Swallowing, Blockage in Esophagus > DiagnosisHealth Health Articles Health Discussions Disease Information
Food Stuck Without Blockage in Esophagus vs Throat Lump
Read Daily Digestive & Swallowing Health News/Tips Here
Dr. Minocha is a practicing gastroenterologist and author of "Natural Stomach Care: Treating and Preventing Digestive Disorders with Best of Eastern and Western Therapies".
complain that food "sticks", or "hangs up" or
"stops" in esophagus. In others, it feels like going very slowly
down through the esophagus. Frequently no narrowing or stricture of
esophagus is found. This is referred to as non-obstructive
Distinction from Globus
Swallowing problems related to nonobstructive esophageal dysphagia are different from globus sensation (lump in throat) which is described at the end.
1. Neuromuscular: Patients with nonobstructive esophageal dysphagia have some neuromuscular dysfunction involving the esophagus. Some of these have a well-defined motility disorder of esophagus, but no specific treatable abnormality is found in most of cases.
2. Acid Reflux or Heartburn: Nonobstructive esophageal dysphagia or swallowing difficulty are believed to be caused by gastroesophageal reflux or acid reflux disease. Acid reflux causes intermittent dysfunction of the contractions of esophagus.
Phoenix, AZ: Colon et al. (2000) demonstrated that large diameter dilation indeed was helpful in 84% of the patients compared to 40% undergoing procedure with a narrow dilator.
Mayo Clinic: Scolapio et al. (2001) showed that dilation is not helpful compared to sham dilation. However, these investigators dilated only the lower end of the esophagus and not the entire esophagus.
Dr. Minocha: Preliminary results from our ongoing study (Digestive Disease Week, Atlanta, GA, 2001 presentation) show that both groups improved, but the magnitude of improvement using a large dilator (19 mm) for stretching the esophagus was similar to narrower dilator (13 mm). However, both groups received PPI drugs (Prilosec, Prevacid, Protonix, Aciphex or Nexium) and some experts present during the MidWest Gut Club meeting presentation in March 2001 argued that the improvement in all both our groups was occurring due to the fact the acid reflux is being blocked. This lends support to the concept that GERD or acid reflux disease plays an important role in the causation of such swallowing difficulties.
If dilation and PPIs fail to provide significant relief, many gastroenterologists use a trial of antidepressants, although there are no studies.
However, globus is not just psychogenic, although psychologic problems and stress tend to be more common in globus patients than those without globus. Therefore, most physicians avoid the use of previously used term, globus hystericus, and prefer the term globus sensation or globus pharyngeus.
Esophagus and acid reflux
Abnormalities of upper esophageal sphincter (UES) of esophagus may be involved. These abnormalities of UES may be brought about by acid reflux. The concept of heightened visceral sensitivity may also be involved as seen in irritable bowel syndrome, non cardiac chest pain and chronic pain disorders.
Diagnosis of globus
The diagnosis is largely clinical. However, the globus may occur in patients with other esophageal problems. Also the diagnosis should be made after excluding a lesion in throat, neck and esophagus.
This is meant to be an informational exercise and NOT a medical consultation. Your doctor is the only one who can best assess your situation and offer you medical advice.
>>Back to Articles on Digestive Health
>>Other Health and Home Page
A message to all visitors and
participants: Contents of this site are meant for educational and discussion purpose only and should not, in any
case, be substituted for a medical consultation. The information posted or linked to
this site should not be used to diagnose or treat a health problem. Your doctor is the only
one who can best assess your health situation and give you a medical advice. No
responsibility/liability can be accepted for any posted or linked information and
use or misuse thereof. Inclusion on this site in no way implies endorsement for a
particular organization, products and/or person/persons and their work. Must read disclaimer ....
Copyrightę 1999- by diagnosishealth. All rights reserved.