Undiagnosed problem swallowing food or pills

You always have to have chest pain investigated properly, but one of the things it might be is the spasm that can be a feature of achalasia.

It feels like a heart attack, apparently, but it isn't, so everybody gets worried.     There are some notes from a meeting for achalasia sufferers on the website of the oesophageal patients association, under The Oesophagus and Achalasia. The discussion included Buscopan, eating bananas, drinking Actimel, taking Manuka Honey, coconut milk, fizzy water, that may help, subject to individual circumstances.

Thank you for your reply. I have just been on the OPA website for the first time. I have had tests done on my heart which came back normal except for ectopic beats and going on medication for that soon. 

If the dismotility problem is not too bad like the Dr said, would I still get chest pain which feels exactly like a heart attack? I get the pain with or without food. I have not had a manometry test and it was never mentioned that I should have one.  

I think that getting the pain means that it is worse than 'not too bad', actually.   The pain may be something to do with the nerve signals sending the muscles into spasm, and I am not sure at all as to what this stage occurs at, even if it is consistently the same for everyone, which I doubt.

The three tests that are needed for a thorough diagnosis are the endoscopy, barium swallow and manometry, and my guess is that they will not be able to get to the bottom of it until they do all three.   It is quite a specialist thing in medical terms.

 I don't really know where to go from here now. As far as my local Dr is concerned I don't think he will send me for a manometry. The pain comes on if I am sitting down, walking around and any movement. I have to be careful not to start the pain off. Never felt pain like it.

Thank you  

That sounds like possibly needing a second opinion from an ear, nose and throat specialist?   And a good idea to keep a detailed diary to show them exactly what you think is happening, and when.

Just wondered if food gets stuck as well. Mine started with tablets getting  stuck then food. I have been diagnosed with a dismotility problem and waiting to see a gastro Dr.  

Hi Merryl I see you have said you have a dismotility problem and thats what I have been told too although they originally said itvwas achalasia they have now decided a complex motility disorder which apparently is difficult to treat. I don't get chest pain like you describe but do have extreme difficulty swallowing and can now only manage liquids and have been prescribed fortisip compact. when i could swallow food i was in agony with burning and a full sensation like the food was piling up and not going anywhere its a horrible condition. Now my throat has a terrible job trying to swallow and often have to force a swallow . I just wondered if you experience a lump in the throat and feeling like something is stuck and will not go no matter how much water i drink or how much i try to swallow it will not go. I have lost so much weight and feel really unwell im lucky as i am getting a second opinion this week i hope they can offer some help i have been suffering four years and it seems to deteriorate does it sound familiar to you. also i have really bad burning in my throat up back of nose in roof of mouth and tongue don't know if you do ? it seems people are affected differently from this. I really hope you get to see a gastro dr soon i think you have to really push to get your point across i have been for years and havent got very far. Hannah

Hi Hannah, sorry to hear you are suffering from this problem. My Dr said it's not too bad but I get horrendous chest pain, if this is not too bad I dread to think what a bad attack feels like. The pain has been really bad today and every time I get the pain I feel as if I should call an ambulance because It feels like a heart attack. I used to get heartburn but since I have been on Lansoprazole for about 10 years I don't get heartburn anymore. It used to come up into my chest and throat and really burn. But the pain I am getting now is a heavy feeling and it is in the center of my chest and stays there for seconds but very painful. I also got an hiatus hernia which was diagnosed over 20 years ago, so I don't really know which of the 2 is playing up or maybe both are. I have lost over 3 stone in the past year and still losing more. I can swallow the food okay but it then gets stuck but not every time. I usually stick to the same foods but get fed up of it. I bought a blender to blend soups etc. I get dry heaving in the morning sometimes after eating and without eating. I get the feeling of a lump in the throat with the dry heaving. I used to have ensure drinks off my GP but he stopped them when the barium swallow came back as Not Too Bad. I have to wait at least another 2 months to see the Gastro Dr. What tests have you had to diagnose the dismotility problem. I feel quite unwell too, could be lack of food.

Let me know how you get on with the Dr and good luck.        

oh no sounds terrible seems to effect everyone differently I don't think they understand the condition to say not too bad especially with the weight loss I think you should ask for the ensure drinks to be prescribed again . I think the lack of energy from such a limited food intake makes you feel unwell and weak especially when its day in day out never lets up. I find it brings on so much anxiety and really has got me down think it gets you like that. I have had 2 endoscopys a barium swallow and manometry and 24 hr pH study. Have you had these tests done? could you call the gastro secretary and see if you could get an appointment sooner or maybe ask your GP for a second opinion like I did. sounds like the pain you get is like a spasm maybe from the food being stuck? maybe you should go to the hospital if the pain is that bad they may take you more seriously and investigate it more.

I have had an endoscopy, and a barium swallow. Could you tell me what a 24 hr PH study is and is the manometry  painful to have. I don't fancy having anything pushed down my throat with the pain I am getting. I had the endoscopy done private about 18 months ago and was heavily sedated so did'nt feel a thing. I have'nt seen a gastroenterologist yet so don't know what tests I might need. I have'nt got the phone number for the gastro secretary.   

