Re: Disphagia testing/ post from H

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In a message dated 9/20/02 11:28:04 AM Pacific Daylight Time, Hob writes:

<< Subj: Disphagia testing

Date: 9/20/02 11:28:04 AM Pacific Daylight Time

From: <A HREF= " mailto:Hob " >Hob</A>

To: <A HREF= " mailto:RCColloran " >RCColloran</A>

Dear ,

Another vigilance report -- Disphagia associated with RP and other

Rheumatic conditions.

In recent months I have had bouts of painful swallowing and the sensation

that food gets stuck in my throat. My Rheumy thought it was probably GERD

caused by the RP drugs and that there could be damage to the esophagus if it

was severe enough.

She was concerned because I was already on 40 mg Prilosec (max dose) to

control stomach acid.

A gastroenterologist did an endoscopy and found a slight narrowing in the

esophagus (unknown if caused by RP scarring or other problem) and a slight

hiatal hernia. Symptoms improved for a while but then returned. The doctor

suggested that I wait a while to see if the medicine he gave me to improve

motility in the esophagus helped. If not there was a 24-hour test of

stomach/esophogus acidity that might be required.

I realized the pain and sticking sensation were higher up than the narrowing

found 35 cm down in my esophagus so I got a second opinion for a

laryngologist.

The laryngologist looked down the throat with a little video camera and

found nothing out of place. Only slight inflammation. (Not all

laryngologists will have this little video camera -- find one who does.)

She said the symptoms I describe are for a condition called Disphagia which

is sometimes associated with the neuropathies (nerve damage) of Rheumatic

conditions. Severe cases make it impossible to swallow anything but liquids

and purees in very small amounts and waiting between swallows.

She ordered a special Barium Swallow test to isolate the area where the

" sticking " occurs.

This test uses a Barium cookie and a couple of other barium compounds of

different consistencies -- not just the thick liquid that a " regular " barium

swallow test includes. An X-ray with video watches each swallow progress

down the esophagus.

My experience is that a cookie is something that " sticks " and I am hopeful

that this test will identify the cause of the problem.

If the test reveals that the sticking is in the area of the larynx and

thyroid where there is a lot of cartilage she may order a CT throat scan to

see if there is any scarring there that is causing an obstruction.

Other list members might find this information useful. I will write again

after the Barium swallow test.

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