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Had Lumpy Feeling In Throat, Esophogram With Barium Showed Anterior Cervical Esophagul Abnomality. Meaning?

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Posted on Wed, 18 Sep 2013
Question: yes, I had a esophogram with barium because I had a lumpy feeling in my throat and felt some food getting stuck in my throat. The test came up with an persistent anterior cervical esophageal abnormality anterior to c4 which appeared to be a mucosal abnormality. What does that mean? the report also stated no eviddence of stricture mass or ulceration or diverticulum
uploaded reports for you
doctor
Answered by Dr. Dr.P.Ratnakar Kini (7 hours later)
Brief Answer:
It is due to th presenc of web.

Detailed Answer:
Hi,
Thanks for posting your query.
I am Dr.Ratnakar Kini and I am pleased to assist you.

This is due to the presence of web on the mucosal lining. Mucosa is the inner lining. When there is a protrusion on the mucosal lining in the upper esophagus (cervical esophagus), it is called a web. It causes difficulty in swallowing and food getting stuck in the throat.

I hope that answers your question.
Let me know if I can assist you further.
Regards,
Dr.Ratnakar Kini
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Dr.P.Ratnakar Kini (46 minutes later)
Did you look at the esophagram report? the radiologist said that there was no evidence of esophageal stricture or diverticulitis. Wouldn't a esophageal web be a stricture,or if it was a web wouldnt the radiologist say that, instead he said it was mucosal abnormality.
doctor
Answered by Dr. Dr.P.Ratnakar Kini (4 minutes later)
Brief Answer:
The doctors have suggested endoscopy for confirmation

Detailed Answer:
Hi,
I went through the reports.

The esophagram report says the anterior cervical esophageal abnormality anterior to the C4 vertebra can be better evaluated on endoscopy. It also says that spurs are seen in the cervical vertebra.
The doctors are not sure whether the abnormality is due to a web or an osteophyte from the cervical vertebra. That is why they have suggested that endoscopy may be done for evaluation as this test would show a web if it is present.

The CT scan has confirmed the presence of the osteophytes, but has ruled out the presence of any upper esophageal mass.

If you have difficulty in swallowing and feeling of food getting stuck in the throat, it is prudent to have an upper GI endoscopy done.

Let me know if I can assist you further.
Regards,
Dr.Ratnakar Kini
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Dr.P.Ratnakar Kini (9 hours later)
I'm worried that the abnormality is cancer. Is there a chance it could be cancer and not a web?
doctor
Answered by Dr. Dr.P.Ratnakar Kini (1 hour later)
Brief Answer:
Cancer is less likely.

Detailed Answer:
Hi,
Cancer is less likely as the CT scan has ruled out presence of mass in the upper esophagus.

Let me know if I can assist you further.
Regards,
Dr.Ratnakar Kini
Above answer was peer-reviewed by : Dr. Mohammed Kappan
doctor
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Follow up: Dr. Dr.P.Ratnakar Kini (10 hours later)
I strted taking omeprazole 20mg since May 29th when I started feeling lump in my throat, after 3 weeks on the medication my throat got better. then few weeks ago while still on omeprazole the lump in my throat came back. That's when I went for a ctscan and esophogram. The past 2 days have had regurgitation after dinner, my biggest meal and Im burping a lot more the past few weeks after meals.
Is it possible the the omeprazole lost its effect, if so what can be done about my current regurgitation. When I went for the esophogram 8/22 they said I had no acid reflux, and I wasnt experiencing this regurgitation at that time either.
doctor
Answered by Dr. Dr.P.Ratnakar Kini (7 hours later)
Brief Answer:
You are having GERD

Detailed Answer:
Hi,
Now you have given a clear history.
You are having symptoms of GERD with globus ( feeling of lump in the throat).

Yes omeprazole can lose its potency over a period of time. You can switch over to other medications like nexium.
Lifestyle changes are also important - weight reduction if obese, avoiding coffee, citrus, tomatoes, fatty food and avoiding eating full stomach, bedtime snacks. Eat multiple small frequent meals and go to bed 2-3 hours after food.
To diagnose GERD, 24 hours pH monitoring is the right test and not esophagram.

Let me know if I can assist you further.
Regards,
Dr.Ratnakar Kini
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Dr.P.Ratnakar Kini (3 hours later)
Isnt nexium and omeprazole pretty much the same and both used to treat gerd?
doctor
Answered by Dr. Dr.P.Ratnakar Kini (7 minutes later)
Brief Answer:
They belong to same group, but not the same medication.

