Gulp! Are You Having Trouble
By Mary Anne Muldowney, RN, BSN
Believe it or not, the seasons can
affect the ability of some people to swallow food, and summertime is one of the
worst. Caregivers at Cayuga Medical Center have treated several Emergency
Department patients this summer with food stuck in the esophagus (swallowing tube).
They had attempted to swallow food particles that were simply too large to pass
down into their stomachs. Left untreated, food stuck in the esophagus can lead
to serious injury.
What is this condition called?
In the summer and fall, when people
with allergies tend to suffer the most, there is an increased risk for eosinophilic esophagitis. This is
an inflammation of the esophagus that causes swelling and makes it more difficult
to swallow. When food gets stuck, it’s called an esophageal bolus impaction.
How can I tell that food is stuck
in my esophagus?
It occurs while eating a meal. You
may experience pressure in your chest. Some people start drooling because not
even saliva is passing through the swallowing tube. It may feel as though you
have a foreign body caught in your chest.
What can I do alleviate the
You can try drinking small amounts
of water, which might trickle through and serve as a lubricant. Changing
positions, stretching, or hopping may help move the food along. However, if the
problem persists, seek medical help by going to the Emergency Department. If
you have a local gastroenterologist, call him or her, especially if you are
being treated for GERD (gastro esophageal reflux disease).
What will happen at the hospital?
You may receive a medication that
can relax your esophagus and help move the food particles along. If the problem
does not resolve, the doctor is likely to recommend that you undergo an upper
endoscopy, which can be performed in the Emergency Department.
During this procedure you will be
moderately sedated to relax. A gastroenterologist will pass a fiber-optic scope
with a camera into your esophagus to see what is causing the blockage and
determine how best to remove it. Depending on the shape, size, and consistency
of the obstructing food there are numerous tools that can be used to remove it.
The doctor will then reinsert the scope and examine the walls of the esophagus
for signs of damage or tearing. Most people can be driven home by a family
member once the sedation wears off. If there is a question of damage to the
esophageal wall, admission for observation is needed.
Who is at risk for esophageal bolus
This condition can affect people of
all ages, although impacted food is more common in adults, especially those
over sixty with existing esophagitis. If you consume a lot of over-the-counter
antacids for heartburn, acid blockers such as Prilosec, or are being treated
for GERD, your risk is higher. When acid from the stomach consistently washes up
into the esophagus, it can cause a ring of scar tissue to form in the lower
esophagus. This inflammation and scar tissue, coupled with swelling from
seasonal allergies, set the stage for food getting stuck. Others at increased
risk are diabetics, people on prescription pain medication, and adults with
poorly fitting dentures.
How do I avoid getting food stuck
in my esophagus?
It’s common sense. Cut your food
into reasonable pieces, chew carefully, don’t talk with your mouth full, and
don’t engage in play or sports while eating. Be especially careful with dry,
stiff meats such as chicken or steak. If something does get stuck in your esophagus,
don’t wait for hours to get medical help. And finally, if you experience
heartburn on a regular basis, get evaluated by a gastroenterologist to
determine the cause of the problem.
Anne Muldowney, RN BSN, is manager of the Endoscopy Unit at Cayuga Medical