What causes Boerhaave’s syndrome?

What causes Boerhaave’s syndrome?

Two factors seem to be involved. One is a build-up of pressure inside your esophagus from extraordinary effort or straining. The other is a build-up of negative pressure outside your esophagus when your upper esophageal sphincter (cricopharyngeus muscle) fails to relax in response to pressure.

The most common cause of strain in Boerhaave’s syndrome is forceful or repeated vomiting. Other possible causes include straining, childbirth, seizures, weightlifting and ingestion of something caustic or corrosive.

Normally, in these circumstances, nerve signals should have triggered the cricopharyngeus muscle to relax to release the internal pressure, but in Boerhaave’s syndrome, this neuromuscular coordination fails for some reason.