Should I just give up?!

[John1027]

I am a 51 YO male with a 16 year history dealing with swallowing/ GI problems. I have had numerous dilations and have been previously diagnosed with rings. My symptoms went away for nearly 5 years (2002-2007) when they simply reappeared last March. I had 2 dilatations last year and one this past March 2008. I am AGAIN experiencing symptoms of the following:
-food sticking solids only
-lower GI issues like IBS
-feeling of lump on the right side of my throat--always the right side
-over all feeling of fatigue

I have had all the tests ie pH, manometry, scopes, dilations etc. No cancer, tumors and the last 2 times nothing evident to the doctors. The strange thing is after I have the scope my symtoms tend to go away. Frankly because of this I think they think its my anxiety causing my symptoms. I go to one of the top GI experts in the city and just getting his attention anymore is exhausting. It can be weeks before you get a call back from his office. He has referred me to another "top doc" who is conducting research in this area. He has said to me his thinks I have some microscopic inflammation that can cause a lot of this but he is not currently researching it.
As far as medications I take simply nexium 1xday and I swallow Flovent when I have the symptoms. Im not sure the flovent even works.
Thanks for any input

[John1027]

Thanks for the response!

You are correct that my current GI doctor was referring me because he himself was no longer  researching  in the area where I was currently having issues. I last had a scope in March 08 and at the time no rings were observed. My GI doc told me there was some microscopic abraison/inflammation that he felt could cause the food sticking feeling. He told me there was no narrowing and, in fact, my esophagus was opened wide. He suggested breathing exercises and positive thoughts basically until the condition subsides. The problem is it can persist for years~~!

I had previous scopes/dilatations where there was a small ring. That ring was biopsed and no cancer was found. Years before I had multiple rings and webbing but my doctor effectively stretched them. No cancer was found then during biopses.
I actually had the swallowing tests done and my esophagus was normal and the pH test showed a normal amount af acid.

I have a history of allergies since childhood: eggs (still) pollen, dust etc...Whenever I ate something with eggs my throat would swell for a number of hours and swallowing was difficult.
I have a family history of AI issues and lost a brother at 40 to CVID. I have had some wierd skin things but all have come and gone.
I dont seem to have any AI issues I am aware of except this one (id it is AI)
I have had 1 incident of food impaction about 9 years ago which was scary--which has heightened my anxiety when ever this condition acts up!

I dont know any one thing I have done differently in the 5 years I was better. I do know stress aggravates the feeling of a lump in the throat tho even if the "sticking issue" doesnt manifest. The strnage thing is after I have a scope I feel immediately better. The last scope there was nothing visually apparent even tho I had symtoms.

I have tried Flovent but it doesnt seem to help. I have read there are other concotions of medicines to swallow that can help.

Thanks again for your thoughts and suggestions!

[CalGal]

I know this condition is extremely tiring and frustrating, but you can't give up. I don't believe your doc is brushing you off in any manner. He may actually be giving you a hand by trying to refer you to someone who is actually trying to research the problem. It's one that at this point in time no one seems to understand the cause of. There are many thoughts on the subject including that rings develop as the esophagus' way of trying to protect itself from reflux issues.

Other thoughts are that perhaps they're due to inflammation as your doc suggested. In some, inflammatory cells can be found in biopsy specimens - at the rings or webs. The cells are typically more common in distal esophageal lesions than in proximal ones, however. And if the cells are neutrophils, it could suggest an acute inflammatory response to a variety of insults GERD, medications, caustic ingestion, radiation, and/or trauma. Eosinophil infiltration on the other hand may suggest a response to GERD, allergic response (food), and idiopathic eosinophil gastroenteritis. If the cells are lymphocytes and plasma cells it may be due to other causes of chronic inflammation. So have your rings been biopsied? And what did you do differently for several years so that the rings/symptoms disappeared?

Do you have any form of autoimmune disease since they have in some cases been associated with esophageal rings and webs? 'Typical' AI problems can include: thyroid disease, rheumatoid arthritis, graft versus host disease, Stevens-Johnson syndrome, psoriasis, blistering skin diseases, and pernicious anemia. I'm sure I've missed a few.....

Give the other doc a try and see if he/she can give you a hand with this problem.