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Hard to swallow/Feeling like something in Throat
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Hard to swallow/Feeling like something in Throat

For the past 10 months I have been having difficulty swallowing.  Like a feeling of something in your throat. Ear ache, neck pain some. Have been going to ENT drs. have had several test run....barium swallow, sonogram of throat, PH Probe 24 hr test, mamometry, have looked down my throat several times with scope...and a CT scan of sinuses.  What they have come up with is that I have alot of post nasal drip so it runs down the back of throat and acid reflux which is coming up so between the two things my throat stays inflammed and irratated all the time.  They put me on Prevacid and rhinitadine (Zantac) but is doesn't seem to be helping much.  I haven't come to grips with the fact that I have acid reflux and have to start eating a certain way which is not helping I am sure.  I don't feel like I have acid reflux (no heartburn) but they say you don't have to have heartburn in order to have it.  My throat is all raw feeling.  In looking down my throat she says my lingual tonsil is huge, really swollen and says she wants to biopsy it.  Of course, that scares me to hear that word...biopsy!!  Anyway, she says she doesn't think that there is anything seriously wrong with it, like lymphoma or anything like that but just wants to cover all the bases.  She said that if it was something like that my lymph nodes would be swollen by now and they arn't.  Only when I have a cold or sore throat. But they go down.  My sinuses have issues so she wants to do surgery on them, biopsy lingual tonsils and remove regular tonsils.  Has anyone experience my situation?  Like others, I am a worry wart!!
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Avatar_n_tn
Also, wanted to add (not enough space in first post) I do have dizziness now and then.  Will feel off-balance.  When my sinuses are acting up is when it usually happens.  My ears will feel funny too...fullness.  Also, when sinuses are acting up, the swallowing problem will get worse. This has been going on for so long, I just am so anxious and worried about myself, that is all I think about and I'm sure I make it worse by worrying.  Can't help it....all you here are people with serious health problems these days....maybe it is because I am getting older.  By the way, I am a 50 year old female.  Anyone experiencing similar problems, would like to here your comments.....thanks!
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Avatar_n_tn
Hi I have had problems with swallowing since August 06, told by ENT that I have throat problems due to GERD or reflux disease prior to this, and now am having problems with so called sinus infection, with mutiple treatments and getting worse still.  I have had post nasal drip with this problem and I assume that my throat problem is related to both the sinus problem and stomach problem.  Waiting to see ENT now about the sinus problem.
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125112_tn?1217277462
I replied to your post in the other thread. A worrywart...you and me both;-)

As for biopsy, don't get worried over this. My palatine tonsils were biopsied. I asked to have this done and my ENT said that it was standard procedure after a certain age.

Yes, you can have reflux despite not having heart burn. It's called Laryngopharyngeal Reflux or simply LPR.

Does your ENT want to perform surgery on both your nose & tonsils? What was her conclusion in regards to your sinuses, the reason she wants to perform surgery?

Yes, my ear & neck did hurt and I experienced dizziness.

Did you ENT suggest nasal irrigation? I found some relief in doing this.

I understand the worry, the age and in hearing, seemingly, nothing but tragedy. Good news rarely makes itself in the media. We are inundated with messages regarding health & medication (pharma adds) on a daily basis.
Because of this, I think it's always at the back of our minds.

Beings that you are 50, are you going through perimenopause? Hormonal imbalances can raise up many discomforts. See: http://www.power-surge.com/educate/34symptoms.htm



