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back to articles on "Digestive Track"

Gulp! Are You Having Trouble Swallowing?

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 situation?

 

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 impaction?

 

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.

 

Mary Anne Muldowney, RN BSN, is manager of the Endoscopy Unit at Cayuga Medical Center.

 

 

 

 

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