Hi, Swallowing difficulties is a nonspecific sign and may indicate several conditions. It is seen in smokers commonly. Also, it can be a sign of esophagal spasms, tumors or GERD. However, the most common cause is a hiatal hernia and this means that the stomach is protruding through diaphragm muscle. It may cause breathing difficulties, nausea, swallowing difficulties and irritation of the stomach. It will also be aggravated by certain food or medications, stress and smoking. You need to avoid fried food, carbonated drinks, coffee, alcohol and spicy food. You should eat more milk products, vegetables and boiled food. Also, certain antiacid medications may be required and as a last option, it is possible to perform surgical repair of hernia especially if there are progressive respiratory discomfort and dyspepsia. To diagnose it you should do gastroscopy and if this is negative as in your case then you should do contrast x-rays of the stomach. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ivan R. Rommstein, General Surgeon