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Avatar_n_tn
OK THIS IS HARD TO EXPLAIN, A YEAR AGO I HAD A VERY SHARP PAIN IN MY RIIGHT EAR AND RIGHT SIDE OF MY NECK FINDING IT HARD TO BEND OR EVEN BLOW MY NOSE.  THAT WENT AWAY AFTER 2 WEEKS.  NOW 1 YR LATER I HAVE PAIN IN THE MIDDLE UPPER PART OF MY BACK AND NECK AREA.  THEN 2 DAYS LATER BACK PAIN WENT AWAY AND NOW THE PAIN IS IN THE LOWER LEFT SIDE OF MY NECK.  MY MOM TOLD IT IT COULD BE A COLD IN THE NECK AND BACK AREA OR MAYBE EVEN GAS.... BUT KNOW.  THE PAIN IT STILL IN MY LOWER NECK AND I HAVE A SORE THROAT. WELL, ITS NOT SORE SORE BUT VERY DRY AND SOMETIMES HARD TO SWALLOW.  MY QUESTION TO YOU ALL IS IS IT POSSIBLE TO HAVE GAS IN THE BACK AND NECK,  SOUNDS STRANGE TO ME BUT.  PLEASE SOMEONE HELP ME GET RID OF THIS PAIN.  
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Avatar_f_tn
I agree with the commenter who suggested LPR. I have a lot of the same symptoms as you. I had an inflamed, scratchy raw sore throat for months. Antibiotics didn't help so I saw an ENT. He looked in my throat and saw the inflammation, as well as swollen lingual tonsils. That's what adds to the 'something stuck in your throat' feeling. I, too, don't have heartburn symptoms. But with LPR, the acid washes up into your throat (mostly at night), but doesnt hang out in the esophagus long enough to have typical GERD symptoms. Check out this site, and try not to worry.  You've had all the appropriate tests done. http://heartburn.about.com/od/gastrictractdisorders/a/whatis_LPR.htm  ... You might as well try the diet changes (I know it's annoying but it helps, at least maybe until you get your symptoms under control).
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Avatar_f_tn
Hi I too had these same problems all my life I am almost 50 but at 16 months of age I drank Kerosene so I always thought that was the problem until it got so bad I saw an ENT he saw my throat and said my reflux was eating away my vocal chords, I went on many medicines did the whole diet thing had every test you could think of finally I saw a surgeon about my reflux he did a fundoplycasion (sp) it worked wonders there are some draw back of the surgery but I would have it done again, before the surgery I had Barretts, and Esophagitsis 1 year after the surgery my esophagus looked much better almost healed. I do still have to take Prevacid. The reflux did alot of damage to my lungs so everyday I have to take my neblulizer and I have to take other asthma medicines, I had all the syptoms (symptoms) ever since I was an infant but 50 years ago they didn't test like today I sure wish the had, maybe my lungs would have so many problems.
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Avatar_f_tn
hey I just wanted to add that I have had the exact same simptoms that you are describeing for on and off for 2  years with no relief I have been on everything you can thing of, Two Specialist rigiht away wanted to take my tonsil out, didnt agree with that cause they hadnt done any test, now I am seeing this other ENT That wants to do some kinda scope and see whats going on but the symptoms are very odd, trouble swallowing at times, pain in throat, glands stay swollen, and I have trouble talking my voice is almost like a whisper and the more I talk the worse I get with it and everyone looks at me like im nuts when I try to explain to them whats going on so now im more confused and dont know what to do Please someone help me with this,.!! I know what im feeling and what im going through im not crazy someone please tell me what they think! and thanks in advanace you can contact me if u like at ***@**** thanks!1
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1070914_tn?1282080944
Hi. I read your stories, have you looked into Eagle's syndrome? This is a possible explanation for combinations of trouble swallowing, neck pain, ear pain and facial pain.

Because it is rare (according to medical literature less rare than many doctors think), most doctors have not heard of it. Because so few really know what it is about, it is often misdiagnosed. It takes a good (not average) ENT to diagnose this. Below some text about this syndrome from medical literature, I hope this may help you or someone else who reads it.

Best of luck!


EAGLE'S SYNDROME - SYMPTOMS

Patients with vague head and neck pain symptoms can lead to an extensive differential diagnosis. One easily overlooked but important cause of chronic pain is Eagle’s syndrome (ES). Beginning in 1937, Dr. Watt Eagle published a series of articles describing a constellation of symptoms associated with an elongated styloid process. This syndrome that bears his name is associated with two classic presentations. The first, which the otolaryngologist is more familiar with, is throat pain radiating to the ear in a post-tonsillectomy patient. The second, and lesser-known presentation, is constant throbbing pain throughout either the internal or external carotid artery distributions.

A patient exhibiting the symptoms associated with Eagle’s syndrome, may consult their family physician or an otolaryngologist, a neurologist, a surgeon (neurosurgeon, maxillofacial or oral surgeon), a dentist or even a psychiatrist in order to be diagnosed. Persistent pain and other symptoms could aggravate the psychological state of a patient. By the time the syndrome is actually diagnosed, many patients have already visited some of these doctors, who have unsuccessfully tried to treat their symptoms.

Symptoms depend on a variety of factors, including the length and width of the styloid process, the angle and direction of its deviation and the degree of ossification. The pathogenesis of the syndrome was described by Eagle, who discussed types.

