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johnalextaylor 09-01-2013 09:12 PM

Kid with dysphagia onset (from one day to the next)
4 weeks ago my son suddenly got dysphagia. As a coincidence, 4 weeks ago we took him to the hospital because he had strong palpitations... While waiting (more than 3 hrs) the palpitations turned normal and practically told that he was OK. Eventually he started to reject solids... He just mentioned that he didn't like or so... It was until recently that he said that he can't swallow. Note that he's is not the type of kid that is picky with food neither with mind problem (e.g. like making up things... Specially if he loves eating)... He could go to a restaurant and eat a double-meat hamburger... Today... he still order it... but he can't eat it (not even a complete byte).

We had visits just two days before and we recall that he eat a lot... Also I checked my credit card statements I to see if we had gone to restaurants and it is very clear he start having problem AFTER the palpitations (and dizziness) problems. We know because since then we started to bring home his food from the restaurants.

I searched for this condition and unfortunately all I retrieve are two (pretty bad) causes. On one hand, being it so abrupt and having it happened when his heart had strong palpitations I tend to think on a Stroke... HOWEVER, the dysphagia related to strokes appears to affect solids AND liquids. He has no problem drinking liquids (Ensure, water, etc..). Does this mean that it is possible that he has obstructive disphagia.... and unfortunately perhaps esophageal cancer? I know this cancer rarely affects children... Also I know that it supposed to be progressive (and not from one day to the next).

So far he's had an X-Ray. Nothing strange on the it but I know an X-Ray is not very effective to provide clues on this situation. He'll have a Barium Swallow test in a few days.


1) Can a stroke cause a esophageal dysphagia instead of Oropharyngeal dysphagia? The first does not affect liquids and the second does.

2) Who would be the first and best specialist to diagnose the problem (and cause)? A Gastroenterologist? (I believe the pediatrician is contacting an ENT but I feel a Gatroenterologist would be more appropriate in the event of needing an endoscopy?).

3) My son was not eating or anything when the palpitations happened.. He just came up for dinner from the basement (where he was playing) and came up to the kitchen very agitated. He did not have dinner... we went straight to the hospital so definitively he got nothing stuck all of the sudden. Is there anything other than a stroke that could trigger dysphagia so sudden? Can a cancer (esophageal or thyroid) cause this?

4) I feel that along with the Barium Swallow he should have an endoscopy and/or MRI. Unfortunately for both the waiting lists as long (I live in Canada... you know what that means). I feel that if it was a stroke I should not wait too much (since he could have another one if what he had was a mini-stroke)... There is a private clinic with very short waiting time (2/3 days). They offer a "package" called "Brain/MRA/Carotids". Would that be a good scan to test for strokes (so I can talk to the pediatrician to accelerate that while "we get an specialist assigned"). As far as an endoscopy it seems I won't have many options to do it that fast and it'll be crucial to rule out or not esophageal cancer.

5) Other causes I have read are hyperthyroidism or anemia but I believe they cause the Oropharyngeal (the one that affect liquids which is not his case... at least not so far).

Please advice.

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