difficulties in swallowing
 

Hi. I am here for the first time. I was diagnosed with polineuropathia sensorica two years ago. I was on Lyrica, small dosage only 50 mg per day. Now my doctor has increased the dosage to 75 mg a.m. and 75 mg p.m. Has anyone of you experienced difficulties in swallowing, like you are eating and then it seems something stuck down the throat? Is it because of lyrica or because disease is worsening?? Any answer is appreciated.
thanks. Dea from Croatia

Hi welcome to the site! I have this same condition during certain (My most severe)times of the year with my auto-immune peripheral neuropathy. I think it is called Dysphasia. It can be a symptom brought on by PN or can be caused be some medications. It is a very irritating symptom no matter where it comes from. Some of the more senior experts will probably come on answer more in depth - but I just wanted to let you know your not alone!:)

I have a burning sensation in my throat after eating. Thank you for posting. I don't know if our symptoms are similar. I didn't think it had to do with Pn or drugs. Hope to hear more replies.

Welcome to NeuroTalk.

Report this to the doctor. I believe this is a serious symptom,
and he will have to determine if it is a drug side effect or
something else, coming on.

Hi Dea
 

Welcome to Neuro Talk. You have found a very compassionate site. I also have difficulty swallowing and it has not been determined why. I have had two endoscopys in the last six months, and the problem I have had for over 5 years, Yes pills and food get stuck. Could you please tell me what test you had that discovered this condition called polineuropathia sensorica? They want to do a test where I wear a tube from my nose to stomach for 24 hours. Did you have this done? I would like to know more how they arrived at that disorder, as I am indeed having trouble. I am not sure I want the test because nobody is telling me what the solutions would be anyway. I sure would like to hear from you. A warm Welcome again to you. ginnie

Hi Adelina
 

Yes Adelina, they have given me that diagnosis too of Dysphasia. Is there any treatment for it? Have they suggested further testing for you? I just finished another endoscopy with the same results. What have they sugested you do about the condition. sure would love to hear from you. ginnie

Re: hello january babe
 

Hello, I am posting for the difficulty in swallowing also. No burning, but food and pills sit at the back of my thoat, and I have to drink lots of water with all food. Dysphasia is what my GI Dr, Termed this. No burning other than for Gerds. Is this pain in your thoat or in your GI tract? What tests have you had? Sure want to hear from more of us who experience this swallowing issue. I am hesitant to go through more tests, as the next batch are particullarly uncomfortable. I would like to hear what your doctors are recommending you do for the condition. I am at a stand still right now until I can make a decision on if I want to go forward with more of these tests. The Dr. is leaving it up to me. any information would be appreciated. I also have heard nothing possitive about a solution to this problem even if I went ahead with more testing. ginnie

Dysphasia? - Do we have the correct term here?
 

I think you folks mean Dysphagia

Dysphasia (or Asphasia) is
Easy mistake. ;)

Doc

Maybe I get overly concerned reading these posts. Mine feels more like eating too fast. I do take Pepto Bismal and that helps.I did mention to doctor and she said not to wait until I get so hungry that I eat so fast.

Okay I thought I was right! (it doesn't happen alot these days:p) I wrote Dysphagia and my spell-check marked it wrong and since today is one of my "bad" days:o - I just don't trust my brain! Guess I could've for once!:p

Hi ginnie - how's going!? Pretty miserable here - stomach flu for 4 now and counting (the third kid came down with it today and I'm still not recovered!).

I was told that my DYSPHAGIA is a part of my ganglioneuritis. That may be in part due to wher it is located in the spine? I don't know ginnie - I wish I had a better answer. I know that the more severe my PN symptoms or pain; the more severe my dysphagia is. My PN symptoms are dependent upon virus, bacterial infections, allergerys, and such. That is why Feb through July is the worst time of year for me. This last virus, the stomach flu has destryod me. It brought back both my dysphagia and allodynia :D:rolleyes::o this is so fun I have never used these big words so much - in fact I never knew/remembered the name for my "sensitivity pain" until I read the post. So now I can use these new words all in one thread and feel like i'm one of the intellecctuals for a moment - :yahoo: - of course you sort of lose the effect when you read my typo's but - I think I got run - my tummy is churning.... byyyeeeeeeeeeeeeee....................:thud:-

Getting scoped from GI doctor or ph test are not going to tell you anything about your swallowing. You need you get a high def manometry. This will tell you what your upper and lower esphogus sphincter pressure is as well as your swallowing motility. Obviously,if your refluxing into your throat (lpr reflux) then that would cause swallowing issues. Tightness in the throat, phlem can be a vagus nerve distinction. Amitriptyline, lyrica, gabapentin are drugs of choice to treat that.