The first type, ‘‘classic Eagle’s syndrome,’’ typically occurs in patients after tonsillectomy, although it can also occur after any other type of pharyngeal surgery. A palatable mass may be observed in the tonsillar fossa, its palpation sometimes exacerbating the patient’s symptoms. Symptoms include ear pain, neck pain extending to the oral cavity and the maxilla, dysphonia, dysphagia, odynophagia, persistent sore throat, the sensation of a foreign body in the pharynx, painful trismus <25 mm, vertigo and tinnitus. Pain is also observed when turning the head or extending the tongue. Apart from turning the head, yawning can also trigger symptoms, particularly those resembling migraine. Other symptoms may include tongue pain in general, a sensation of increased salivation, alterations in taste, vocal changes, pain in the upper limbs, chest, and temporomandibular joint, facial paresthesia, pharyngeal spasm, pain triggered by the movement of the mandible, cough, dizziness, or sinusitis. Eagle’s syndrome has also been reported as the most important cause of secondary glossopharyngeal neuralgia or atypical craniocervical pain. All of these symptoms are attributed to the irritation of cranial nerves V, VII, IX or X, all of which are situated very close to the styloid process. The observation of symptoms after tonsillectomy generates the hypothesis that these nerves are entrapped in the locally formed granular tissue. Trauma to the soft tissues during tonsillectomy may cause bone formation, leading to an elongated styloid process or ossified stylohyoid ligament. Ossification typically appears from 2 to 12 months after the trauma.

In the stylo-carotid artery syndrome, an elongated styloid process deviating slightly from its normal direction can impinge the internal or external carotid artery, stimulating the sympathetic nerve plexus accompanying the artery and causing pain during artery’s palpation. Stimulation of the internal carotid artery causes pain along the artery that is sometimes accompanied by pain in the eye and parietal cephalalgia. These symptoms can result in wrong diagnoses, such as cluster headache or migraine. Symptoms may also include aphasia, sight disturbances, weakness or even syncope episodes. Stimulation of the external carotid artery causes facial pain, mainly in the area under the eyes. Histological examination of the vessel wall in such cases may reveal arteriosclerosis. Stylo-carotid artery syndrome might also result in arterial variation.



DIAGNOSIS

The diagnosis of Eagle’s syndrome is based on four different parameters:

(1) clinical manifestations
(2) digital palpation of the process in the tonsillar fossa
(3) radiological findings and
(4) lidocaine infiltration test. During the lidocaine infiltration test, lidocaine anesthetic is administered to the area where the styloid process is palpable in the tonsillar fossa. If the patient’s symptoms and local sensitivity subside the test result is considered positive and Eagle’s syndrome is diagnosed.

A patient exhibiting the symptoms associated with Eagle’s syndrome, may consult their family physician or an otolaryngologist, a neurologist, a surgeon (neurosurgeon, maxillofacial or oral surgeon), a dentist or even a psychiatrist in order to be diagnosed. Persistent pain and other symptoms could aggravate the psychological state of a patient. By the time the syndrome is actually diagnosed, many patients have already visited some of these doctors, who have unsuccessfully tried to treat their symptoms. This is quite understandable considering that the clinical manifestations of Eagle’s syndrome resemble those of many other diseases. Consequently, it is quite difficult to make a correct diagnosis based solely on clinical manifestations. However, it is very important for physicians and dentists to include Eagle’s syndrome in their differential diagnosis when treating patients experiencing pain in the cervicofacial and cervicopharyngeal regions.

A 3D-CT scan is considered the gold standard in the radiological diagnosis of Eagle's Syndrome. It provides an accurate measurement of the length and angulation of the styloid process and is considered to be the best supplement to the plain x-ray.

It is important to note that an elongated styloid process does not necessarily signify Eagle’s syndrome, as the majority of individuals exhibiting this anatomical anomaly experience no symptoms. Additionally, although an elongated process is found bilaterally in most cases, patients typically display unilateral symptoms. Also it is noteworthy that the occurrence of the syndrome correlates with the length of the styloid process, its width and its angulation. In fact a number of mechanisms can result in the onset of the syndrome and are responsible for the variety of symptoms. Consequently, patients may experience any number of symptoms, which often mislead physicians and necessitate the use of other data such as radiological findings to confirm the diagnosis. Both physicians (head and neck, oral and maxillofacial surgeons) and dentists must have a high index of suspicion for this clinical entity. Eagle’s syndrome should be included in the differential diagnosis of cervicofacial and pharyngeal pain. The fact that it is often excluded in such cases results in underdiagnosis and, consequently, an underestimation of the incidence of this syndrome.
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Avatar_f_tn
I am having the same problems. I was wondering if you have had a diagnoses? I have been to three different ENT's in the past year and a half. I had my EGD done with a throat stretch earlier is year. Today I found out that I have a Hiatal Hernia that they think was caused by the esophageal stretch but not sure. I have an appointment with a GI doctor in three weeks to see what else they can do for me. I need answers, I am tired of having a sore throat and having a hard time swallowing. Help please.
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