I have been having esophageal spasms frequently for several years. I had manometry, EGD, & Barium swallow tests 4 years ago. I was placed on PPI s, and used them for a few years... my next EGD showed atrophy of my gastric mucosa , so I discontinued PPI s. Now, my spasms are causing me to black out (occasionally, and within the last year ) The frightening part is that I never know when it s going to happen. A doctor at the mayo clinic told me to not worry, because if I pass out, it will always relax. The spasms are coming on quicker, and without adequate warning, I have blacked out even from swallowing room temperature water. I cannot drink or eat anything while driving, as I m at a huge risk. If I use peppermint to relax my esophagus , I end up having reflux. My life is less stressed than ever, except for this problem. I m already on Cymbalta, Trazadone for PTSD, propanolol, and clonazapam. Could it be the pain that is causing me to black out? ( happens within a few seconds) vagal nerve involvement?