Google you should also see an ent to examine your vocal folds. It's important to see if they are working properly.

I'm on myipad right now but I can give you more information about all this if you need. This is how my PN started.

Zenker's Diverticulosis
 

I had a problem swallowing several years ago--I think it may be different from what you all are experiencing, but I had difficulty swallowing some of the larger supplement pills as well as chicken and beef. I told the Endocrinologist about it at my 6 months visit, and he said I had to get to the bottom of it. He scheduled an appointment for me with a surgeon who was an esophagus specialist.

It turned out I had Zenker's Diverticulosis. In layman's terms, this is a pocket that forms in the esophagus that catches food, named for the physician who discovered the problem. He told me that in ancient times, some people with this disorder used it to their advantage for smuggling jewels into the country. Anyway, I had to have it repaired surgically by stapling the pocket closed. I had a long nasty scar for a while, but it has healed nicely now and is really not even noticeable any more. Joan

**********the tube is a sensor to monitor over 24 hrs the pH of the stomach, placed while you are awake, swallowing and maybe drinking water while it goes down, it is typically lubricated with jelly (lidocaine) to make it easier. After it is placed it can be annoying, but tolerable. When removed the monitor box is connected to a computer and downloaded, reported to the GI doc. The MD is just looking for more info to treat you better, however, they can assume you have excess acid levels and treat anyway. The problem with under treated acid conditions is that the esophagus can narrow down ( that's why food gets stuck) they (the MD's ) have a nifty trick for that....repeated dilalations of the esophagus. So much fun, try to get proper treatment before that is needed.
Daily hints, eat slowly, especially the first bite, eat something like a few Cherrios after difficult meds, tap temp water ( not cool). If food does get stuck and does not move ( like when you try to unstuck by vomiting, it is a medical emergency) the hospitals always have a GI team on call. Beware of the fresh grilled juicy steak!!!:wink:

Actually, there is a swallow test called, video flouriscopic swallow study. The radiologist views your swallowing with barium or other contrast--in various forms (liquid, solids, crackers, pills, etc) right there (of course it's recorded also). Better then manometry, (IMO) The probe for manometry is further down in the esophagus so great test for ruling out esophageal spasms and motility disorders.

Inquire about a swallow study for an accurate diagnosis of swallowing problems.

:(
 

Hello to you all. Thank you for wellcoming words. I feel much better knowing some of you experience something similar. My neurologist told me to wait a little, she thinks it may have something with me reading the side effects of lyrica (drug I am taking)! can you believe it? I have to chew food really good before swallowing it and my heart beats pretty hard when that stucking takes place... If you know what I mean...
Anyway, I was diagnosed with polineuropathia sensorica two years ago. I have done EMNG of the both feet, done all kinds of blood tests including one for tumour markers which was negative, thanks God... EEG of lungs, heart, uzv of abdomen, etc..Anyway the cause was not found yet so they are treating only consequences... Pretty stupid... My left foot is all numb, I feel it but different from the right one. I also have a problem with wearing socks, it kind of starts to cramp and pinch and I have to wear socks which are much bigger (my husbands!)... Does anyone of you have that also as a problem?
I am so happy to find you... There is a forum here in Croatia about these problems but nobody wrote a post for several weeks!!!! so, I am so glad to have found you all. Love you all!!! I am so sad and helpless... It is winter, cold, and I cannot wear socks and tight shoes and I could only a month ago. And now this swallowing sensation...it is not just in my mind...I feel something is wrong... Awaiting your kind replies.. Regards.
Dea

