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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Swallowing Problem With GERD

Swallowing Problem I am a male 68 years old. I was diagnosed with GERD about 8 years ago. Since then I have been taking NEXIUM and other PPI medications. My reflex is under control so long I am careful with my eating habits. Since last two years or so I am having serious problem in swallowing. In the morning I take two glasses of water and it goes down smoothly than I have few loud BURPS. However as soon as I start having my breakfast (or for that matter any meal of the day) I feel heaviness in my chest as if the food is stuck . In order to let it go down I try to drink water which some times helps but some time even the water refuses to go down and I feel SEVERE pain in trying to let it go down. I feel like I would die of pain. Mostly the water goes down with difficulty. However till I have few loud burps the feeling of uneasiness continues. Some times even the water backs up from my mouth and nose and the pain continues ! I have had about five Gastroscopies inlast 8 years and one Barium XRAY recently. They could not find any abnormalities. Can you please help me ? Thanks
Tue, 2 May 2017
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General Surgeon,  's  Response
Hi.
Thanks for your query.
Noted the history and understood your concerns.
Since you are a known case of GERD and are under the correct line of treatment the feeling of food stuck and even water not helping and regurgitating at times after food indicate the following in presence of normal barium studies and X-rays.
There may be a motility problem or esophageal spasm problem that can be detected only by Manometry studies.
Please consult your Gastroenterologist, discuss about Manometry and get it done.
Also take motility regulator which does not have effect on lower esophageal sphincter.
You should have barium swallow under real time visualization while being done to know about esophageal spasm and so.
Take small frequent meals and be under liquid diet.
I am sure you do not smoke or take alcohol.
Continue rest of the medications as you are already prescribed for.
Stress and/or anxiety have a direct effect on esophageal motility hence control of these is very important and helps positively.

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Suggest Treatment For Swallowing Problem With GERD

Hi. Thanks for your query. Noted the history and understood your concerns. Since you are a known case of GERD and are under the correct line of treatment the feeling of food stuck and even water not helping and regurgitating at times after food indicate the following in presence of normal barium studies and X-rays. There may be a motility problem or esophageal spasm problem that can be detected only by Manometry studies. Please consult your Gastroenterologist, discuss about Manometry and get it done. Also take motility regulator which does not have effect on lower esophageal sphincter. You should have barium swallow under real time visualization while being done to know about esophageal spasm and so. Take small frequent meals and be under liquid diet. I am sure you do not smoke or take alcohol. Continue rest of the medications as you are already prescribed for. Stress and/or anxiety have a direct effect on esophageal motility hence control of these is very important and helps positively.