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What Causes The Feeling Of Something Stuck In Throat?

Posted on Fri, 27 Feb 2015

Question: Dear Doctor,
I have a constant feeling of something stuck at the base of my throat for months and it is much reduced when I burp or have meal (not when having drinks). I've already done a gastroscopy which found nothing abnormal of my esophagus and mild chronic gastritis, and a laryngoscopy which found normal structure inside my throat.
While, I want to check the possibility of cricolaryngeal spasm. Then, can a barium study(upper GI series) give the relevant information? As I have some concern to be exposed to X-ray in a barium study, is there any alternative test that can be done to examine the state and function of my cricopharyngeus muscle? And is there any test to examine the state and function of my whole esophagus?
Thanks a lot,
XXXX

Answered by Dr. Naveen Kumar Nanjasetty (57 minutes later)

Brief Answer:
Barium meal study is relatively safe...

Detailed Answer:
Hi

Thanks for posting the query

Barium meal study being the safest and baseline investigation to detect cricopharyngeal function, should be tried first. Do not worry! It is relatively safe and exposure to radiation is almost negligible. The other alternative investigations are:

1. Manometric measurement of esophageal pressure - this is the most direct method for assessment of motor function.

2. The intraluminal flow can be measured by scintigraphy, or intraluminal impedance monitoring.

3. 24hour acid pH monitoring can also aid in diagnosis of the acid reflux disease.

Hope I have answered your query; I'll be available for the follow up queries.

Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Naveen Kumar Nanjasetty (1 hour later)

Dear Dr XXXXXXX

Thank you very much for the reply. I have a few more questions to ask for your advice:

1. I have no problem in swallowing. Then can the barium study detect if it is just cricolaryngeal spasm? which may lead to the constant feeling of something stuck at the base of my throat.

2. Similarly, can barium study detect spasm of the whole esophagus?

3. I think barium study is usually the Upper GI series including esophagus, stomach and duodenum. Is there certain barium study that is limited to esophagus which includes cricopharyngeus muscle? so that the radiation is lower.

4. Is "intraluminal impedance monitoring" also 24 hour? Can it be conducted together with 24hour acid pH monitoring?

5. Why reflux can give one the symptom of something constantly stuck at the base of throat? What is the mechanism behind? Can it be some food constantly stuck in one's throat? Or is it causing some constant spasm there?

Sorry to ask so many as I'm really suffering from this heavy throat symptom.

Sincere thanks,
XXXX

Answered by Dr. Naveen Kumar Nanjasetty (20 hours later)

Brief Answer:
Please find the answers for the multiple questions

Detailed Answer:
Hi XXXX

Welcome back

1. The barium sulphate is a salt which coats the lining of the gut being tested. Therefore, abnormalities in the lining or structure of the gut can be seen on the X-ray pictures.

Barium study cannot be limited to just one portion of the GIT.

The total amount of radiation for each test performed is quite small and thought to be safe.

2. Barium radiography allows assessment of both the structure and function of the swallowing mechanism. Hence, it can detect any abnormal spasms in the esophagus.

3. Barium study cannot detect acid reflux problems.

4. Multichannel intraluminal impedance can be combined with either Esophageal Manometry or 24hour acid pH monitoring.

5. Continuous pH monitoring is considered the best test for the evaluation of GERD and permits determination of the presence and severity of reflux.

6. Patients with sphincteric dysfunction typically complain of dysphagia for liquids and solids.

7. According to me, you seem to be suffering from Laryngopharyngeal Reflux secondary to Acid reflux disease. This is the prime cause of sense of foreign body struck in the throat.

When the acid from the stomach regurgitates into the throat, the mucosa gets burnt and inflamed. The inflammation of the mucosa produces mild edema which gives the sensation of lump or foreign body in the throat.

Hope this clarifies your doubts.

I wish you good health.

Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Naveen Kumar Nanjasetty (1 hour later)

Dear Dr. XXXXXXX

Thank you for the detailed reply. I think I'll go for a barium study first.

Thanks for your wish and wish you all the best,
XXXX

Answered by Dr. Naveen Kumar Nanjasetty (10 hours later)

Brief Answer:
Wish you good luck and good health

Detailed Answer:
Hi XXXX

Thanks for writing back

I wish you good luck and good health

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju