Aa
Click when swallowing
Hello,
I was wondering if someone could help me. For a few weeks now I have this click in my throat when I swallow. Not when I am drinking water or eating, but just during normal swallowing. It doesn't click when my head is down or up, but it clicks when I am looking straight. If I put my fingers just above adams apple I can feel a click.
Please help me to identify what it could be.
Thank you,
B
I was wondering if someone could help me. For a few weeks now I have this click in my throat when I swallow. Not when I am drinking water or eating, but just during normal swallowing. It doesn't click when my head is down or up, but it clicks when I am looking straight. If I put my fingers just above adams apple I can feel a click.
Please help me to identify what it could be.
Thank you,
B
It has been 3 years since I made that post and my throat still clicks.
Sometimes it is frustrating and sometimes I don't pay attention. It is not worse than it was. Hope someone will figure out what is wrong with us and helps us get rid of this click.
Sometimes it is frustrating and sometimes I don't pay attention. It is not worse than it was. Hope someone will figure out what is wrong with us and helps us get rid of this click.
This sounds like my symptom. I was rear-ended by someone under the influence and had whiplash. I began chiropractic treatment and the thyroid cartilage grinding when swallowing began within a few weeks and now, 5 months after the accident the grinding seems to be worsening. It was originally the same thing of it not occurring when I turn to the right. One ENT said it would "resolve on it's own", but another said it wouldn't without surgery. I'll let you know of my progress. By the way how are you now one year after posting?
If the discomfort just above your stomach is between your breasts and just at the start of the stomach, it may be in the region of the valve where acid can reflux and cause irritation or burning feeling. Or it may be muscular spasms from postural movements, or possibly spasms of the oesophagus induced by small amounts of acid that might spill into the base of the oesophagus? The antidepressant amitriptyline used at a low dose such as 10mg/day (much lower than that used for depression) might provide some relief. It has some unexplained analgesic properties, often used to desensitise areas and nerve endings. It is useful in post herpatic neuralgia pain. You could consider amitriptyline by asking your doctor. It can produce drowsiness, but not in everyone. Therefore if you drive or use machinery, it is important to make a risk assessment and not do those activities in periods of drowsiness. Sometimes that can be addressed by altering daily patterns where you may sleep and get up later etc. It can also give quite a relaxing sleep, though it is not a sleeping pill. You would not be able to drink alcohol. It is important to consider any other medications that you may be taking, so ask the doctor and tell them of other over the counter medications that you may be taking so they can judge if there are any adverse reactions or is safe to take.
As you say, the discomfort when swallowing hard or dry foods may be part of a healing process. The surfaces or lining of the base of the oesophagus might have been irritated but healing now. Dry or hard food might scrape past and irritate. You could consider having a little water with a meal and to start off by having a drink to wet the insides before taking any dry food.
It’s good that you’re looking at and changing diet and monitoring effects.
Yes, the sensations in the throat, it’s possible that continued inquisitiveness could bring to your attention some normal aspects that always existed but you just weren’t aware. When that happens, you wonder if those aspects are new symptoms or normal e.g. you might start to become aware of gurgles, which are possibly due to normal fluid movements in the throat. But it does no harm to ask doctors if you have any concern. They can rule out things for you.
Good luck with the ENT. If they just scope your throat via the nose, it’s easy. They’ll possibly put a local anaesthetic up your nose as a squirt from a can or on cotton wool balls soaked in local anaesthetic and left there for 15 mins before scoping. It numbs the sensations in the throat as it runs down. It’s probably likely that you’ll be given a clean bill of health. If it’s a gastroscopy you are to have, it takes only a few minutes. Just keep calm, it shouldn’t hurt. You’ll possibly gag on occasions (usually at the start getting it over the tongue and on withdrawing the scope). Concentrate on breathing and tell yourself, it’s fine, it’ll be over in a couple of minutes. You can opt for sedation, or not have it. It is possible to do it without sedation.
If its your throat that is of concern to you, it's a direct fibre laryngoscopy (fibre optic thin scope up the nose) that is usually done. A gastroscopy looks at the oesophagus, stomach and duodenum (sometimes called an oesophagogastroduodenoscopy OGD for short). It's probably not the appropriate technique if the sole intention is to look at the throat. They made that mistake with me, when they should have done the more conservative laryngoscopy to look in the larynx first.
As you say, the discomfort when swallowing hard or dry foods may be part of a healing process. The surfaces or lining of the base of the oesophagus might have been irritated but healing now. Dry or hard food might scrape past and irritate. You could consider having a little water with a meal and to start off by having a drink to wet the insides before taking any dry food.
