There are a number of conditions that can lead to swallowing problems. A sudden problem could be due to a swallowed foreign body or food bolus causing an obstruction. This would constitute an emergency situation and require admission to Hospital.
An infection can also result in swallowing issues as could a Stroke.
A more gradual onset of swallowing issues could be due to a neurological condition or simply due to acid reflux and muscle spasm. A pouch may form in the oesophagus, causing swallowing issues and reflux of recently swallowed food. A tumour could also affect swallowing.
Very commonly though, no physical cause can be found for the sensation experienced by the patient. The term, Globus Pharyngeus, is applied to the sensation of a lump in the throat or discomfort in the throat. This discomfort is usually relieved by eating and drinking and only present on swallowing saliva. The symptoms are made worse by the patients constant swallowing to try to get rid of the sensation and the anxiety which occurs due to afear of what may be causing the problem.
In this situation a thorough history and examination, including an examination with a flexible telescope through the nose (Nasendoscopy) to look at the throat and voice box is needed. A proportion of patient will have acid reflux, some will have mild chronic dehydration and others will be stress related.
Quite often there are numerous overlapping causes. In a proportion there may be no cause found.
Reassurance that there is nothing sinister going on is all that is required. If symptoms do not resolve, then Xrays or an examination under a general aneasthetic may be needed.
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