### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Dea doctor, i experience diaphragm spasms, or that is what i think I have reading from the internet. It occurs at night and is a debilitating pain right under the bust area, almost like a knife being poked out from under the skin. When this happens, breathing is difficult, lying down is utterly painful, the only position confortable is sitting cross legged on grond and having my head tilted forward, arms below head, to relieve the pain from the spasms. They occur mainly at night and the pain continues throughout night, and is debilitating. It may be connected to stress but am unsure. I am desperate to find a cure or way to stop these diaghram spasma, is there a specialist i should visit? I live in Pasadena, CA. Thnak you. Isabelle

### output:

Diaphragm spasms are usually more like hiccups, although bad hiccups can also be quite painful. It sounds like you are having esophageal spasms, which can be very painful. Either way, you need to be evaluated for both as treatment may vary. You might also have reflux esophagitis which can be related to aspiration of stomach acid. This can cause laryngeal spasm which can also result in shortness of breath and pain. Your best option is to start with a gastroenterologist (GI specialist). They can do an endoscopy to take a direct look into your esophagus or other tests to check the pressures and see there are muscle spasms or inflammation. Stress could certainly aggravate these conditions, but it would be important to know exactly what is causing them so that the correct treatment is started. Hope this helps.