It’s good that you’re looking at and changing diet and monitoring effects.
Yes, the sensations in the throat, it’s possible that continued inquisitiveness could bring to your attention some normal aspects that always existed but you just weren’t aware. When that happens, you wonder if those aspects are new symptoms or normal e.g. you might start to become aware of gurgles, which are possibly due to normal fluid movements in the throat. But it does no harm to ask doctors if you have any concern. They can rule out things for you.
Good luck with the ENT. If they just scope your throat via the nose, it’s easy. They’ll possibly put a local anaesthetic up your nose as a squirt from a can or on cotton wool balls soaked in local anaesthetic and left there for 15 mins before scoping. It numbs the sensations in the throat as it runs down. It’s probably likely that you’ll be given a clean bill of health. If it’s a gastroscopy you are to have, it takes only a few minutes. Just keep calm, it shouldn’t hurt. You’ll possibly gag on occasions (usually at the start getting it over the tongue and on withdrawing the scope). Concentrate on breathing and tell yourself, it’s fine, it’ll be over in a couple of minutes. You can opt for sedation, or not have it. It is possible to do it without sedation.
If its your throat that is of concern to you, it's a direct fibre laryngoscopy (fibre optic thin scope up the nose) that is usually done. A gastroscopy looks at the oesophagus, stomach and duodenum (sometimes called an oesophagogastroduodenoscopy OGD for short). It's probably not the appropriate technique if the sole intention is to look at the throat. They made that mistake with me, when they should have done the more conservative laryngoscopy to look in the larynx first.
Just wanted to thank you for all of the information you've contributed to this thead. About seven months ago I started experiencing symptoms almost identical to your own, and the first doctor informed me it was stress (despite the fact that my life is about as relaxed and easy as lives get). It takes forever to get appointments lined up in the area of Canada I'm in (they're usually scheduled a couple days before one's funeral), so I'm still waiting for an appointment to have a scope now. But about a month ago I changed my diet completely and started taking over the counter acid reflux meds (Zantac), and the symptoms eased significantly.
The worst part was that tight, closed off feeling lower in the throat, and after removing everything 'bad' from my diet (french fries, pizza, soda, and alcohol in my case) that sensation vanished almost entirely within about two or three weeks. It was unfortunately replaced with some minor discomfort/pain just above my stomach when swallowing dry or hard foods, but I'm hopeful that's part of a healing process. I also have that click others have mentioned, and a sizzling sensation in the back of my throat, but I find that much less troubling and I can't even be sure that those weren't always present. I definitely have become hyper aware of it all.
Anyway, just wanted to add my experience for anyone else experiencing this rather worrying problem - it had been at the forefront of my mind for about six months. I'll update too following the ENT appointment.
The worst part was that tight, closed off feeling lower in the throat, and after removing everything 'bad' from my diet (french fries, pizza, soda, and alcohol in my case) that sensation vanished almost entirely within about two or three weeks. It was unfortunately replaced with some minor discomfort/pain just above my stomach when swallowing dry or hard foods, but I'm hopeful that's part of a healing process. I also have that click others have mentioned, and a sizzling sensation in the back of my throat, but I find that much less troubling and I can't even be sure that those weren't always present. I definitely have become hyper aware of it all.
Anyway, just wanted to add my experience for anyone else experiencing this rather worrying problem - it had been at the forefront of my mind for about six months. I'll update too following the ENT appointment.
Try not to worry. Easier said than done. Take things a step at a time. If you develop awful thoughts of everything that may or may not happen, challenge them and say, it may not be as bad. Again, easier said than done, but try. The good thing is the gastroscopy didn’t show anything sinister and stomach ulcers can heal completely.
I note you had a GI bleed and ulcer (were they stomach or duodenum). Look at what medication you’re taking for pain relief. NSAIDs such as aspirin, ibuprofen, naproxen, dicolfenac can (but it’s not guaranteed) cause GI bleeding. It may have been those that caused your ulcer or worsened it. You may have to use alternative painkillers in general. Ulcers can be caused by indigestion and I believe, sometimes associated with H Pylori. PPI’s (e.g. lansoprazole, omeprazole, esomeprazole) can heal ulcers.
