28 Year Old Male/Sudden Swallowing Issues/Not sure what is wrong

[jamesrwright]

Here is my situation. I am a 28 year old male, almost 29. Perfect health. No chronic conditions.

It stated all of a sudden about 4 weeks ago..I suddenly had trouble swallowing solids. It felt as if food was getting stuck in my throat, and it was causing me to cough. I went to the ER that weekend since it wasn't getting better. They did an x ray and didn't see any tumors and sent me home. It still was not getting better. I went to an ENT at UPMC . They did an endoscope and made me swallow 3 consistencies from a liquid to a thick pudding. They said I was not apsirating and thought it may be GERD since the area around the larynx was inflamed. I am not sure how GERD would cause me to have trouble swallowing, but I started the prilosec. I have been on it for about two weeks now.

I still had trouble and called them back. They sent me for a barium swallow this past Friday. Nothing came up..it looked fine. I didn't know there was a thing called a modified barium swallow until I got to the test and the radiologist said if this was inconclusive, my doc may prescribe one of those. I am not sure why the doc wanted me to do a standard one since I have no trouble with liquids whatsoerver, only solids.

I am honestly on the verge of a nervous breakdown. I lost about 7 pounds already and would have lost more if it had not been for weight gainer shakes from GNC.  I am tired of not being able to eat. Any idea what could be causing this? Any other tests you would recommend?

[woodsguy]

A related discussion, Lyme? was started.

[maried2007]

I have the same symptoms you all have. This "food getting stuck" feeling is just horrible. I have not loose weight because it is now less a problem since I take prevacid (and I drink a lot of ensure) but I just wish there will be a day where I will be able to eat 3 normal meals without feeling like I am going to choke. I had endoscopy, barium swallow, modified barium swallow... all normal! The only thing the ENT could find was that my throat was a little red (laryngoscopy) so he diagnosed LPR. He tells me it can be long to heal but it has been almost 3 months since I started the prevacid. I am now on antidepressants because of the stress of all this. I always thought reflux was a minor problem but this is ruining my life.

[YankeeRose]

Hi lisa,
  I seem to have the same swallowing issues as you do.  I have gerds and I am taking protonix.  i also get spasms in my esophagus.  The last few weeks have been more stressful than usual for me, and that is when the swallowing issues started.  I can swallow, but its like something is missing in the reflex.  It has me very worried.  I am afraid to eat or drink, because I am afriad I will choke.  I have an upper gi scheduled for next week.  Im really frightened as to waht this could be.

[N_scoma]

     I can also relate to your situation. In my particular case it was not GERD but fungal esophagitis caused by candida. I had gotten multiple barium swallows which all came back perfectly normal and it was not until I got an upper endoscopy followed by a biopsy that the true cause of the problem came to light. I strongly suggest you look into this procedure.
     I have struggled for many years with this problem, being mis-diagnosed, given "allergy"/ anxiety medications that did NOTHING, and was left to feel like I was a lunatic and that nothing was wrong with me. Just remember you are not alone in your condition and do not stop going to doctors even if you feel defeated. Someone will figure it out! Best of luck.

[STEVEG1]

I also have problems swallowing. I have been diagnosed as having esphageal dysplasia, which is all fine and good but my doctor says nothing can be done. When I drink cold water I gag, when I eat fried foods I throw up immediately. I can't even eat a meal at a restaurant without food getting stuck in my throat. I feels like I have pudding in my throat even when I am not eating. I fear eating. Foods like pasta, rice, any foods with a milk base and even water feels like it gets stuck. My doctor has given me omeprazol, which I believe is the fancy name for nexium, but that just controls my reflux. And to make matters even worse,I get terrible chest pains near the base of my ribs where my esophagus ends for no reason at all, and I can't do anything about it but wait it out. It feels like I am having a heart attack. Does anyone have a clue or have the same symptoms? I could really use some advise. Thanks, SteveG from Massachusetts.

[lisa12371]

I have been similar issues for the last 6 months.  I too have had several tests including upper GI series, modified barium swallow, endoscopy and the ENT scoped me.  All test showed nothing with the exception of the top of my esophagus was mildly swollen.  Dr. said this could be from mild reflux and put me on nexium.  So we will see what happens with that.  My symptoms include hoarseness from time to time, fatigue, sore throat sometimes, mouth ulcers monthly, sometimes I have a metallic taste in my mouth, dry mouth at times, and of course the difficulty swallowing.  I NEVER feel like my throat will close up , I know i can swallow.  It is almost like a hesitation.  Like the natural reflex to swallow is gone sometimes.  You shouldn't have to think about swallowing.  I too have lost weight (13 lbs.) I feel like I am going crazy.  I have to 5 different specialist and they all tell me the same thing.  EVERYTHING IS NORMAL.  I feel anything but normal.  In your case I sould defitely ask the dr. to do endoscopy.  They need to look and see what is goin on.  The barium test are good to show mechanical problems, but they won't show swelling and reddness.  You have to be persistent.  I have found that out.  Do you have any other symptoms?  Do you feel like your throat is closing or that you just can't swallow?  Hope you get some answers soon.  

[Kevin Pho, MD]

I agree with the diagnostic approach thus far.

I think the next step should be an upper endoscopy.  This would be the definitive test to ensure there are no anatomical strictures nor masses leading to your symptoms.

A referral to a speech pathologist and obtaining a modified barium swallow can be done to further evaluate the swallowing mechanism.

These options should be discussed with a GI physician, or in conjunction with another opinion.

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.
kevinmd_

[jamesrwright]

One other quick question..
Should I request an upper GI endoscope even after the barium swallow came up with nothing? Can I ask a doctor to do a scope? I am not sure how the doctor will react to that..