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Developed cough and swallowing difficulty. Taking antihistamine. Allergic to dust. Required treatment?

Nov 2013
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Hello. I am a 34 year old female. Last September, I started having to clear my voice quite a bit to talk. I saw my doctor and he advised me to drink more fluids. I used to teach English, so my voice was worked quite a bit. By December, I had developed a cough. It was more of a dry, hacking cough. I would cough when I talked and even coughed when I laughed. I began to notice I was starting to have difficulty swallowing as well. I saw my doctor again, and he gave me an antihistamine to take. He said that it was probably a reaction since I am highly allergic to dust. In January, I went back again because the antihistamine didn't seem to be working. I was having more difficulty swallowing food and fluids. I actually had two instances in which I felt like I was choking on my food. He then put me on a mix of Roxithromycine, Miflonil/Budesonide (inhaler) and Omeprazole (20mg 1x daily). I was also given an injection of Kenacort. I was given a full blood panel in which he said my results were good. I also had a chest x-ray, which was completely clear and normal. The coughing I have now is mainly when I eat (worse with things like bread and pasta) and since I clear my throat so much, it feels dry and raw. I also have the sensation that I am swallowing a small pebble or something every time I swallow...even just saliva. The next step is an Endoscopy, which I might have this week. I fear there is something really wrong with my esophagus. I tried to look up similar symptoms online and I get some terrifying results. I fear it's something bad, like Barrett's. I haven't had any stomach issues (only back in 2011 when I went to the doctor for stomach pain and vomiting - everything came back normal), but nothing like that since then. Which is why I didn't think it was GERD. I feel like I can't eat or talk properly, and since swallowing is something your body has to do, it's constantly on my mind and I am stressed out and losing sleep over it. Is there any chance this could just be something minor? Any advice you could give would be greatly appreciated.
Posted Sat, 2 Mar 2013 in Ear, Nose and Throat Problems
Answered by Dr. Sudhir Kumar 2 hours later

Thank you for posting your query.

I can understand your discomfort as talking and swallowing are routine day-to-day activities.

As of now, all the attention has been put on throat, esophagus, etc, which is fine. I hope that endoscopy also comes normal.

But I think, you also require a neurological evaluation. This is because, a problem in esophagus can explain your swallowing problem, but not the problem in speaking.

However, a neurological weakness of muscles could explain both, as muscles for swallowing and speaking are supplied by the same nerve.

Common conditions to be excluded are myositis (muscle inflammation) and myasthenia (muscle weakness), which can lead to muscle weakness.

I hope it helps. Please get back if you have any more queries.

Wishing you good health,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
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