Hi Merry, I was actually scheduled to have the Bravo PH test, along with the upper endoscopy and high resolution Esophagela manometry done on 1/13.  It took a year for me to scheduled it.  I went to the hospital and just as we were about to start the procedure the capsule malfunctioned, so they cancelled and i am waiting to reschedule.  i am curious also if anyone else has had this done and if it is painful.  I prep to get there for me was very difficult as i had to come off my protonix pills for 14 days prior.

Hi Hannah30321, i had the POEM 14 months again and i am so grafeful to be able to eat and sleep and drink fluids.  I still have days though when i am extremly tired and drained.  I had blood work several times and the results are always normal. Do you get tired.I take multivitamins daily and eats lots of fruits and vegetables, but still tired.

Hi Wendy, is the Poem an operation to cure the oesophagus problem, if so, why do you need the Bravo PH test if your eating problem is better? Could you tell me what kind of test is this?   

Hi Meryl, i take protonix twice a day for acid reflux, with the poem surgery i no longer have a spinster muscle between tje stomach and. Osephagus. The doctor will record the level of acidityand see if there is any damage to the osephagus, as there is the worry of cancer. I have also signed up for infor,ation collected from my treatment. Be part of a rrsearch study. I was in the 110 peom surgies performed in ny as poem surgery is still new to the country

Hi Merryl how are things are you any further on or are you still waiting on your gastro appointment? I have seen a different consultant now and need another endoscopy and they are going to try botox into lower oesophageal sphincter i think to see if it helps if it doesnt need tests again as things getting worse! I was just wondering what foods are you able to eat daily? Thank you Hannah

Hi Hannah, sorry to hear your symptoms are getting worse. What symptoms are you getting now to make it worse? I phoned the hospital to find out how long I have to wait for my gastro appointment and was told it should be March to April.

Funny you mentioned botox, I was watching tv yesterday called Mystery Diagnosis where they go from Dr to Dr trying to find out what was wrong. When this lady mentioned her symptoms I knew what it was and I was right. One of her symptoms was fetching up white bubbly frothy stuff, I have this often with gagging/ choking feelng. When she finally got the diagnosis she started on botox which she needs every 6- 7 months and she feels much better and eating well. 

I mostly eat weetabix, soups, quavers, mashed potato/gravy  baked beans you can blend, or sauces with no lumps. I also bought a blender, so if I got soup or other food  with lumps. I can blend it. I also have soft deserts like ice cream and pour toffee sauce over it. You could try fish cake with mash potato and beans. I sometimes eat plain chocolate which melts on the tongue.  

What type of food are you eating now?         

Can't beleive you have to wait that long it all takes so long doesn't it and when suffering day in day out just makes it seem even longer! thats positive about the botox then. my symptoms are getting worse in terms of feeling so full up from small amount food only eating food like really runny porridge or milky drinks some days cant swallow well at all so have fortisip compact prescribed now and when i eat i am in so much pain with a burning sensation like i am raw inside from my mouth to stomach i hungry all the time but full at top lump in throat horrible lost lots weight generally feel unwell not much energy at all hope doctor can get to bottom of it soon and same for you. might give some of your food ideas  go get bored of such limited diet expect you do too  .

Hi Hannah30321, did you look into the P.O.E.M surgery.  I took me a lot time to get to it, the same symptoms you described i had in the last months before the surgery.  The symptoms for me, o0nly got worse, i reached a point where not only was i not able to sleep, was loosing weight, my skin was dehydrated, had constant headaches, was always weak, tired, experiencing memory loss.  My whole body was failing apart.  POEM was the best thing i feel i could have done.  My weight have returned.  I take protonix pills twice a day to help with the acid reflux.  i have had to learn to change my diet, i still relapse sometimes as i love spicy and fried food, but at lease i am able to eat pretty much everything, not to mention be able to eat out and not run to the bathroom after the meal to rid my body of it.  Its been over 14 months, i am trying to include more sleep and exercise in my diet.  from all the research i have done, there does not seem to be any cure, but through the various treaments, you can still have an active life and be able to eat pretty much everything.  I hope this helps.

 

Thank you Wendy for response glad you are doing well now. Inwould be happy to have surgery to help with this but I have now seen four different consultants! my results don't fit completely fit with a diagnosis of achalasia so they want to trial the botox to see if this helps before they would consider surgery. the thing is my symptoms have been getting progressively worse over the last four years my test results they are looking at were from july last year its taken them so long to review them decide get a second opinion etc  that my symptoms are alot worse since then I think I need tests repeating. How long were you suffering before you got the diagnosis and did things get progressively worse? 

hi, if you don't mine me asking what test have you done already?

I have had two endoscopies two barium swallows the manometry i have had ent dr look down throat because my throat feels so painful and damaged i first saw consultant in 2011 and they still havent got to the bottom of it so now got to have another endoscopy at end of feb so they can have another look and they will do botox at same time just like i am going round in circles!

