An endoscopy allows your doctor to view your esophagus, stomach and part of the small intestine. Here’s how it works.
An endoscopy procedure involves inserting a long, flexible tube (endoscope) down your throat and into your esophagus. A tiny camera on the end of the endoscope lets your doctor examine your esophagus, stomach and the beginning of your small intestine (duodenum).
I am defining SWALLOWING TROUBLE as the difficulty in transport of food to the stomach, once clear of the throat. Problems with the initiation of the swallowing process are discussed separately.
PAIN in the mid-chest ON SWALLOWING is a worrisome symptom which can be due to inflammation of the lining of the esophagus from a variety of causes. An esophageal yeast infection, which can also involve the throat (called ‘“thrush”), often warns of immune deficiency and can be a sign of AIDS, or be caused by immune suppressing medication. If persistent, pain on swallowing can be a warning sign of CANCER.
If in the presence of GERD, it can be a sign of chronic inflammation or ulceration. In-coordination of the normally smooth muscular propulsive wave can cause a cramping, muscular pain.
Normal “peristalsis” is so efficient, that food can be swallowed without the help of gravity, when UPSIDE DOWN. I wouldn’t recommend trying this, even to cure hiccoughs. There is a muscular “gate” at the bottom of the esophagus, just as it enters the stomach. This gate is often too relaxed, and allows for the reflux of acid and food from the stomach, or GERD. It can also Fail to open, called achalasia, and hold up the food in its journey to the stomach.
The area can be scarred by repeated acid reflux, and become NARROWED; this is called a STRICTURE, and can cause a blockage in swallowing. One of my Doctor friends had to go to the Emergency room when some Steak got stuck in the esophagus.
The ER Doctor removed the steak with a fiberoptic Scope, and then proceeded to DILATE the stricture with a “bougie”, an instrument of a precisely calibrated size designed to STRETCH the constricted area. This uncomfortable procedure had to be done repeatedly, a caution to those who would wait too long before getting such a problem evaluated and corrected.
EOSINOPHILIC ESOPHAGITIS has been diagnosed with increasing frequency, and can cause Pain in the middle of the chest, trouble swallowing, and even regurgitation of food. This special type of inflammation is more common in allergic patients, and can be caused by certain foods.
So as you can see, swallowing trouble, if persistent, is nothing to fool around with, and should be checked out by a competent doctor. Don’t wait too long.
DYSPHAGIA covers a wide range of troubles, symptoms and diseases, as indicated from the excellent Infographic posted August 21, 2020. I have already discussed GERD, or trouble with the food coming back up after being swallowed.
This post will be on “choking”, or getting the food into the Airway instead of the Esophagus, or swallowing tube. In the future, I will develop a post in “swallowing difficulties”, or trouble getting the food to pass easily and freely down the esophagus into the stomach.
CHEWING the food properly is rare in our rushed, fast-food society, but it is very important, the first part of the digestion process. Mastication breaks the food into smaller particles that are easier to digest, and also EASIER TO SWALLOW. Saliva flows as you chew, and contains Ptyalin, an enzyme which breaks down starch into absorbable sugars.
Chewing also SLOWS down the rate of eating, improves enjoyment, and allows more time for the stomach to send Satiety signals to the brain. This leads to less overeating and weight gain. In children, chewing is said to aid in jaw development and to reduce dental crowding and need for Orthodontia.
Some people have trouble in Initiating the swallowing process. This can be caused by neurological problems like Parkinson’s Disease. It can also be Psychological, a reflection of fear of discomfort on swallowing.
I have the opposite problem, a tendency to swallow too eagerly and rapidly, causing me to choke on liquids, sometimes even on water. I went to an ENT specializing in swallowing problems. He checked the sensitivity of my throat to touch, and found it normal.
Apparently LESSENED sensitivity is the main concern, which would lead to Aspiration of food. The only guidance he gave me was to eat and drink more slowly. I find that I am most likely to choke when I drink wine, or a tasty beverage which I tend to “slurp” so as to fan the aroma out broadly in my mouth. I am having a hard time breaking myself of that habit.
Sometimes I find that residual amounts of food builds up in the back of my throat, probably by my epiglottis. I worry about nuts especially. If I don’t drink some water to flush it away, I am likely to choke on it. I guess that is the reason people are told to offer some water to a person who is choking.
I seem to be choking more as I get older, which is reasonable. Swallowing requires an amazingly intricate coordination and motion in the throat area, especially in getting the epiglottis, the little door that closes off the windpipe, to close properly.
My other dexterities are fading, why should swallowing be an exception? Pill swallowing is getting more frequent and more problematic at the same time.
Tablets are worse than capsules, maybe because they are not as slick. There is one size in particular that tends to get stuck in the back of my throat just above the uvula. I sometimes have to cough a lot and choke the offending object back up. One more reason to constantly try to cut down the number of pills.
There is one good thing about this problem, however. I now take the pills separately with a big swallow of water, improving my Hydration.