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What causes difficulty in swallowing solid foods?

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Posted on Thu, 28 May 2015
Question: I am a 48 year old female, non smoker, non drinker , primarily vegetarian with occasional fish. Last year I developed a strong gnawing pain in the stomach area just below the sternum. Ultrasound was clear, endoscope showed throat normal and only mild stomach inflammation- 3-4 out of 10. Doctor said it was healthy diet syndrome and that over 40 it becomes harder to digest fresh friut and veg and a lot of gas was being created (apparent on ultrasound) which was creating pain. Ompreazole was prescribed. I took it for a couple of weeks but did not really agree with me and did not want to take long term re increased osteoporosis risk so decided to manage by modifying diet- cut out lunch time salad and cut down on fruit and replaced with soups and nore cooked veg. This had seemed to work and symptoms seemed to go other than mild on occasion. Have never felt like I have acid reflux in throat.

Over past few months have felt tickly feeling behind larynx if talk a lot. The a couple of months ago I was at dinner with friend when my throat felt tight and when I swallowed to clear it it felt like my throat got stuck i.e I struggled to 'unswallow'. As there were a lot of nuts in the dish my friends though maybe an allergic reaction (not normally allergic) but A & E said no- felt a bit foolish but throat was very very strange. Since then this has happened a couple of times- not painful just feels like throat has swollen at larynx and is very disconcerting. Two weeks ago I rushed eating a slice of toast- swallowed too big a bit without properly chewing as was rushing about- it got stuck on way down behind larynx and stuggled to swallow it - felt very scratchy . I then ate a chewy vitamin and immediately felt like it got stuck and I could not get it to pass down. Since then i have been having a horrible throat time- feel like there is something in my throat behind larynx or as if someone is pressing on front of it. Feel at time like it may impinge on breathing. Don't understand what has happened or how to make it better. trying to eat only soft or liquid because symptoms have been horrendous on couple of occasions ate something with more bulk- had to resist going to A & E because feels like whole throat will close.

Have I injured something?

doctor
Answered by Dr. Krunal Karade (1 hour later)
Brief Answer:
Investigation needed Video endoscopic swallowing study

Detailed Answer:
Hi XXXXXXX ,
Thanks for the query.

I have read your query ,reviewed your medications and understand your concern.

As per your clinical history it appears that you are most probably having cricopharyngeal muscle dysfunction (In this condition cricopharyngeal muscle fail to relax properly) or
allergic post nasal discharge or
Acid reflux or
combination of more than 1 condition .

If I were your treating Doctor for this case , I would advice you
Plenty of fluids ,
salt water gargle twice daily ,
Antihistaminic Tab Allegra at night &
Antacid Tab Rantac before meal .

Investigation needed Video endoscopic swallowing study or Video fluoroscopic swallowing study to know about cricopharyngeal muscle dysfunction & Complete blood picture to know about general status .

In my opinion , you have not injured any anatomical structure inside .

You will get relief .

Hope this information helpful to you .If you have any further questions I will be happy to help.
Regards.
Above answer was peer-reviewed by : Dr. Pradeep Vitta
doctor
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Follow up: Dr. Krunal Karade (1 hour later)
I have had a look at the conditions that you mentioned. Just not sure why it has suddenly become a constant issue. My ear are also sore when the 'something' stuck in my throat' feeling is bad.

Yoga seems to aggravate- being head downwards like in forward folds or downward dog or shoulder stand
doctor
Answered by Dr. Krunal Karade (22 minutes later)
Brief Answer:
Yes , Yoga will aggravate feeling of throat blockage .

Detailed Answer:
Hi XXXXXXX ,
Thanks for the follow up query.

Ear soreness while 'something' stuck in your throat is because of refer pain from throat due to same nerve supply .

Yes , Yoga will aggravate feeling of throat blockage due to partial temporary anatomical obstruction .

You need to investigate the condition properly .

Till then use above treatment plan , you will get relief .

Regards.


Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Krunal Karade (20 hours later)
Thanks. Sorry to keep asking questions.

Did 2 salt water gargles yesterday and 1 today and that really seems to help- it would be great if you could explain why

Condition has generally been worse when stomach is empty

eating a meal can improve the sensation- why is this?

Seem to have a lot of air is stomach which comes out but not as strong as a belch- air leaving stomach helps too - why?
doctor
Answered by Dr. Krunal Karade (2 hours later)
Brief Answer:
Salt water breaks thick mucin secretion coming to throat from nose

Detailed Answer:
Thanks for the follow up query.

Since , Salt water gargle improve your condition then it is more because of allergic post nasal discharge . Salt water breaks thick mucin secretion coming to throat from nose hence improve swallowing .

Empty stomach produces lot of gases & eating meal remove gases due to relax of cricopharyngeal junction during swallowing . Hence , while swallowing pressure inside stomach decreases .

Now , My treatment plan will be
Saline nasal rinse thrice daily ,
Plenty of fluids ,
salt water gargle twice daily ,
Antihistaminic Tab Allegra at night to decrease production of secretion &
Antacid Tab Rantac before meal for acidity .

You will get relief .

Regards.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
Dr.
Dr. Krunal Karade

ENT Specialist

Practicing since :2009

Answered : 1000 Questions

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What causes difficulty in swallowing solid foods?

Brief Answer: Investigation needed Video endoscopic swallowing study Detailed Answer: Hi XXXXXXX , Thanks for the query. I have read your query ,reviewed your medications and understand your concern. As per your clinical history it appears that you are most probably having cricopharyngeal muscle dysfunction (In this condition cricopharyngeal muscle fail to relax properly) or allergic post nasal discharge or Acid reflux or combination of more than 1 condition . If I were your treating Doctor for this case , I would advice you Plenty of fluids , salt water gargle twice daily , Antihistaminic Tab Allegra at night & Antacid Tab Rantac before meal . Investigation needed Video endoscopic swallowing study or Video fluoroscopic swallowing study to know about cricopharyngeal muscle dysfunction & Complete blood picture to know about general status . In my opinion , you have not injured any anatomical structure inside . You will get relief . Hope this information helpful to you .If you have any further questions I will be happy to help. Regards.