Whatsa matta for me?

[jeeplover]

Hi folks, I'm Tom. I am a 53 yr old caucasian male. I have had occasional trouble swallowing for a long time now. The food gets far enough down that I am not in danger of choking, but it gets hung up before reaching the stomach.

Just a couple days ago I noticed when I was lying on my back and had started to get up that I have a fairly prominent bulge in my abdomen when the muscles are tensed, as when getting up from a prone position. This bulge runs from the navel to the breastbone. It is not noticeable when I am standing or sitting, only when the abdominal muscles are tensed.

I intend to get to a doc ASAP, but anyone know what might be wrong with me?

Thanks

[jeeplover]

No opinions from anyone?

[Wilson]

I don't have an opinion about your "bulge" - your doctor will help you with that. What I can tell you is your swallowing problem sounds alot like the one my father used to have with his hiatal hernia. Food would make it down but get hung up right before the stomach. He had several dilation procedures over the course of a few years to widen the sphincter opening, and now with lifestyle changes and medication for GERD (reflux) he's doing much better. You might try eating smaller meals, taking smaller bites, and for sure always sit up real straight when swallowing. But you do want to see a GI doc as soon as possible to have everything checked out. Good luck.

[smart_squared]

Hi Tom,
Don't have an idea about your bulge but your swallowing problems may stem from several things.  If your food seems to get hung up right about where your breastbone is, chances are that this is being caused by a problem with your Lower Esophageal Sphincter (LES).  This is the area between your stomach and esophagus which stays shut to keep gastric contents from coming up into your esophagus (reflux) and opens to let food pass into the stomach.  Sometimes the LES has too great a pressure, making it hard for your esophagus to push the food through it.  Sometimes the timing of the opening is off and it opens and closes before the food actually gets there, and sometimes the muscles of the esophagus are not coordinated or strong enought to actually push the food through the LES.  These combined problems are often part of a disease called Achalasia (Ak-a-LAASH-a). Often times, modifying eating habits (ie smaller bites, chewing thoroughly, swallowing completely before another bite, etc.) can alleviate the problem.  If they do not, I would suggest having an esophageal manometry study done.  For this study, a small catheter with pressure sensors is passed through your nose and down through your LES.  As you take small sips of water, these sensors will be able to tell if your LES is tight, not opening properly, or if your esophagus is not coordinated.  Depending on the test results, a combination of physical stretching (dilitation during endoscopy) or medication may be able to help.  One note, if you choose to have this test done, search out a physician and center who specialize in manometry disorders as although many physicians order this study for their patients, not all are adept at interpreting the results and not all study administrators (usually a nurse) are adept at getting a good study.  Hope this helps.

[marygold]

About your bulge, I get one too, usually. Are you on any medication? I am 19 and have had severe GERD since I was 12, and am taking 40mg Nexium a day for the past 10 months. Occasionally after eating, my stomach bulges out incredibly. My roomie said I looked 6 months pregnant! Mine generally lasts for a couple hours to a day. I'm not sure exactly, but I think mine is caused my my medication. If you're on a medication, try an internet search for the official website. They should have a link for complete product information, and on it they have a list off all the different side effects. Check with your doctor just to be on the safe side and to make sure it's not something else more serious. I haven't gotten mine checked out yet because I just moved and am not eligible for medical here for another month or two. I'd really like to know for sure what causes it too, but right now, all I have is speculation. Sorry I couldn't help more.

I also have difficulty swallowing, but I figure that's from being misdiagnosed for 4 years without proper treatment. The acid irritation on my esophagus caused much of my esphagus to turn into scar tissue, thereby narrowing it. There is a surgery that can fix this, but it's a major procedure. In short, they have to go through your chest to fix it rather than down your throat. Nobody wants to do this on me yet because they insist I'm still growing. Another possibility is esophageal cancer, where the narrowing is caused by a tumour. It's fairly rare, but if you want to be sure, talk to your doctor about it.

[jeeplover]

Thanks for your responses, everyone.

I went to the doc to see about that bulge, and it is a common type of hernia, unrelated to my swallowing and reflux problem. Doc says no treatment is needed.

I am going to have the endoscope procedure Monday, and the surgeon who will be doing it says he will stretch the old espohagus for me while he is in there.

Thanks!

Tom