Swallowing Issues

Hello Everyone - I need some advise. Let me give you a little background of my initial sypmtoms and where I'm at today. It all started back on July 24, 2004 I got real sick with a upper respiratory infection. A few days into it I started getting real dizzy and a few months later was diagnosed with Vestibular Neuroits. In Nov. 04, I started noticing my muscles moving. Well it continued and I still have body wide faciculations to the day. The severity comes and goes. Well after reading what can causes these I gotten frightened and made an appointment with a neuro. In Feb 05 he done an EMG and Nerve Study on my arm and it was normal and he diagnosed me with BFS. Since then I have developed a tightness in my throat that comes and goes. I've had this for probably about a year now. I've also got a second opinion from another neurologist with the same dianosis, BFS. I have been back to see them both and they tell me the same thing. Well this last week my throat feeling got really bothersome, so I called my ENT and he ordered a Barium Swallowing test. The results were that I had a henia and that my esophogus was not felt to have completly normal contractions. This really is freaking me out that this is more serious. My doctor and neurologist both said that this really had nothing to do with ALS and it was probably stress related. I need more clarification on my results from my swallowing exam. What would cause these results and could it be related to ALS Thanks!!

[Kevin Pho, MD]

A hiatal hernia seen on the barium swallow can lead to the throat symptoms via GERD.  If the symptoms continue, an upper endoscopy can be considered, as well as 24-hr pH study - which would be the definitive test for GERD.  

If ALS is a concern, I agree with the nerve conduction studies.  Imaging, such as an MRI of the central nervous system, can be considered to exclude other neurological causes.  

If the tests continue to be negative, a referral to an ENT can be considered.  Chronic post-nasal drip can lead to the sensation of throat tightening as well.

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 patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
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