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Long term swallowing difficulty
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Long term swallowing difficulty

I'm a 40 year old male, 6', 185lbs, no smoking, occasional glass of wine, recently started on cholesterol medication (ldl 168).  3-4 years ago I suffered from anxiety problems.  The anxiety lead to all variety of physical symptoms which compunded the anxiety.  

I had a variety of tests run to check: irregular heart beat (stress test), fullness pressure lower left side of chest (ultra sound) and swallowing difficulty (felt tightness in left side upper throat).  All tests showed no problems.  

With the help of the occasional lorazepam and a job change the anxiety problems and almost all symptoms disappeared.  Only the swallowing issue remained.  An ENT looked down my throat and saw nothing except a slightly irritated throat.  He prescribed an OTC Prilosec.  My General suggested the tightness might be due to a slightly enlarged lyph node, though he could feel nothing in my neck.  

I went on my way thinking the swallowing thing would take care itself (like my other symptoms).  As time went on the swallowing issue did not change.  As it was very mild (I'd forget it was there at times) I did not fret.  I did notice that when I was getting sick (not often), the swollen area seemed to get sore (leading me to think it was a lymph node, as well).  I considered it my early warning signal.

~2 months ago, I felt that the swallowing problem was getting a little more noticeable.  Then over the holidays it started to get even more uncomfortable (not painful, just a little pressure, more food sticking).  I took motrin for a few days and it seemed to help ease the pressure.  I saw my family doctor who performed a physical, checked my neck for swelling, and looked in my mouth.  He found no issues.  He scheduled me to see a specialist who will evaluate my swallowing (guessing barium swallow or some such thing).

Your opinion on what this could be???

Related Discussions
233190_tn?1278553401
There are various causes that can affect swallowing.  This can be a mass, stricture, esophageal motility disorder, or any other anatomical abnormality.  

Imaging the esophagus is needed at this point.  This can be done with an upper endoscopy, in conjunction with a gastroenterologist.

If negative, you can consider a modified barium swallow to see if there is any dysfunction with swallowing mechanics.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com
8 Comments
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129913_tn?1207651404
Hi~

I have had this trouble off and on for a LONG time.  They did a regular barium swallow and a modified barium swallow on me and basically found nothing.  I had an endoscopy when this first started, but all they found was a small hiatal hernia.

I was referred a woman who works w/ stroke patients--- even though I had not had a stroke-- and she gave me some "throat" exercises to try.  Everytime now-- that I start to get the "feeling" that I cannot swallow, I start the routine again.  The lady I worked w/ was a speech pathologist.  Very simple exercises involving sticking out your tongue....... sucking very hard on a bent straw.... and using this special tool that looks like a dentist's mirror.

It took a while.......... but I am fine now.

I can't tell you what to do........ but this seems somewhat psychiatric.  I would have the barium tests.............. but endscopies are not fun.......... and maybe if you saw a person who works w/ stroke patients and retains them to swallow-------- first--- it might just solve your problem.

Good luck and God Bless-

Misti
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Avatar_m_tn
At age 51,i had problems swallowing food,food would get stuck in my throat for 20 seconds,then it would go down,followed by a belch,sometimes hiccups,sometimes bring-up saliva from the mouth and nose,went for a upper endoscopy,tests came back negative,then a barium swallow,they seen tapered narrowing of the lower esophagus [birdsbeak] and decreased aperistalsis, went for a botox injection,first one lasted 6mos,second one lasted 2wks,finally went for pneumatic bougie dilation, to open up the cardia junction,swallowing fine now with no heartburn
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Avatar_n_tn
Hello

I feel your pain! I too suffer from swallowing problems. Back in 2003, I had several tests done to rule out all the usual esophageal culprits and saw several doctors who all prescribed different medications, none of which worked for me. I was getting more upset as they couldn't offer any resolution. In the meantime, even swallowing my own saliva became painful and unbearable.

I started seeing a chiropractor for neck pain and after three or four visits, I noticed that my swallowing problem had disappeared, When I mentioned this to the chiropractor on a subsequent visit, he said, "Well, of course chiropractic would help you... all the major nerves of the body funnel through your neck. If something is out of alignment and one of those nerves is getting pinched, the related part of the body will respond negatively." To this day, whenever I start having the swallowing problems again, I go back to the chiropractor. I swear by it and highly recommend trying it!

Good luck! Good health!
Denise
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Avatar_m_tn
Thank you all for your comments.

I had an endoscopy performed on Thursday.  Doctor dialated my espophogas "a little" and prescribed prilosec.  He also took a small biopsy -- results due early next week (fingers crossed, but optomistic).  Between the dialation and the prilosec my symptoms have improved (not 100%, yet).  

I was a bit surprised that acid reflux could have such profound an effect.  I will provide further updates as my prognosis and treatments continue.

Thanks again.

pp
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Avatar_m_tn
Final word.

The biopsy came back negative (woohoo!).

I've been on the prilosec for about 1.5 weeks now and my symptoms seem to be improving (food still sticking a bit, but no pressure/discomfort).  I've also been avoiding soda and eating w/in 2 hours of going to sleep.

We'll see how it goes.

Thanks again.
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190885_tn?1333029491
i have had swallowing problems for the last 12 years...i have had the heimlich maneuver 2 times...this symptom comes and goes...sometimes its bad...i'm not sure what causes it though...could be anxiety..could be my hep c....have you been tested for hep c ? i do have this more then i don't but i have to say again it is much worse at times...the neck post above is interesting ...i have had neck problems in the past and never really paid attention to what i was doing before the swallowing problems.....good luck ...billy
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Avatar_f_tn
What is hep c?   I hate my swallowing issue and am willing to try any test or medication.  I feel this misery from the pit of my stomach to the tip of my tongue....it is like fire..and the swallowing is depressing....like I am being strangled at times and the burning..  I take so may heartburn medications and NO RELIEF?????
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