[26F] With progressive chest pain and dysphagia

Patient Description

A 26-year-old female presents with an 8-month history of progressively worsening stabbing pain in the center of the chest and mid-back. The pain initially occurred periodically, mostly at night, but now occurs 1-2 times per hour, lasting a few minutes each time. The patient experiences significant difficulty swallowing, with food feeling stuck in the throat and occasionally blocking the airway until vomiting occurs. Eating exacerbates the chest pain. At night, a dark brown fluid sometimes pours from the nose, and the patient has a deep, productive cough. There is associated constipation, a weight loss of approximately 10 pounds, and a significant decrease in appetite. Occasional nausea, vomiting, and voice changes are reported, along with a sensation of a lump in the throat. There is no heartburn, acid reflux, fever, or chills. Medical history includes asthma diagnosed at age 5, managed with Albuterol as needed. No known drug allergies or family history of esophageal or gastrointestinal disorders. A CT scan revealed esophageal thickening and two majorly swollen lymph nodes.

Show More

Arora's Assessment

What might be happening

Based on the symptoms you've described, there are a few potential conditions that could be causing your symptoms:

  1. Esophageal Stricture or Obstruction: The difficulty swallowing and sensation of food getting stuck could indicate a narrowing or blockage in your esophagus. This can be caused by inflammation, scarring, or growths. The CT scan showing thickening in your esophagus and swollen lymph nodes could be related to this.

  2. Gastroesophageal Reflux Disease (GERD): Although you haven't experienced heartburn, GERD can sometimes present with atypical symptoms like difficulty swallowing, regurgitation, and chronic cough. The dark brown fluid from your nose could be related to reflux reaching your nasal passages.

  3. Esophageal Cancer: While less common, the combination of weight loss, difficulty swallowing, and esophageal thickening could suggest a more serious condition like esophageal cancer. It's important to follow up with your healthcare provider for further evaluation.

  4. Infection or Inflammation: The swollen lymph nodes and productive cough could indicate an infection or inflammatory process affecting your esophagus or respiratory system.

What you can do

  1. Seek Immediate Medical Attention: Given the severity and progression of your symptoms, it's crucial to follow up with a healthcare provider as soon as possible. They may recommend further testing, such as an endoscopy, to get a clearer view of your esophagus and determine the cause of your symptoms.

  2. Modify Your Diet: Until you can see a doctor, try to eat soft, easy-to-swallow foods and avoid anything that seems to trigger your symptoms. Eating smaller, more frequent meals might also help.

  3. Stay Hydrated: Ensure you're drinking enough fluids, especially if you're experiencing vomiting or have a decreased appetite.

  4. Avoid Smoking: Smoking can exacerbate esophageal and respiratory issues. Consider seeking support to quit smoking, as this could improve your symptoms and overall health.

  5. Monitor Your Symptoms: Keep track of any changes or worsening of your symptoms, and seek emergency care if you experience severe chest pain, difficulty breathing, or any new alarming symptoms.

Remember, while I can provide information based on your symptoms, it's essential to consult with a healthcare professional for a formal diagnosis and appropriate treatment.

Show More

1
 Hugs
0
 Comments

Save

1 mo ago

People Also Ask

What could cause difficulty swallowing and a sensation of food getting stuck in the throat?

Difficulty swallowing and the sensation of food getting stuck can be caused by conditions such as esophageal stricture, obstruction, or inflammation. These issues can result from scarring, growths, or other abnormalities in the esophagus.

Can GERD occur without heartburn and still cause significant symptoms?

Yes, GERD can present with atypical symptoms such as difficulty swallowing, regurgitation, and chronic cough, even in the absence of heartburn. It's important to consider GERD as a potential cause of these symptoms.

What are the potential implications of esophageal thickening and swollen lymph nodes?

Esophageal thickening and swollen lymph nodes can indicate several conditions, including inflammation, infection, or more serious issues like esophageal cancer. These findings warrant further investigation by a healthcare provider.

How can I manage my symptoms while waiting for a medical evaluation?

To manage symptoms, try eating soft, easy-to-swallow foods, avoid triggers, eat smaller meals, stay hydrated, and avoid smoking. Monitoring symptoms and seeking medical attention for severe or worsening symptoms is crucial.

No comments yet

Be the first one to comment

Share your feedback

All Stories

Experiencing symptoms?

Our AI will conduct a medical interview and assess what might be happening. You can also make a post afterwards.

Share your feedback