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Food feels stuck in throat, painful swallowing, history of bulimia and anxiety. Esophageal cancer?

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ENT Specialist
Practicing since : 1991
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I am a 31 year old female with a history of on and off bulimia since I was 20. I never threw up every single day, or every single meal, it was more intermittant. Anyway, now, occasionally (and it seems like when I am eating fast, like in the car) food feels like it is lodged in my throat for a minute and it's painful to go down. This doesn't happen every meal or even every day, just occasionally. I'm petrified of Esophageal Cancer. I've made an appointment with a gastro doctor for November. Is this cancer very common in ex-bulimics? I am worried sick. I also have a long history of anxiety (especially health anxiety).
Posted Wed, 18 Apr 2012 in Abdominal Pain
Answered by Dr. Sumit Bhatti 22 hours later

Thank you for your query.

1. Esophageal Cancer is a rare form of cancer and ever rarer in ages below 60 years.

2. The earlier a cancer is detected, the greater the chances of a complete cure.

3. In your case, you had intermittent purging bulimia over the last decade. Severe bulimics usually throw up daily or even more often, hence your condition was mild and you have it under control now. Every time you threw up, along with the stomach contents, acid and digestive enzymes also reflux into the esophagus, throat, mouth sinuses and even the ears. This acid reflux damages the delicate lining of the esophagus, throat and other areas it comes in contact with. Over the years, such chronic irritation may lead to cancer. More commonly, such chronic reflux such as in patients of GERD (Gastro Esophageal reflux Disese) or LPR (Laryngo Pharyngeal Reflux) causes dryness in the throat and foreign body sensation while swallowing occasionally.

4. Exposure to tobacco, alcohol increase the risk of developing esophageal cancer. In addition esophageal cancer also has other signs and symptoms such as dysphagia (difficulty swallowing. initially for solids) and odynophagia (painful swallowing), chronic cough, sometimes hematemesis (vomiting up blood) or change in voice, sudden weight loss, pain in the epigastrium, or symptoms of metastasis.

5. It is not possible to reverse all the mucosal damage of years of reflux, however anti reflux medication will help reduce your discomfort.

6. If your symptoms persist despite a course of medical treatment, or if you have any of the above signs or symptoms do not hesitate to get a barium swallow study and a gastro-endoscopy done to rule out resophagitis, reflux, Barret's Esophagus and to rule out any suspicion of esophageal cancer. Ultrasound, CT Scans, biopsies ( there are different types) and PET Scans may also be used in the diagnostic work-up.

7. Health anxiety is known to be associated with bulimia. I will again stress that Esophageal Cancer is not very common in ex-bulimics as it is a rare form of cancer. The risk however is higher than in the general population. Hence a normal set of tests and examinations will help ease your anxiety.

Hope I have answered your query. If you have any follow up queries I will be available to answer them.

Above answer was peer-reviewed by
Follow-up: Food feels stuck in throat, painful swallowing, history of bulimia and anxiety. Esophageal cancer? 2 hours later
Thank you for your answer.

I do not think I have had any symptoms such as what I mentioned since Sunday, when it happened once that I had a little pain with a large bite. If I had esophageal cancer, would the episodes not happen more often than that?

Answered by Dr. Sumit Bhatti 23 minutes later

Thank you for writing back.

Yes, esophageal cancer would lead to persistent symptoms. Since you have intermittent symptoms, these are most likely due to chronic acid reflux. Avoid speculation and follow the guidelines mentioned above.

Wishing you good health.

Above answer was peer-reviewed by
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