for autoimmune hepetitis, Sjogren's, and autoimmune thyroiditis, they are not consistent positives (they seem to go away). I also get extreme inflammation easily, of joints and muscles and nerves, run fevers, and have pretty consistent fatigue and limited energy.
I do not take medication because of the lack of a consistent diagnosis. I put myself on an elimination diet, and have found ways to eliminate and avoid the chronic pain that accompanied me for several years.
However I still have to consistently deal with fatigue, occassional fevers and muscle spasms, impaired mental function (brain fog), limited energy, muscle/joint/nerve inflammation, and occasionally new issues spring up.
I take care of myself as well as possible. I am on a gluten free, vegan, whole food diet; no refined sugars, corn or corn products, soy or soy products, and no legumes. I also take maca powder, Vitamineral Green, and hemp protein. I am still working hard on trying to improve my health and reduce my symptoms.
Almost each time I try to improve or change my exercise...I basically end up with numbness and tingling in my feet, hands, and arms, my muscles spasm, and I start to lose strength especially in my hands. I have to go through that for about a week and a half as my body adjusts. It usually lasts about a week to two weeks. For some reason, taking Vitamiberal Green reverses the numbness. Stretching and rest get me through the spasming. Right now, I just changed my exercise and am dealing with back spasming that moved to abs and affects breathing. It is frustrating.
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Hi, thanks for replying.  I was recently diagnosed with COPD/emphysema, which is what has been causing my symptoms for the past 7 yrs. It was wrongly diagnosed 5 yrs ago as
asthma.

It is interesting you have a problem exhaling, as coincidentally people with emphysema have the same problem, and find it hard to empty the lungs fully.  This means my lungs are hyperinflated most of the time, which in turn leads to other problems, such as pressure on the diaphragm, muscle pain and gastric dysfunction because of the internal pressure on my stomach and small bowel. .  
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Hi, I have diaphramatic spasms.  I have spinal cord injury and autonomic dysfunction.  I understand exactly what you feel.  I take neurontin, potassium, and magnesium.  They help the most medication-wise.  My potassium must be at least 4.2 or more, and my magnesium at kept at the high end.  I had very good specialists help with my medications.  What helps the most with a doubt is oxygen at night and a BiPAP machine.  Because exhaling is difficult for us, I have a BiPAP harmony machine and am on 2-3 litres of oxygen at night.  Portable oxygen during the day will significantly reduce the spasms.  I can now talk if I use portable oxygen, otherwise the spasms hurt so badly.  
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Hi, I have not had any trauma as such, to the abdomen, however, 5 yrs ago I had an enterocutaneous fistula, (related to my Crohn's Disease) which exited right above the diaphragm. It took a year to drain and heal, and it was after that the tightness and spasms in my diaphragm began.

My gastroenterologist thought the fistula may have caused an adhesion when it healed, and tightened the surrounding tissue, which would account for the pulling sensation I get in the abdomen.  There was also the suggestion  you referred to, that I might have a diaphragmatic hernia.

However, when I had the MRI scan of the abdomen with enteroclysis, everything looked normal.  The radiologist said a hernia would have shown up, as probably would an adhesion. So the conclusion is there is no physical evidence of anything, and that therefore it must be a functional disorder, rather than a mechanical disorder. I find this hard to believe as nothing at all seems to relieve the symptoms, and if it is functional surely something should help......  

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Avatar universal
My spasms sound very similar.  They started after a car accident 2 months ago- I was rear-ended by a drunk driver travelling around 50 mph while I was stopped at a red light.  Had some other abdominal, pelvic and spinal injuries, but now the spasms and swollen abdomen are my worst symptoms.  

One doctor I spoke to thought that a diaphragmatic hernia could be the cause.  I am waiting to hear how my doctor wants to proceed.  Just wondering if you have had any blunt abdominal trauma in the past or if hernia of the diaphram has been ruled out in your case.

Best Wishes-
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I have been taking Natural Calm Magnesium Citrate for 3 months but regret to say it has had no effect on the muscle spasms in my diaphragm progressing up my chest wall.