The throat problem might be related to (are aggravated by) reflux. There is such a thing as silent reflux, which is not the same as gastro-oesphageal reflux (GOR, or GER). In silent reflux, you are not aware that some reflux is escaping from the stomach and going into the oesophagus. It’s miniscule amounts – possibly as droplets, or moist vapour containing some stomach acid and stomach pepsins. The oesophagus has a local bicarbonate producing ability and therefore can cope with tiny amounts of silent reflux neutralising it (bicarbonates neutralise acid just in the same way bicarbonate of soda is used as an antacid). However, the larynx doesn’t have a local bicarbonate producer and if any reflux manages to get into the larynx, it can’t neutralise it and it can become irritated. Irritation causes mucous formation in response. Signs could be sore throat and reddening of the back of the larynx area (difficult to see by looking in the mirror, its further down and only a doctor should look with a mirror or laryngoscope up the nose and into the throat- procedure is easy). If no sore throat, you probably don’t have silent reflux. But irritation of the larynx can cause mucous build up in the area – causing a globus sensation in the throat. There are chemical and physical causes of globus pharyngeus as well as anxiolytic muscle spasm-based “lump in the throat” type globus. It then manifests itself as a need to clear the throat of mucous or phlegm that won’t go away after each clear. This constant repeated throat clearing might aggravate the throat structures (bones, cartilages) too much. I know coughing is a natural reflex action to clear the airways. But too much could aggravate an existing bone/cartilage impact that might otherwise be almost or not noticeable. That is, if there is a slight cartilage impact (say slight misalignment for some unknown reason or cause) that happens during the swallow mechanism, if you constantly clear your throat and dry swallow, you’ll become aware of the impact much more. You may find that the click occurs at a certain head position when you swallow, but not at others. But you become aware and aware and it causes distress. Distraction techniques might help – doing other things like hobbies, listening to relaxing music, playing a musical instrument. When you said you were under a lot of stress, it does sound that the heartburn could be related. Hopefully you’re out of the mice ridden house and back to normal living.
The thing is, if things become stressful, it’s because too many things are happening at once and you can’t control it fast enough. Becoming ill makes it worse. So, you could benefit from some time off work. You might be able to get some flexible arrangements with work so that you can go in late avoiding traffic and working later, or the other way around. Try to tackle things bit-by-bit, step-by-step. Say to yourself, it is impossible for anyone to do deal with all these things. And question, do they need all need to be tackled altogether right now? Can some wait? Question -what really would happen if you did nothing for some of those things – would anything major happen, or would nothing happen at all. Prioritise what’s needed to be done. At the same time, plan time out for yourself and your family. Some lifestyle changes might help with the heartburn and then it would be one less thing on your plate.
I note you had a GI bleed and ulcer (were they stomach or duodenum). Look at what medication you’re taking for pain relief. NSAIDs such as aspirin, ibuprofen, naproxen, dicolfenac can (but it’s not guaranteed) cause GI bleeding. It may have been those that caused your ulcer or worsened it. You may have to use alternative painkillers in general. Ulcers can be caused by indigestion and I believe, sometimes associated with H Pylori. PPI’s (e.g. lansoprazole, omeprazole, esomeprazole) can heal ulcers.
The throat problem might be related to (are aggravated by) reflux. There is such a thing as silent reflux, which is not the same as gastro-oesphageal reflux (GOR, or GER). In silent reflux, you are not aware that some reflux is escaping from the stomach and going into the oesophagus. It’s miniscule amounts – possibly as droplets, or moist vapour containing some stomach acid and stomach pepsins. The oesophagus has a local bicarbonate producing ability and therefore can cope with tiny amounts of silent reflux neutralising it (bicarbonates neutralise acid just in the same way bicarbonate of soda is used as an antacid). However, the larynx doesn’t have a local bicarbonate producer and if any reflux manages to get into the larynx, it can’t neutralise it and it can become irritated. Irritation causes mucous formation in response. Signs could be sore throat and reddening of the back of the larynx area (difficult to see by looking in the mirror, its further down and only a doctor should look with a mirror or laryngoscope up the nose and into the throat- procedure is easy). If no sore throat, you probably don’t have silent reflux. But irritation of the larynx can cause mucous build up in the area – causing a globus sensation in the throat. There are chemical and physical causes of globus pharyngeus as well as anxiolytic muscle spasm-based “lump in the throat” type globus. It then manifests itself as a need to clear the throat of mucous or phlegm that won’t go away after each clear. This constant repeated throat clearing might aggravate the throat structures (bones, cartilages) too much. I know coughing is a natural reflex action to clear the airways. But too much could aggravate an existing bone/cartilage impact that might otherwise be almost or not noticeable. That is, if there is a slight cartilage impact (say slight misalignment for some unknown reason or cause) that happens during the swallow mechanism, if you constantly clear your throat and dry swallow, you’ll become aware of the impact much more. You may find that the click occurs at a certain head position when you swallow, but not at others. But you become aware and aware and it causes distress. Distraction techniques might help – doing other things like hobbies, listening to relaxing music, playing a musical instrument. When you said you were under a lot of stress, it does sound that the heartburn could be related. Hopefully you’re out of the mice ridden house and back to normal living.
