[51M] With sharp and burning chest pain when swallowing

Patient Description

A 51-year-old male has been experiencing sharp and burning chest pain when swallowing food for about a year. The pain occurs after swallowing and is relieved once the food goes down. The patient sometimes has to induce vomiting when food gets stuck, which happens approximately once every three weeks. The vomit contains the bite of food just swallowed. There are no specific foods that trigger this issue. The patient has not experienced any unintentional weight loss, vomiting of blood, black tarry stools, or new or worsening heartburn. He also reports a sensation that food is getting stuck in his throat or chest. There are no pre-existing conditions or chronic illnesses, and he is not taking any medications.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your symptoms:

  • Esophageal Stricture: This condition involves a narrowing of the esophagus, which can cause food to get stuck and lead to pain when swallowing. It can result from chronic acid reflux, which causes scarring and narrowing over time.

    • Treatment: Treatment often involves procedures to dilate (widen) the esophagus and medications to reduce stomach acid.
  • Gastroesophageal Reflux Disease (GERD): GERD can cause chronic inflammation and damage to the esophagus, leading to pain when swallowing and the sensation of food getting stuck.

    • Treatment: Lifestyle changes, such as avoiding trigger foods, eating smaller meals, and not lying down after eating, can help. Medications to reduce stomach acid, such as proton pump inhibitors (PPIs), may also be prescribed.
  • Eosinophilic Esophagitis: This is an allergic condition where eosinophils (a type of white blood cell) build up in the esophagus, causing inflammation and difficulty swallowing.

    • Treatment: Treatment may include dietary changes to avoid allergens, medications to reduce inflammation, and sometimes esophageal dilation.
  • Achalasia: This is a rare disorder where the esophagus has trouble moving food down into the stomach because the lower esophageal sphincter doesn't relax properly.

    • Treatment: Treatment options include medications, botox injections to relax the sphincter, or surgical procedures to help the esophagus function better.

What you can do

While you should consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take in the meantime:

  1. Eat Slowly and Chew Thoroughly: Take small bites and chew your food well to make it easier to swallow.
  2. Stay Upright After Eating: Avoid lying down immediately after meals to help prevent reflux.
  3. Avoid Trigger Foods: If you suspect certain foods make your symptoms worse, try to avoid them.
  4. Stay Hydrated: Drink plenty of water, especially during meals, to help food pass more easily through your esophagus.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe or Worsening Symptoms: If your symptoms become more frequent or severe, it's important to see a doctor.
  • Unintentional Weight Loss: Losing weight without trying can be a sign of a more serious condition.
  • Vomiting Blood or Black, Tarry Stools: These could indicate bleeding in the gastrointestinal tract and require immediate medical attention.
  • Difficulty Breathing: If you have trouble breathing, seek medical help right away.

Remember, while this information can be helpful, it's important to consult a healthcare professional for a proper diagnosis and treatment plan.

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7 mo ago

People Also Ask


What are the common causes of sharp and burning chest pain when swallowing?

Common causes of sharp and burning chest pain when swallowing include esophageal stricture, gastroesophageal reflux disease (GERD), eosinophilic esophagitis, and achalasia. These conditions can cause inflammation, narrowing, or dysfunction of the esophagus, leading to pain and difficulty swallowing.


How is esophageal stricture diagnosed and treated?

Esophageal stricture is typically diagnosed through an endoscopy, where a camera is used to view the esophagus, or a barium swallow X-ray. Treatment often involves procedures to dilate the esophagus and medications to reduce stomach acid, which can help prevent further narrowing.


What lifestyle changes can help manage symptoms of GERD?

Lifestyle changes to manage GERD symptoms include avoiding trigger foods, eating smaller meals, not lying down immediately after eating, and maintaining a healthy weight. Medications such as proton pump inhibitors (PPIs) may also be prescribed to reduce stomach acid.


What are the symptoms and treatment options for eosinophilic esophagitis?

Symptoms of eosinophilic esophagitis include difficulty swallowing, food impaction, and chest pain. Treatment options include dietary changes to avoid allergens, medications to reduce inflammation, and sometimes esophageal dilation to widen the esophagus.


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