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Prescribed with lansaprozole for swallowing difficulty. What is the need of endoscopy?

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General Surgeon
Practicing since : 2008
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Hi,

Had pain when in throat when swallowing. ENT specialist looked through a camera through my nose and prescribed lansaprozole three months ago. I still get some pain when swallowing and now he suggested rigid endoscopy. I am concerned because this is a high risk procedure. Is there any other alternative. Could I continue longer on the medication to see if I improve more?
Posted Wed, 6 Feb 2013 in Ear, Nose and Throat Problems
 
 
Answered by Dr. Grzegorz Stanko 24 minutes later
Hello!

Thank you for the query.

Pain while swallowing can be caused by several reasons including throat infection, enlarged thyroid, gastric reflux disease, stomach or esophagus cancer.
As you can see, some diseases can be serious and that is why your doctor has ordered an endoscopy. This test is not a high risk procedure. It is quite uncomfortable test, some people find it painful, but the risk of complications is lower than 1 percent.
There is a test called barium swallow, witch allows to see if there are any narrow places in the esophagus and some large pathologies in stomach however it is quite old and sketchy test which wont rule out all possible conditions.
It is not advisable to take Lansoprazole without the endoscopy as it can only delay proper diagnosis.

Hope this will help. Feel free to ask further questions.
Regards.
Above answer was peer-reviewed by
 
Follow-up: Prescribed with lansaprozole for swallowing difficulty. What is the need of endoscopy? 15 minutes later
Many thx for your prompt reply. I've taken medication for 3 months
and I improved quite a bit. I was hoping I could improve further
By taking this medication for couple of months more.
I was told by the physician that rigid endoscopy was high risk
and for this reason I wanted to try medication for
a bit more. I wasn't told to stop taking medication as of yet.
Thanks for reminding me there could be a serious case for pain
when swallowing. I do have heartburn as well.
So, my question is: can I stay some more time on this medication
or your advice is that there is no point in delaying
the rigid endoscopy any further.
With thx in advance for your reply!
 
 
Answered by Dr. Grzegorz Stanko 13 minutes later
Hello!

Generally you should have an endoscopy before starting the treatment. In 3 months, your symptoms should totally go away if the reason is increased acid secretion. If not, either the dosage was no enough (the dosage of lansoprazole is 30 mg once a day for 30 days) or the reason is not only increased acid secretion.
In some cases such treatment does not help, because of Helicobacter Pylori infection which can be diagnosed with endoscopy and should be treated with antibiotics. The other point of so long Lansoprazole therapy are the side effects which it can cause. Decreasing stomach acid secretion you become prone to stomach and intestines bacterial infections.
So in conclusion, you should not wait another month or so, and get scheduled for endoscopy. Do not be afraid of this test, just ask for some sedation as it is quite uncomfortable.

Hope this will help. Feel free to ask further questions.
Regards.
Above answer was peer-reviewed by
 
Follow-up: Prescribed with lansaprozole for swallowing difficulty. What is the need of endoscopy? 16 minutes later
Thanks. This is supposed to be rigid endoscopy under
general anesthesia sedation. My last question
is: should I ask for a flexi endoscopy instead if
rigid one?
Thank You.
 
 
Answered by Dr. Grzegorz Stanko 3 minutes later
Hello!

Rigid endoscopy is not used nowadays as it was quite brutal test. Definitely flexible endoscopy is something you should have performed.

Hope this will help.
Regards.
Above answer was peer-reviewed by
 
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