[57M] With recurrent esophageal food obstructions

Patient Description

A 57-year-old male reports recurrent episodes of food obstruction in the esophagus, particularly with the first one or two bites of chunky foods like steak or apples. During these episodes, he cannot swallow or belch, and any attempts to eat or drink result in regurgitation, sometimes through the nose. The obstruction is usually cleared by drinking a few hard swallows of water. This issue has been present for most of his adult life. He does not experience heartburn or regurgitation outside of these episodes and denies any unintentional weight loss, black or tarry stools, chest pain, or severe abdominal pain. There is no family history of gastrointestinal disorders. His medications include Celebrex 200 mg daily for shoulder and knee pain, testosterone gel 1.62% daily, and Omega XL (4 pills daily) for joint health.

Arora's Assessment

What might be happening

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

Esophageal Stricture: This is a narrowing of the esophagus, which can cause difficulty swallowing, especially with solid foods like steak or apples. It can be caused by chronic acid reflux, certain medications, or other conditions that cause inflammation and scarring of the esophagus.
- Treatment: Esophageal dilation (stretching the esophagus), medications to reduce acid reflux, and in some cases, surgery.
Eosinophilic Esophagitis (EoE): This is an allergic inflammatory condition of the esophagus. It can cause difficulty swallowing, food impaction, and heartburn.
- Treatment: Dietary changes, 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. It can cause difficulty swallowing, regurgitation of food, and chest pain.
- Treatment: Medications, esophageal dilation, or surgery.
Esophageal Motility Disorders: These are disorders that affect the movement of the esophagus, such as diffuse esophageal spasm or hypercontractile (jackhammer) esophagus.
- Treatment: Medications to relax the esophagus, dietary changes, and in some cases, surgery.

What you can do

Consult a Doctor: It's important to see a healthcare provider for a formal assessment. They may recommend tests such as an endoscopy, barium swallow, or esophageal manometry to diagnose the issue.
Dietary Modifications: Try eating smaller, more frequent meals and chew your food thoroughly. Avoid foods that are difficult to swallow.
Stay Hydrated: Drink plenty of water, especially during meals, to help food pass through the esophagus.
Avoid Triggers: If certain foods consistently cause problems, it may be best to avoid them until you have a clearer diagnosis.

What you should look out for

Seek medical attention if you experience any of the following:

Severe Chest Pain: This could be a sign of a more serious condition.
Unintentional Weight Loss: This could indicate a more serious underlying issue.
Persistent Vomiting: This could lead to dehydration and other complications.
Difficulty Breathing: This could indicate that the obstruction is affecting your airway.

Remember, while this information can help guide you, it is not a substitute for professional medical advice. Please consult a healthcare provider to receive a formal diagnosis and appropriate treatment.

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6 mo ago

People Also Ask

What are the common causes of food obstruction in the esophagus?

Common causes of food obstruction in the esophagus include esophageal strictures, eosinophilic esophagitis, achalasia, and esophageal motility disorders. These conditions can lead to narrowing or impaired movement of the esophagus, making it difficult to swallow solid foods.

How is eosinophilic esophagitis diagnosed and treated?

Eosinophilic esophagitis is diagnosed through endoscopy and biopsy, where a sample of the esophageal tissue is examined for eosinophils, a type of white blood cell. Treatment often involves dietary changes to eliminate allergens, medications like proton pump inhibitors or topical steroids to reduce inflammation, and sometimes esophageal dilation.

What lifestyle changes can help manage esophageal motility disorders?

Lifestyle changes that can help manage esophageal motility disorders include eating smaller, more frequent meals, thoroughly chewing food, avoiding foods that trigger symptoms, and staying well-hydrated. Medications to relax the esophagus may also be prescribed by a doctor.

When should I seek medical attention for swallowing difficulties?

You should seek medical attention for swallowing difficulties if you experience severe chest pain, unintentional weight loss, persistent vomiting, or difficulty breathing, as these could indicate a more serious underlying condition.

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Anonymous#4896

6 mo ago

I have EoE and it took an upper endoscopy and biopsy to diagnosis it. My father had similar problems but only later in life. I've had similar issues as you probably since high school (39 now). It's very much something I can control because it's linked to very specific foods for me that cause choking. Pizza / beer combo and steak are the biggest violators for me. Also if I do a intense work out it tends to flair up. There also seems to be some stress response to it. I got a omeprazole prescription but rarely use it because I just learned to manage it over the years, mine will stop within a few minutes of stopping eating and I just have to control my breathing.

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[57M] With recurrent esophageal food obstructions

What might be happening

What you can do

What you should look out for

Experiencing symptoms?