[Dysphagia] 29 Year Old Male/Sudden Onset Dysphagia/StillOngoing/Anything else it could be?

[speechhuffman at nc.rr.com (Speech Julie)]

Dear Jim,

Hang in there!  I don't think anyone on this list thinks its "all in your 
head".  I agree with the manometry evaluation.  This would help identify a 
motility problem.  Dysmotility symptoms can range from feeling as though 
food gets stopped somewhere, feeling like it doesn't go through to severe 
chest pain.  It is often intermittent, so the person doesn't know when to 
expect it.  However, it can be very consistent as well.  The other tests you 
have had ruled out structural abnormality, but not functional abnormality. 
Do keep in mind that the manometric evaluation could also come back normal 
if your problem is intermittent.

Since you have been found to have reflux, I would try to pull out all the 
behavioral/ dietary/ positioning modifications for reflux (you can email me 
off list if you want lots of suggestions).  Lots of dysmotilty is as a 
result of reflux and although you are on Prilosec, that only decreases the 
acidity of what comes up, does not stop the act of the contents coming back 
up.  You may want to try warm fluids (like warm decaf tea) with meals which 
has been shown to aid esophageal clearance and decrease the likelihood of 
spasm.  Cold foods and liquids can make the symptoms worse.

Good luck.  I see lots of people just like you for swallowing exams on a 
weekly basis!  Keep up posted.

Sincerely, Julie
----- Original Message ----- 
From: "James Wright" <jamesrwright at windstream.net>
To: <dysphagia at dysphagia.com>
Sent: Wednesday, July 11, 2007 9:16 PM
Subject: [Dysphagia] 29 Year Old Male/Sudden Onset 
Dysphagia/StillOngoing/Anything else it could be?


>I am not sure what to do or where to turn.
>
>
>
> Here is my situation. Sorry if ramble. I am a 29 year old male that had a
> sudden onset of dysphagia at the end of April. Stuff suddenly felt as if 
> it
> was not going down smoothly. I have been to a variety of doctors, and
> basically they are telling me it is in my head. I do have anxiety now 
> about
> eating, but only because I feel like stuff is not going down right. I am
> desperate to get better since I am scheduled to go back for my MBA this
> fall. I had no surgeries or trauma to my throat.  The foods that are 
> giving
> me problems are "harder" solids such as rice, crackers ,even harder
> vegetables i.e. bits of carrot inside of a wrap. Softer items are no 
> problem
> for me.  Sometimes I feel as if I have to cough..I don't cough anything 
> up,
> but I have that urge. I have never had a choking episode per se, at least
> none recent. (choked on a chicken bone when I was 5)I am now paranoid to 
> eat
> foods such as  chicken or hot dogs in solid form but only because I have
> been having issues with them. I never had any fear of choking before. I 
> used
> to drive down the road with a 12 inch hoagie at 50 miles an hour and eat
> with no problem. I know dangerous and messy, but I am using it to 
> illustrate
> my point that there was no long standing fear..Here are the tests I have 
> had
> so far.
>
>
>
> 1.       ENT did a Flexible Endoscopy back at beginning of May. I had 
> normal
> closure of my airway when swallowing, but I did not swallow anything I 
> would
> be having trouble with i.e. solids. The test was performed with
> pudding/applesauce with food coloring. He thought maybe it was caused by
> reflux despite my lack of symptoms so I have been on Prilosec twice a day
> since beginning of May.
>
> 2.       I had a CT scan. Nothing showed up other than mild sinus disease;
> nothing that could account for my dysphagia.
>
> 3.       I had two barium swallows, regular and modified. I am not sure 
> why
> the doctor did the regular once since I never had trouble with liquids. 
> The
> modified one was down with a soft cookie; once again, I don't have trouble
> with mushy carbs such as cookies, and Nutri-grain bars, just hard stuff. I
> told the doctors that, but they did not include such a bolus in my swallow
> tests.
>
> 4.       The upper GI endoscopy revealed mild felinization of my 
> esophagus.
> They did a biopsy. They did fine some eosinphils in my esophagus, but 
> fewer
> than 5 per high powered field. There were no visible lesions or webs or
> anything like that in my esophagus. The number of cells was consistent 
> with
> reflux, but visibly I had no damage per se.  The doctor put me on a 
> Flovent
> swallow just in case it may have been due to allergy.
>
>
>
> I am at my wit's end as to what is going on. I am going to a respected
> medical center, UPMC in Pittsburgh.  I swear I am not crazy..really..I am
> not. I tried to talk myself out of there being a physical cause, but I 
> keep
> on having feelings in my throat when I am eating that alarm me. Anyone 
> have
> any idea as to what this could be? Possibly a different angle on this? Any
> assistance would be appreciated. I need to get better ASAP.
>
>
>
> Thanks!
>
>
>
> Jim
>
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