Question: Question from Rusda Cloete

Hi, Doctor. I had two babies a year apart. Soon after the birth of my second baby, I had trouble swallowing food. I would try to swallow but my throat would push it back into my mouth. It has gotten progressively worse to the point that I'm now almost exclusively on a liquid diet (smoothies, soups) and chocolate/anything really soft which dissolves in the mouth). I've been to several doctors and specialist without much help. I've done a barium swallow but the machine broke down midway through and I ended up swallowing the gross liquid many times which made me nauseous and impacted on the results I think. The tests showed that the liquid went down the throat without much trouble but it came back up briefly after I swallowed. I think it was because I had consumed so much and got nauseous. I've been to an ENT specialist but he doesn't see anything wrong with my throat. It feels like I have no control over my throat muscles when I swallow. Maybe it's weak, I don't know. I had C-sections and epidurals with both babies. I have had a choking incident when I was younger. I'm wondering if these factors are the cause. I'm not sure whether it's psychological or medical anymore. I really don't think I have GERD or acid reflux because I can't even manage to swallow food, it doesn't get past the first point of entry and I don't have the symptoms for any of those. I don't feel any pain when swallowing. What can the cause be? Please help.

Answer

Hi Rusda, thank you for your question. The problem that you are experiencing is called Dysphagia in medical terms. There can be many causes and the dysphagia is actually just a symptom of a greater picture. I am happy to hear that you have already sought the advice of a specialist to rule out any life-threatening conditions. Your symptoms can absolutely be explained by gastro esophageal reflux disease (GERD), or “heart burn” as you might know it. Damage to esophageal tissues from stomach acid backing up into your esophagus can lead to spasm or scarring and narrowing of your lower esophagus. You might not be experiencing reflux throughout the day but might be having reflux while you are asleep due to a lax stomach valve.

If you experienced a faulty barium swallow previously, I definitely recommend that you repeat it sometime soon. I will also advise you to test your stomach acidity with your doctor as chronic reflux can have serious health implications in the long run. I hope that helps to clear some of the questions you have.

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