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Pain and Difficulty Swallowing, Choking... Q's

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Old 05-22-2012, 10:58 AM   #1
Join Date: May 2012
Location: San Francisco, CA
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besuelle HB User
Question Pain and Difficulty Swallowing, Choking... Q's


I'm posting because I'm looking for information and just found this board. In 2008, I had surgery for the same thing that is happening to me now: pain with difficulty swallowing both liquids and solids.

I had a series of tests and finally surgery for a schatzki's ring which was small. That resolved the problem, which was severe choking, pain with a clicking/abrasive rubbing feeling in my throat when swallowing, and a general difficult feeling of swallowing (mainly) food. I also had problems with my throat seizing up when I drank anything chilled which lasted for hours afterwards. This all seemed disproportionate to the size of the ring which was really small. I had no GERD. The surgery helped enough, but I've never returned to eating in public because of how hard it is for me to eat at all.

I'm in my 30's and healthy, not under any particular stress otherwise.

In the past few months, I began to choke on food again and at this point, have lost ten pounds and made an appointment with my previous surgeon -- it's not for eight more weeks though. Yesterday, I choked on a bite of rice and couldn't even drink water all evening. I was scared. When I would try to drink anything at all, I would choke on it. It feels like my throat isn't working.

And it's not. This is why I'm asking about this: when I had a barium swallow, they saw that I had severe aspiration of the liquid. They also saw that the pill I swallowed sat in my throat for 45 minutes but then didn't go down. The food I ate cleared extremely slowly as well. They decided this was fixable by seeing a speech pathologist, so I went, and she said she couldn't help me at all because she didn't understand why I was referred to her. She told my doctor that. He returned to putting me on Prilosec even though I didn't have GERD. I felt like they all wrote me off.

Now it's four years later and I can only wonder why I'm aspirating liquid and the food isn't going down right. That's exactly what it feels like too. It feels like the eggs I had for breakfast are literally still sitting in my throat three hours later. But it was never even followed up on? Beyond sending me to someone who didn't know what to do? I did some exercises with her where I made different noises, extended my neck, and tried eating different things. We wound up sort of thinking it was strange. She was at a major hospital and said I hadn't had a stroke; she was worried about the aspiration though but did not know what to do about it.

One more thing: over the years, I also have sporadic problems where I eat solid food and get immediate, intense, stabbing pain under my breastbone and unless I vomit, it doesn't improve. I can feel the food stuck near what feels like my stomach? So this is a separate, second feeling. This used to only happen about once a month but has recently started much more often. I have no idea what this problem is at all, and the doctor never addressed it.

I also forgot to mention that every time I eat, I eat by gulping water. It's the only way I can ever get any food down at all for many years now.

Any thoughts? Any experiences? Does anyone know what the xray meant? Thanks!

Last edited by besuelle; 05-22-2012 at 11:06 AM. Reason: forgot to add some significant symptoms

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Old 05-23-2012, 09:46 AM   #2
Join Date: May 2012
Location: San Francisco, CA
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besuelle HB User
Re: Pain and Difficulty Swallowing, Choking... Q's

Maybe it would help to clarify which tests I've had? Medications I've taken? Doctors I've seen?

Doctors I've seen: ENT who was not helpful who gave me Prilosec for months and didn't do anything else. Otolaryngologist who sent me for the tests below.

I had a barium swallow xray which showed aspiration of fluid and not passing food or medicine.

I then had an endoscopy under general anaesthesia which showed a small Shatzki's ring, which was dilated and ruptured. It showed no redness or swelling which would be expected with GERD.

The speech pathologist said my voice was extremely raspy and thought it was from aspiration.

That's all the tests and examinations I've had.

I also forgot to mention that I've previously had extensive throat operations, radical neck dissections, for previous cancer. I've been in remission for over twenty years, however. I don't have much left in my throat although the otolaryngologist thought I had "scar tissue" effecting me potentially. I have no idea at all how they would test for that or what they could do for it, or how scar tissue from past surgeries could be impacting my swallowing.

I'm having a very hard time with the constant painful, friction feeling when I am swallowing anything these days - food or water. And then when I do manage to eat (for food only), I'm terrified it will stick in my esophagus, and I will have to make myself vomit to stop the pain, which is absolutely stabbing, or worse that I could pass out again from choking.

I hope someone has any kind of recommendation. I have two months until I even see the otolaryngologist again, and then I suspect I will just get put on the same long runaround that I was last time -- just to have the endoscopy took ALMOST A YEAR from the time I first started seeking medical help.

I thought about trying to see an oncologist, since mine is now deceased, but don't know if that would make sense either and could also take a long, long time.

All of these doctors cost a lot of money as well, and my insurance only pays for part of it. Because the doctors aren't well-coordinated and take so long, and sometimes order what seem to me like really random tests, it sometimes is more than I can afford. So I'd really like to avoid playing the doctor-chasing game. I did this last year with a completely unrelated, minor problem and wound up getting no help and multiple diagnoses, plus a huge, huge bill. No thanks. Any thoughts about who the best doctor to see for my problem would be helpful.

Last edited by besuelle; 05-23-2012 at 09:54 AM. Reason: more info added

Old 05-23-2012, 09:47 AM   #3
Join Date: May 2012
Location: San Francisco, CA
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besuelle HB User
Re: Pain and Difficulty Swallowing, Choking... Q's

sorry, computer double posted!

Last edited by besuelle; 05-23-2012 at 09:49 AM. Reason: sorry, computer double posted!

Old 05-23-2012, 01:44 PM   #4
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Re: Pain and Difficulty Swallowing, Choking... Q's

Okay, it sounds like you definitely have a problem with your esophagus and/or lower esophageal sphincter. I seriously doubt you have GERD, in fact you probably have the opposite of GERD. (With GERD, food passes through too easily and comes back up, with you, it can't get down to the stomach in the first place.)

Thick liquids and purees are often the easiest things to swallow, sometimes easier than clear liquids. There are neuromuscular drugs such as Reglan or Baclofen which might help.

If you can find a gastroenterologist who deals specifically with motility disorders, that might help a lot.

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