Detailed Answer:
Hi,
Nexium and omeprazole belong to the same group of medications called PPI. But they are not the same. Nexium contains esomeprazole which is different from omeprazole.
These medications are used to treat acid peptic diseases including GERD.
There are 6 different PPI used for this purpose - Prilosec ( Omeprazole), Nexium (Esomeprazole), Protonix (Pantoprazole), Aciphex ( Rabeprazole), Prevacid (Lansoprazole) and Ilaprazole.
Sometimes changing the medication ( from one PPI to another) gives good relief.
And as mentioned earlier, lifestyle changes are also very important.

Let me know if I can assist you further.
Regards,
Dr.Ratnakar Kini
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Dr.P.Ratnakar Kini (6 hours later)
I have an appt with a nurse paractitioners office XXXXXXX at the gi doctor. Let me see what she will recommend. Also wanted to know if esophageal mucosal abnormality would show up in the ctscan I did?
doctor
Answered by Dr. Dr.P.Ratnakar Kini (5 hours later)
Brief Answer:
It may or may not show in the CT scan

Detailed Answer:
Hi,
The mucosal abnormality may or may not show in the CT scan and it depends on its size.
As mentioned in the earlier posts, endoscopy is the right method to assess it.
Let me know if I can assist you further.
Do post about what the nurse practitioner recommends you.
Regards,
Dr.Ratnakar Kini
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Dr.P.Ratnakar Kini (12 hours later)
that really is not answering my question, what Im stating is that do ct scans usually pick up abnormalities in the lining of the esophagus or any other kind of diseases in the lining of the esophagus?
doctor
Answered by Dr. Dr.P.Ratnakar Kini (22 minutes later)
Brief Answer:
Yes it picks but not all times as size and type of lesion matters

Detailed Answer:
Hi,
I have mentioned in my previous post that it may or may not show in the CT scan.
If you would like to have a detailed answer -

It depends on the size and type of lesion in the esophagus. If it is just a small web, superficial ulcer or mucosal break, it may not show in the CT scan. If it is a growth from the mucosal lining, it may show in the CT scan.

CT scan is used to detect ulcerative lesions in the stomach by giving a contrast material orally.
But it is difficult to detect a small web, superficial ulcer or a mucosal break in the esophagus with CT scan even if a contrast is given and the lesion may be missed.
In this situation, a esophagram is helpful as it can show the lesions mentioned above and as you know in esophagram test, a contrast material is given orally.

So the answer is --for a mucosal lesion of esophagus to be detected by CT scan, factors like type and size of the lesion are important.

I hope that answers your question.
Let me know if I can assist you further.
Dr.Ratnakar Kini
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr.P.Ratnakar Kini (22 hours later)
Thank you, that was better. Another issue I have is that my stools are very loose and I have a lot of undigested food also. I sometimes after a meal go to the bathroom and have a loose bowel movement after a hour or so. I've had this issue more so since I started the omeprazole. I also had this issue when I first went on the cymbalta two years for few months then it went back to normal. Normal stools for me are loose not usually formed, but are digested. Looks more like a pile. What could be the reason? Had a colonoscopy last year and things are normal.
Im waiting for an answer to my recent question, do you have any questions?
doctor
Answered by Dr. Dr.P.Ratnakar Kini (45 hours later)
Brief Answer:
It could be IBS or SIBO

Detailed Answer:
Hi,
Your symptoms could be due to two possible causes - 1. SIBO 2. IBS.

Since you have said it all started after you started taking omeprazole, it could be due to small instestinal bacterial overgrowth (SIBO). This occurs due to infection as omeprazole eliminates the protective acid barrier of the stomach. This allows the bacteria to enter the gut causing loose stools.Aspiration of the fluid from the upper small intestine during endoscopy and doing a culture test would help to confirm it.

The other possibility is irritable bowel syndrome(IBS). It is a functional disease and in this condition, the way with which the bowel works gets altered resulting in loose stools. There is no diagnostic test for IBS and it is a diagnosis after excluding every common reason.
I hope that answers your question.
Let me know if I can assist you further.
Regards,
Dr.Ratnakar Kini
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Dr.P.Ratnakar Kini

Gastroenterologist

Practicing since :1994

Answered : 2215 Questions

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Had Lumpy Feeling In Throat, Esophogram With Barium Showed Anterior Cervical Esophagul Abnomality. Meaning?

Brief Answer:
It is due to th presenc of web.

Detailed Answer:
Hi,
Thanks for posting your query.
I am Dr.Ratnakar Kini and I am pleased to assist you.

This is due to the presence of web on the mucosal lining. Mucosa is the inner lining. When there is a protrusion on the mucosal lining in the upper esophagus (cervical esophagus), it is called a web. It causes difficulty in swallowing and food getting stuck in the throat.

I hope that answers your question.
Let me know if I can assist you further.
Regards,
Dr.Ratnakar Kini