Steakhouse spasm

Sudden esophageal obstruction after eating poorly chewed meat has been called the Steakhouse syndrome. Some cases have demonstrable esophageal narrowing above which food impacts, but in many patients with identical symptoms no underlying obstruction is demonstrated. We report four patients with acute dysphagia who were unable to swallow liquids or solids for as long as 72–96 h. Onset occurred after eating meat in three patients and after taking psyllium in one. All had a structurally normal esophagus demonstrated by x-ray and endoscopy, but motor disorders were denned by manometry in three. We hypothesize that an underlying motor abnormality led to food impaction and call this presumed spastic variant “Steakhouse spasm.” We suspect that this is a common but frequently unrecognized manifestation of esophageal dysmotility.