The thing is, if things become stressful, it’s because too many things are happening at once and you can’t control it fast enough. Becoming ill makes it worse. So, you could benefit from some time off work. You might be able to get some flexible arrangements with work so that you can go in late avoiding traffic and working later, or the other way around. Try to tackle things bit-by-bit, step-by-step. Say to yourself, it is impossible for anyone to do deal with all these things. And question, do they need all need to be tackled altogether right now? Can some wait? Question -what really would happen if you did nothing for some of those things – would anything major happen, or would nothing happen at all. Prioritise what’s needed to be done. At the same time, plan time out for yourself and your family. Some lifestyle changes might help with the heartburn and then it would be one less thing on your plate.
You poor soul, sounds like you’ve had too many things happeneing at once, which can cause a stressful and anxious time (don’t I know it).
The heartburn might be caused by hiatus hernia but I thought they would have said on the gastroscopy if you had one. If you have the common infection with helico bacter pylori in the stomach and duodenum, that might be a cause of heartburn or indigestion which antacids such as Tums, Rennies etc would only partially stop the acid but not the underlying cause – H Pylori. There are tests that can be done to see if you have it. One is usually done at gastroscopy where they take a small biopsy of the stomach (painless during the scooping procedure). You might not have had H Pylori at the time of the gastroscopy but could have picked it up later? It is a common bacteria – possibly 1 in 3 or 1 in 5? are said to have it. It can come from some tainted red meat as well as other ways. But many can have no symptoms. I understand there is a breath test, which is not invasive or unpleasant like the gastroscopy. I believe you blow into an instrument and it gives a reading. You may have to drink something first and then blow into the instrument. (I think it measures C13 in the CO2, but I’m not sure).
I don’t know what can be done about umbilical hernias but if its clinically significant the doctors would tell you what was needed. It may be that it needs treatment or, it may be that a more conservative approach is used, such as watchful waiting. I don’t know if it’s possible that it can be reduced by a doctor pressing on it and then something is applied to stop it from coming back, and the muscle might??? heal up. Aren’t umbilical hernias common in children after birth? I vaguely recall many years ago, an English penny was put over the umbilicus (above the dressing) where it was cut and it helped to seal the umbilical cut. I don’t know if it was used to treat umbilical hernias at the same time (if they were present). Best to get doctors opinions (and not just one doctor – get a balanced consensus).
It concerned me that this hernia developed after the gastroscopy. You say you nearly choked to death during the gastroscopy. It’s normal to gag/retch. Some people tolerate and control well, others don’t. But, I can say from experience (I’ve had 3), the first and third were tolerated well. I gagged a bit but it was straightforward. I was able to compare all 3 and how they were handled by the gastroscopists. The second one was a nightmare. I started to choke and cough and they had to completely knock me out with an additional heavy dose of sedation. I’ve had a click swallow ever since.
On the heartburn, you could get this non-invasive HP test done to rule out/in. If positive, you may be treated with “triple therapy” – usually two antibiotics and a proton pump inhibitor (ppi). The ppi are to control the rate of stomach acid production, which you’re using now. I see they appear to be ineffective for you. It may be that one type of ppi might be more effective for you than another. But even the best ppi won’t be fully effective if there is another reason that is causing the heartburn.
Another very important thing you should consider is looking at lifestyle and your diet – what you eat, how much and when you eat. It really is important. Don’t take it lightly. If you eat lots late at night, you’re going to bed on a full stomach and when you lie down, some of the content can spill out and reflux up the oesophagus. The oesophagus can’t cope with acid as well as the stomach can, and it can burn the lining, which is partially what heartburn is. Even if there is no hiatus hernia present, if you lie on a full stomach, the contents might cause pressure and open the valve allowing some reflux.
You should look at what you eat. Some foods worsen reflux. Any web site or doctors book will list foods to avoid. Peppers and peppermint can apparently lower the oesophageal junction pressure and increase chance of reflux (I think this just means it make the valve open easier when it should be tightly closed). Cereal breakfasts rather than fried can be better. Too much chocolate and sugary sweet things can cause reflux.
