Dysphagia: A Throaty Issue

Question: Sometimes, food such as rice or a piece of meat gets stuck in my throat. I can’t swallow at all; it is as though my throat has seized up. It takes about 10 minutes or so before the food finally goes down, but the process is very painful.

Seek medical assistance if you are experiencing chronic dysphagia or dyspepsia.

Answer: Having both dysphagia (difficulty swallowing, including having food stuck in the throat) and odynophagia (painful swallowing) is a cause for concern. These differ from the more common condition, which involves a sensation of something in the throat when swallowing saliva, but not when you are swallowing food or liquids.

If you feel something when you are swallowing food or liquids (but you have not been diagnosed with dysphagia nor odynophagia), then the sensation is usually a manifestation of throat irritation from either nose back drip or stomach acid reflux.

If you have dysphagia and odynophagia, you will need a proper medical evaluation. An ear, nose and throat (ENT) doctor would need to determine if there is a blockage of the food pipe (gullet or oesophagus) or if there is a nerve problem that has resulted in discoordination of the swallowing muscles. The food pipe is like a tube, and blockage of this passage can arise from a problem within the cavity, tube or exterior tube wall.

Blockage can be caused by a fishbone or other foreign objects that obstruct the food pipe or a tumour that has arisen from within the wall of the food pipe or outside it and compressing it. Sometimes, severe acid reflux problems can also give rise to dysphagia and odynophagia.

A stomach specialist (gastroenterologist) will be consulted if the problem is found to be lower down the food pipe.

Dr Ho Eu Chin
Consultant
Department of Otorhinolaryngology
Tan Tock Seng Hospital

Practicing good eating habits can alleviate dyspepsia.

Bad Eating Habits Can Cause Dyspepsia

Question: I’ve always eaten my dinners late, at about 9 pm, but nowadays, I wake up with a bloated stomach and indigestion. The General Practitioner (GP) I saw attributed this to gastric and advised me to eat at a more normal mealtime. I tried, and indeed my condition improved slightly. However, due to the nature of my work, I can’t always have dinner at an earlier time. What can I do?

Answer: What you have described seems to indicate that you are suffering from dyspepsia. The symptoms of dyspepsia include abdominal bloating, belching, heartburn, nausea and vomiting.

Eating habits play an important role in improving dyspepsia. Try dividing your meals into smaller portions and eating them at a fixed time and interval every day. You should take your meal at least two hours before bedtime and avoid eating too much oily and spicy food.

Consider refraining from consuming alcohol and caffeine, as they are common substances that can cause dyspepsia. For individuals who suffer from lactose intolerance, consumption of dairy products may also worsen the condition.

Do talk to your doctor if you are taking any medication for chronic conditions. Medication such as painkillers, antidepressants and diabetic medicine could cause dyspepsia too. You can consider antacids, which are available over the counter to help with the symptoms of dyspepsia.

Be sure to pay attention to the red flags of dyspepsia, such as change of stool colour, weight loss or prolonged and worsening of symptoms. Further investigations via endoscopy and ultrasound may be needed to rule out peptic ulcer disease, malignancy and gall bladder disease.

Dr Chu Chun Hong
Family Physician
Toa Payoh Polyclinic
National Healthcare Group Polyclinics


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