I also had an MRI scan of the spine, which found mild spondelosis in the upper part of the spine, which I was told by the consultant could NOT be causing the tension and spasms in the diaphragm.  My lung specialist says the spasms are due to a CNS disorder, but he does not know what exactly, and cannot suggest what tests to have next.

It is very depressing as it is affecting my life so much.  Having had to give up so many things I enjoy, such as all sports, and even long walks, I have now had to give up my singing, as it is too painful to move my diaphragm when taking a deep breath.
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Avatar universal
Thank you for the helpful suggestion.

I have been taking magnesium citrate in capsules for the past 4 years, but according to the Natural Calm website it is more effective taken as a powder in hot water. So, I have ordered some of it, and hope it will be as good for me as you have found it.  Will let you know how I get on.

Thanks again.
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Avatar universal
Re diaphragm spasms (or any muscle spasms), I have found that a powdered magnesium supplement called Natural Calm has been amazingly helpful; it generally helps the muscle begin to relax within just a few minutes.  You add it to water and drink (not bad flavored, either); apparently it's more bio-available because it is powdered.

--Emilie
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Avatar universal
Hello.
I am not english speaking but I try.
I`ve been taking the thyroid replacement for 10 years now. When I still had my thyroid gland and my TSH was 1, and I took my first Eltroxin, I felt sick, and had many of the symptoms you have. I took 25µg every day for 3 month.
I couldn´t live like that and decided not to take it anymore, but I took 50µg once a week anyway. I felt much better after few days.
I was trying to take the medication and not to take it maybe 5 times with the same result every time since the year 2000.
Now 10 years later I almost don´t have my thyroid gland and 1 year ago I had to take the replacement every day. I never felt more sick. I almost don`t go out anymore.
But I found out that thyroxin is a smooth muscle relaxant. And it could be the reason to all the symptoms. My digestion is not working as it should. I got hernia every time I started to take the replacement, pain in the solar plexus, throat feels dry, some kind of tension in cheast, caugh, I feel like "drunk" all the time, very tired, breathing problems. First time I didn`t sleep for 4 days( and nights). It feelt like I was forgetting to breath the second I fall a sleep. I also get some kind of short "black outs" when I´m very relaxed.
If the smooth muscles are relaxed, you can get hernia. The stomach acid irritates the rest, throat, lungs ...
Thats is my teory after reading a lot about it for one year and feeling how my body reacts.
If this is true, taking smooth muscle relaxant makes it worse. Nicotine, coffein, and maybe magnesium does it also.
My experience is that C vitamin makes the stomach acid stronger.
The problem is that the acid should be in the stomach, but the esophagal valve is not closed.
I got pneumonia, two times, after taking 2 grams of C vit for 3 days.
My tongue is more white on the surface, since problems with the stomach acid started.
One more thing is that the refluks can also be alkaline, so you don`t feel the acid - when the pancreas enzymes run back to the stomach.
I still don`t feel well and now Im trying to eat more organic in stead of taking vitamins and minerals, and dont take any smooth muscle relaxant. I dont know if D vitamin has someting to do with it, but it feels that way.
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Avatar universal
Dear Jenni,
I'm glad you posted back about what was causing your health issues for so long.  It is very helpful to those of us who try to advise others here in gastroenterology.  I'm so sorry your small intestines were diseased and caused all this!  I wonder if when they finally operate on you, maybe you'll get to eat all that stuff you've been having trouble digesting for so long!   Anyway, in the meantime, I hope you continue to manage well.  

Dear Chrissie,
I think it's the disease you have in your upper digestive tract, the larynx and esophogus, that is making your diaphram feel like it's got to cough, PLUS you've been coughing because of the recent irritation to your throat.  Probably some soothing tummy medicines will help this, ask you doc.  I do not think it has too much to do with withdrawals, altho they can intensify anything physically and mentally problematic to you.  
GG
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Avatar universal
Hi Chrissie,

I am sorry to hear of your problems.  

It is difficult to say what is causing the pressure in your diaphragm.  All I can say in my own case, is that the cause of the pressure in my diaphragm and the muscle spasms in my diaphragm and chest, has turned out to be due to congestion in the upper part of my small bowel.