If you don’t eat regular and miss meals, try to curb that and eat more regular. It will make your stomach get used to when it gets food. If you don’t and you become starving all day, the stomach acids will have nothing to work on to digest and that will cause indigestion like symptoms. Good advice for those with hiatus hernia is said to eat light and regularly. Don’t binge eat and don’t pig out. Avoid alcohol if you can. I found sugary sweet wines can worsen reflux. Leave at least 2-3 hours between last eating and going to bed, to allow the stomach to have passed the food further down so you don’t have a full stomach.
The heartburn might be caused by hiatus hernia but I thought they would have said on the gastroscopy if you had one. If you have the common infection with helico bacter pylori in the stomach and duodenum, that might be a cause of heartburn or indigestion which antacids such as Tums, Rennies etc would only partially stop the acid but not the underlying cause – H Pylori. There are tests that can be done to see if you have it. One is usually done at gastroscopy where they take a small biopsy of the stomach (painless during the scooping procedure). You might not have had H Pylori at the time of the gastroscopy but could have picked it up later? It is a common bacteria – possibly 1 in 3 or 1 in 5? are said to have it. It can come from some tainted red meat as well as other ways. But many can have no symptoms. I understand there is a breath test, which is not invasive or unpleasant like the gastroscopy. I believe you blow into an instrument and it gives a reading. You may have to drink something first and then blow into the instrument. (I think it measures C13 in the CO2, but I’m not sure).
I don’t know what can be done about umbilical hernias but if its clinically significant the doctors would tell you what was needed. It may be that it needs treatment or, it may be that a more conservative approach is used, such as watchful waiting. I don’t know if it’s possible that it can be reduced by a doctor pressing on it and then something is applied to stop it from coming back, and the muscle might??? heal up. Aren’t umbilical hernias common in children after birth? I vaguely recall many years ago, an English penny was put over the umbilicus (above the dressing) where it was cut and it helped to seal the umbilical cut. I don’t know if it was used to treat umbilical hernias at the same time (if they were present). Best to get doctors opinions (and not just one doctor – get a balanced consensus).
It concerned me that this hernia developed after the gastroscopy. You say you nearly choked to death during the gastroscopy. It’s normal to gag/retch. Some people tolerate and control well, others don’t. But, I can say from experience (I’ve had 3), the first and third were tolerated well. I gagged a bit but it was straightforward. I was able to compare all 3 and how they were handled by the gastroscopists. The second one was a nightmare. I started to choke and cough and they had to completely knock me out with an additional heavy dose of sedation. I’ve had a click swallow ever since.
On the heartburn, you could get this non-invasive HP test done to rule out/in. If positive, you may be treated with “triple therapy” – usually two antibiotics and a proton pump inhibitor (ppi). The ppi are to control the rate of stomach acid production, which you’re using now. I see they appear to be ineffective for you. It may be that one type of ppi might be more effective for you than another. But even the best ppi won’t be fully effective if there is another reason that is causing the heartburn.
Another very important thing you should consider is looking at lifestyle and your diet – what you eat, how much and when you eat. It really is important. Don’t take it lightly. If you eat lots late at night, you’re going to bed on a full stomach and when you lie down, some of the content can spill out and reflux up the oesophagus. The oesophagus can’t cope with acid as well as the stomach can, and it can burn the lining, which is partially what heartburn is. Even if there is no hiatus hernia present, if you lie on a full stomach, the contents might cause pressure and open the valve allowing some reflux.
You should look at what you eat. Some foods worsen reflux. Any web site or doctors book will list foods to avoid. Peppers and peppermint can apparently lower the oesophageal junction pressure and increase chance of reflux (I think this just means it make the valve open easier when it should be tightly closed). Cereal breakfasts rather than fried can be better. Too much chocolate and sugary sweet things can cause reflux.
If you don’t eat regular and miss meals, try to curb that and eat more regular. It will make your stomach get used to when it gets food. If you don’t and you become starving all day, the stomach acids will have nothing to work on to digest and that will cause indigestion like symptoms. Good advice for those with hiatus hernia is said to eat light and regularly. Don’t binge eat and don’t pig out. Avoid alcohol if you can. I found sugary sweet wines can worsen reflux. Leave at least 2-3 hours between last eating and going to bed, to allow the stomach to have passed the food further down so you don’t have a full stomach.
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