I was being treated for acid reflux for years but all tablets they tried me on werent working when they eventually did the manometry it showed 0% acid but problems with the lower and upper oesophageal sphincters and barium swallow showed hardly any peristalsis in oesophagus i just hope the botox will help and one day someone might be able to help 

 

i had a tota of 5 endosopies, 2 barium swallows and 2 swallow test where a tube was placed through the nostil into the stomach and i had to swallow 10 sips of water and 10 tea spoons of apple sauce.  I went to several gi doctorw who all told me i had GERD, ulcers and dysplagia, then i saw a mystery dianosis show where the girl had Achalasia, i took the information to my gi and he did not believe me, recommended treatments from Nexium to botox.  i found one doctor from India who listened to me and reviewed all my records and suggested i give the Achalasia diagnoses a try. I am so happy i did.  Try and find a 5th consultant.  Get another opinion. Try the botox, see if it helps.  I know for myself looking back, i may have had the symptoms from a teenager,but i dismissed it when ever i felt better and labelled it stress.  i also used chiropractic care and accupuncture as well as reflexology that helped at the time. In 2012, i realized that i had to get out of the denial stage and face that i was only getting work and in late August to Spetember, i started loosing weight, dar cirlces under my eyes and almost being afraid to even drink in public, i had to take a chance, which is where the POEM came in.  I hope what i share help, each individual is different and what worked for me, may not for you, but write everything down and share it with your doctors.

 

Hi Hannah30321, ask the doctor to also do a biopsy to see if there is anything else going on.  I had that done.  ask your doctor about Nexium or Pantoprazole sod 40mg.  This really helps with the rawness of the osephagus and the bloating in the stomach. I hope the endoscopy will shed some light for your treatment.  Try and hang in there, this is a horrible condition.

 

Thank you makes sense what you are saying i cant eat around anybody brings on so much anxiety im so afraid of choking i hardly leave the house anymore some days much worse than others where did you get the poem surgery done?

My manometry showed no peristalsis also.  I always felt like the food was stuck in my throat, but because i liked to drink and eat at the same time i had dismissed it.  The botox should relax the muscles so swallowing will be easier.  Ask the doctor, if it woeks, how often you will need it and for how long you can have botox?

 

There is a 6 month waiting list to see the gastro Dr. Have you tried complan? I have this about 3 times a week. I have lost over 3 stone now. I am still getting chest pain whether I eat or not and I know it is not heartburn because the only time I get burning is when I forget to take Lansoprazole. My pain is like a heavy bruised feeling in my lower chest and does not come up to my throat. I have'nt seen anyone on this site complaining of this. When you have the endoscopies are you sedated or awake.?  

 

I feel what you are saying, many people does not realize what a mental strain this is.  I could not travel or participate in things.  But i think the worst for me was when my body started reflecting the lck of nutirents, my nails were brittle, hair was dull and falling out and my skin was always dry and ashy not to mention all my clothes were swinging on me.  My coworkers would stop and ask me why i was loosing weight and i would busrt out crying.  i work with about 50 doctors and i was so embarress to share my illness, finally 2 of them sat me down and i spilled and they encouraged me to keep getting consults and one referred me to a GI from India.  He was the only GI that took me serious.  This condition is so rare, not many western physicians know about it much less have a patient with it.  I am the only patient for my primary care doctor and for 3 of the old GI doctors i had.

 

Merryl, the chest pains are from the acid reflux, i have them still when i don't take my protonix(pantoprazole sod 40mg).  Prior to the protonix, i would wake up choking or have fluid or food particles in the wind pipe, Complan and ensure are great to drink and it helps to nourish the body, plus try and keep on the weight and give most needed energy. The endoscopies you are usually sedated but finished within 45 minutes to 1 hour of you going under and waking up

Hi Wendy, when you get the pain does it feel as if you got a golf ball stuck in your chest because that's what mine feels like. I need to burp when I get this and the pain goes away until the next time. I have taken my blood pressure when the pain is bad and it is quite high. I have read on here that it is the oesophagus going into spasm. Hopefully I will see the gastro Dr soon. I had the endoscopy 18 months ago and went private so was put right out and did'nt feel a thing. I don't fancy having it done again.

I feel tired and got no energy to do anything. I also got dry skin, hair coming out.Glad to hear that you are feeling much better after the operation.   

Hi, it always felt like a lump stuck, i aalways keep seltzer water close by. His would make me burb.the lack of energy is from your body and getting enough nutrients and rest and stress. Try to drink at least one endure a day and soups that have been blended out , also try and comsume your meals at least 4 hours before bed and sleep with your head elevated. I hope the suggestions help.

Hi, I get the lump feeling, it is very uncomfortable. I had a barium swallow 5 months ago but achalasia was not mentioned. I phoned my GP for the results and was told I had a dismotility problem and it was'nt too bad.