Could this be Achalasia?

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Greetings from Canada, I came upon your discussion while trying to sort out what might be causing my symptoms (which I have had for 6 months) If anyone can give me suggestions it would be greatly appreciated : )  symptoms are... the feeling that sometimes after food has been swallowed,  it come back and sits in my throat.  I wake up in the morning with this feeling and after being upright for a bit it seems to go away, only to come back the following morning.  At the moment I am taking proton pump inhibitors as the Dr. thinks that I have GERD or some acid reflux, I have not experienced any acid taste in my mouth at any time.  I have gone to the ENT and had a scope just down the first part of my throat and nothing came about, then just before Christmas had a barium swallow done, this also showed nothing.  Could I possibly have Achlasia and if so what can be done.  I should probably mention than  I have just tipped over the other side of 50 yrs and maybe, just maybe a little bit overweight could these be factors.  Any help is appreciated.

Janette

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  • Posted

    Hi Janette

    Well key to this is the fact you have had a barioum swallow which has shown nothing abnormal. If yoiu had some obstruction they would have seen it and if you had some degree of dysphagia (problem swallowing) then again they would have seen it, Barium swallows are quite good and they can even sometime see any areas of ulceration. But you could possibly still have some degree of achalasia and you need to see your doctors about getting some manometry and Ph tests done plus an endoscopy. IF these come back all normal then I suspect the swallowing problem you are having may be due to irritation from the acid reflux, and maybe you should be on a proton pump inhibitors.

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    • Posted

      Hi Graeme, thanks for your help, I have been on the PPI's  for the past 6 months, they don't seem to do anything.   I have been putting off going back to the Dr's as the sensation is  more annoying than anything.  I will however have to make an effort to have this taken care of, I think what frightens me is that they will send me for an endoscopy, which I'm not up for.  They say ignorance is bliss : )

      Thank you again  

      Janette

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  • Posted

    Hi Janette - It takes some time to get to the root of the problems. I have been seeing a speech and language therapist for some time - they are able to detect and help with swallowing ( dysaphagia ). I am under the care of a Rheumatologist and undergoing tests for Sjogrens Disease - this too is difficult to diagnose and is an auto-immune disease. Your saliva glands slow down or even stop working and without saliva you cannot swallow, or digest foods as the oesophagus becomes dry also. I have had an endoscopy with an upper GI consultant, as I thought I had oesophagul cancer. He discovered a Hiatus Hernia, Thrush and inflammation. We still haven't got to the bottom of my inability to swallow properly, but the speech and language therapist has achieved more than the consultants. Gave me something called a "Chewy Tube", bite on it for a minute or so with back molars and the saliva starts. I have had a very sore and swollen tongue and hopefully the chewy tube will help this also. I am making lots of soft (more  like liquid) food, plenty of fresh vegetable soups, scrambled eggs, ready brek porridge, tinned pears and peaches chopped up - they slip down easily. Today I had some fresh Mango slices.I also make lots of egg custards, some with grated cheese and some with vanilla and nutmeg. So my swallowing is improving. Have the Dr's checked to see if you have a "Pouch" in your throat, food will be swallowed and then collected in this pouchand can make you vomit. I believe this can be corrected with an operation. As you get older your muscles can weaken, but I wouldn't call you "Older" as I am coming up to 69. I have been given lots of throat/voice excercises to help strengthen the muscles. Also are you stressed or tense - as this too can tighten in your throat and stop food from going down.

    I hope you get this sorted out soon, but I do sympathise with you, I have not eaten properly since Nov 10th last year, my diet is supplemented with prescription liquid meals. I lost about 14lbs but has now stabalised. Don't give up Janette just keep hassling your Doctors. xxxx

     

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    • Posted

      Hi Margery, thank you for your help, looks like you've been going through the war, I'm glad to hear that the chewy tube is giving you some relief it's amazing what little things can provide help : )  My barium swallow didn't show anything, I think what might have to happen is the endoscopy, which I'm a bit frightened of, that thought in itself could be a little bit of stress right there. I think the fact that I haven't been back to the Dr's they will probably start hassling me cheesygrin When I finally get down to the nitty gritty and make the apointment I will come back and tell you what they found.  Take care of yourself.

      Janette

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    • Posted

      Hi Janette

      I was scared of the endoscopy too, so I asked my Dr to put me out. I needed some answers and had to go through with it, but as I was unconcious I didn't feel a thing !!!!

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  • Posted

    You probably realise that this is not the place for getting a diagnosis really.

    Did the endoscopy look at all your oesophagus down to your stomach?   Did they find anything like Barrett's Oesophagus?   (columns of cells that change into stomach-like cells because of acid).

    A fair number of people suffer from acid reflux without feeling heartburn but might get, say, a persistent sore throat, husky voice, problems with tooth enamel failing etc.   Some over the counter medications might be worth trying (Gaviscon in the UK creates a protective raft for a few hours for instance and could be taken at night without interfering with PPI medication).

    Sometimes reflux might be bile rather than acid.

    It might, as has been said, that you have some irritation being caused for another reason.   I would feel inclined to keep a food diary to see whether anything sets it off (eg spicy food).

    A gastroenterologist might be able to advise if you have seen an ENT (ear nose and throat specialist), and vice versa.

    I hope it clears up soon.

     

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    • Posted

      Hi Alan yes your right about diagnosis, I just wanted to see if anyone else had similar symtoms and if it was attibuted to Achalasia as opposed to something more serious, although there aren't any other symptoms other than the ones mentioned.  I'm going to have to buckle down and make another Dr's apointment to have more tests done as the next thing could be the endoscopy, which I don't fancy.  Thanks again : )

      Janette

       

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    • Posted

      Like Margery, I was worried about the endoscopy.   I had a sedative and did not feel a thing.
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