The congestion is caused by narrowing (visible on the x-ray) due to years of inflammation and infection in the small bowel, probably due to undiagnosed Crohn's Disease.  Food I eat gets stuck at the point where the bowel has narrowed.

It is likely I will need surgery eventually to remove the damaged part of the bowel, but for the moment I am finding some relief by following a low residue diet  (very low fiber), eating very small meals, and drinking large quantities of water (up to 3 liters a day) to wash everything through the congested area.  I don't know whether it would help you to try this, but you may think it worth trying it perhaps.

Best of luck.
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Avatar universal
I am posting this wherever I think I may get some help. I wonder if the folk on this thread are still around?


Can anyone help please. I have a problem with my diaphragm that I dont know how to explpain! It is almost CONSTANT and is driving me crazy. It feels as though it is contracting for me to be sick or cough or expel something. It is an URGE. feeling. I just expel air and it feels as thougha dozen snakes are wiggling about inside me making me PUSH from the diaphragm area.

I do have gastritis and esophagitis which I think is not active as I have no pain. I also have reflux disease of the larynx and pharynx which I have stirred up by drinking coffee 5 weeks ago. (Stopped now) Because of this I have had an incessant tickly cough for 5 weeks. This is of course making the diaphragm worse. But it is not the cause as I had it before this.

I was addicted to diazepam and tramadol - prescribed by my doctor - for a year. I came off - cold turkey - 4 months ago. Could the diaphragm problem be part of the w/d? Also I began taking a potassium supplement a few weeks ago. Could this have effected it?

PLease someone help me! I have had a dreadful year with the drug problem and can hardly face this new thing - especially as I am still going thruogooh withdrawals from the diazepam.

Thank you.
Chrissie
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Avatar universal
Hi, thank you for your comments.  The spasms and tightness in my chest emanate from the spasms in my left side under my ribcage, and the burning pain in my sternum also comes on when the pain in my diaphragm is bad. My neurologist is certain the mild deterioration in my spine cannot be the cause of the pain in my lower left side. He does not want to refer me for an MRI at present. I have no problems bending, stretching etc.

Thank you for your suggestion for relaxation -- I tried it and it's a great idea.  

I agree it is a good idea to take supplements. I have osteopenia, so I have to take calc/mag & Vit D and Boron. I also take all the B vits, CoQ10, Vit C, Selenium, Zinc, and Omega 3.

Thanks again.
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Avatar universal
Hey Jenni,
I read your thread here, I have thoracic spine issues, so I think you do indeed need to have either CAT scan or MRI of your spine.  When I broke my back in three places in the T-spine, those nerves go around the chest, and at the time made it very hard for me to breathe.  Also, I've had thyroid problems, and keeping the dose right is challenging for docs, so of course keep up with the visits to the endocrinologist.  While they're figuring your spasms out, I have a few suggestions to sort of help you relax your abdomen.

Lay down in a quiet low-lit room, flat on the floor with your legs bent, and do some deep breathing.  Rub your tummy with a flat hand, soft but firm, in a clockwise motion at the same time.  Also, focus on an object in the room that catches a light, just stay with it and empty your brain of all thoughts.  Do this for ten minutes a couple times a day.  

Another thing is, they ought to put you on better spasm type drugs, in the category of the barbituates as epilepsy medicine, the doc needs to find one that will not dry you out and constipate you.  Lastly, even tho your bloodwork says all is well, I think you should take extra B vitamins, extra calcium and vitamin D, keep protein going especially eggs for the omega3s, and consume probiotics once a week just to keep you digestion completely straight since it's a disaster when it goofs up.  These are just my suggestions, take what you want and leave the rest.
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Avatar universal
I had the results of all the blood tests I had recently.  Everything was within normal range. I do not have hypokalemia, or hypocalcemia. My B12 is normal, as is my ferritin. There were no inflammatory markers.  Nothing the least bit suspicious.

So my GP decided it is IBS causing the pain under my ribcage,  and he prescribed hyoscine butylbromide, a smooth muscle relaxant. I  took 40 mg for 4 days and it was a disaster.  It messed up my BMs, which are usually normal, and gave me terrible griping pain in my abdomen that kept me awake at night. Also it gave me severe eye pain, visual disturbance,  dizziness, copious sweating, itching,  breathlessness and horrible fatigue.
It also triggered several asthma attacks.  The area under my ribcage became stiff, so that kind of numbed the pain a little bit for a while.  

I felt too taking the hyoscine to continue. Have felt much better since stopping it, but of course I have the pain under the ribcage back again in full.  I cannot see how my pain can be due to IBS if I get such a bad reaction to a medicine that helps many people who have IBS.

One doctor in the past suggested I might have an adhesion (from the stomach to the transverse colon) as this could account for the painful pulling, stretched feeling I have. However, as I have never had abdominal surgery it was unlikely.... do you agree?

Another thing mentioned in the past was possibility of a small hernia not visible on the xray. However, usually there would be acid reflux with this (which I do not have), and PPIs would help, whereas they did not help me with the pain.

Although I have mild diverticular disease in the sigmoid colon, the docs are sure I have none in my transverse colon, as they say it would have shown on the xray. Or at least some narrowing or widening would have shown up.

So it continues to be a mystery.
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Avatar universal
My GP has just prescribed Hyoscine butylbromide for me,  which is a derivative of Hyoscyamine.  I am hoping I can tolerate it and it will help, as I have not got on with other smooth muscle relaxants in the past..
An extended release form sounds convenient. If  I am going to be taking it longterrm I will ask the GP about it.  Many thanks.
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About the constipation, yes these meds usually slow you down so I try to balance that in my diet. I have to be careful with insoluble fiber because of the IBS so it balances out
most of the time. Fat is really my enemy with IBS and is my number one trigger.
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Levsin is hyoscyamine, a smooth muscle relaxer. I use an extended release form.
I also have used Belladonna alkaloid which is a combination of phenobarbital, with the following anti-spasmodics: atropine, hyoscyamine, and scopolamine. I use the Belladonna  when I am having an "attack" of pain. One of my additional problems is that my body becomes accustomed to pain type meds or muscle relaxers quickly and I have to up the the dose to achieve the same results. So the Belladonna worked well when I first used it but now I have to increase the amount. A good resource for medical info including medications is medlineplus.gov  
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Thank you for directing me to the Vagus Nerve posts -- they were very interesting to read, and helpful.   I think it could well be the case there is pressure in my diaphragm on my vagus nerve, and maybe it is this that is causing my chronic severe breathlessness.  Though there does not seem to be any treatment for vagus nerve problems....

I was also interested you mentioned dysautonomia, as that has been mentioned to me before by doctors, and to that end I was prescribed a small dose of tricyclic antidepressant a year ago but unfortunately I could not tolerate it as even 2.5.mls made me unbearably agitated and irritable. The drug does this to some people apparently.  

I am just about to start learning Tai Chi, as I have heard it can be very helpful for many things including dysautonomia.   I will post here to report how I get on with it..
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Avatar universal
Thank you for your comments. It is reassuring to know there are others such as yourself suffering similar symptoms. I have gotten so depressed with this illness as it restricts my life so much, and being in constant nagging pain gets me down.  Unfortunately as I have asthma I am very allergic to codeine based meds such as Vicadin, and all opiate derivative painkillers.  Nor can I take NSAIDs as I have had gastritis. So am left with paracetomol, which I do not find very effective, especially against the agonising burning pain I get in my sternum and ribcage. I am grateful I don't have GERD on top of everything else.

3 yrs ago I was diagnosed with Chronic Intestinal Pseudo Obstruction (CIPO) as on the basis of my symptoms I was a clear cut case. However when I had all the x-ray investigations
there was no evidence of the disease, so the diagnosis was withdrawn and I was instead told I had IBS.  I have never thought IBS fits my symptoms as I don't have constipation or diarrhea.  However it is true to say  foods are a trigger for my attacks. Or I should say, were a trigger, but no longer as I worked with a nutritionist for over a year and identified all my triggers and now strictly avoid them. My diet consists of only fresh cooked organic meat (non red meat) fish, vegetables and a little fruit. Nothing else. All I drink is water.  

I have not heard of Levsin -- is it a painkiller?

Which smooth muscle relaxants do you find helpful?  Do any of them cause constipation?  That was my experience when I used them in the past.
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