Hi to you all, first of all let me thank you for the warm wellcome 
There is a forum for the similar issues here in Croatia but nobody visited it for few weeks, can you imagine?
Now, for the swallowing problem, I told my neurologist but she thinks I red too much the side effects of the lyrica (drug I am taking) so it may be only in my mind!!! Can you imagine? Now I see I am not alone and that I am not mad or stupid
I was diagnosed with polineuropathia sensorica two years ago, I ve been taking lyrica in small dosage ever since. Now, since my problems became bigger doctor has prescribed me higher dosage… This swallowing problem is like I am eating and if I dont chew it too good it kind of stuck in the throat, like I cannot swallow it all through. Then my heart starts to beat really fast and soon it seems like I cannot breath. It lasts only like couple of seconds but quite enough to be scared…
Also, wanted to ask You, how about wearing socks? I am having trouble with that, namely, I cannot wear tight socks or shoes because I get cramps, pins in my legs…Looks like both legs are made of ice… It is hard to walk…
I am so scared. I have a small baby and insstead of enyojing him all the time I worry non stop and I am scared of all of that…
I thank you again for all the posts. Hope to see them again.
Regards from Croatia,
DEA

The Test you are referring to is called a FEESST test and it’s not better than a Manometry. You can use a FEESST test once you understand want is going on with the swallowing to aid in the diagnosis of the dysfunction. There are exercises you do with a speech pathologist where the FESST can assist with.

There are several reasons why your swallowing motility could be affected.

Medication, Thyroid, Zenker's Diverticulosis, Achalasia,Diffuse esophageal spasm, Barrets, Non Specific motor disorders, Sinsus, Reflux or a combination of multiple reasons.

The easiest test to determine if it’s Zenker's Diverticulosis or some type of visible blockage is an Esophogram. You swallow barium and the Xray you while you are doing it). If everything looks normal then you do the Manometry.
By the way, for the person who commented on 24 ph test, if they didnt perform the manomerty first how did they know how long your esophagus is? They need that in order to place the sensors in the correct position otherwise the data from the test is useless. There is a new ph test that measure acid fumes, as well and has a LED that can determine the correct placement of the sensor but I doubt they used that one as only a few doctors have it.

Why play games with ph test when you can first understand if the LES is weak to begin with.

Here is a link to Doctor I went to when I had throat problems. This article talks about people with chronic cough but really is applicable to people in general who has Laryngeal Sensory Neuropathies.
Because there could possibly be multiple underlying causes of issues going on, some people never get relief of their issue until all aspects are treated aggressively.

I wasn’t until I went on reflux med, domperidome, and amitriptyline that my globus went away.
http://www.chronic-cough.net/2012/02...related-cough/

It all depends on what the potential/suspected problem is as for what test is best. I've had both. Manometry cannot determine if aspiration is taking place which is the most important factor in swallowing problems (IMO)...fluoriscopic swallow study can tell immediately. It can also tell lots about delayed swallowing and other mechanic problems in that first few motions of the swallow, that the manometry cannot. Manometry is great for suspected motility problems, spasms, reflux, etc...where the fluoriscope is pretty much useless for these. So comes down to what you're looking for.

PH test is good to determine reflux. I don't think they put patients through the trauma of manometry just to determine length of esophagus. I believe they have been doing PH probes long before manometry was even widely used. Don't they just do a couple follow up x-rays for ph probe placement? Been a long time since I had it done, can't remember.

If you are doing a bravo PH test where they attach the Sensor to the lower part of your esphogus then you dont do a manomerty. That PH test is useless. If your are doing a dual sensor ph test where the put tube through your nose and into your stomach then yes you need a manometry to figure out sensor placement. Yes there are GI doctors who dont do manomertys but the tests are flawed.

I had 2 ph tests and 4 manomertys done. I would rather have a tube in my mouth for 15 mins then for 24 hours. PH test is pure hell.

Many GI and ENT's dont want to do them. I think its because they dont know how to interpret them. The ones who do have equipment dont have High Def ones so the test is more torture as its a pull through system. Test takes 25-30 mins instead of 10 mins.I am not knocking the ph test all I am saying is your show know your motility and LES pressure to start with. Obviously, if someone has LES pressure less the 10hg's then need PPI's. If that doesnt work, you need surgery. There is ofcourse the poor folks who are refluxing Bile (non acid) and are waiting for a drug to supress both.

Actually, I just realized the name I gave initially was correct...video fluoriscope swallow study. The FEESST is something completely different and not what I was referring to. The fluoriscope study would be best for initial assessment of swallowing problems, especially if aspiration or mechanical problems are a concern. It's completely non-invasive and results are immediate. But again if motility is the concern, then manometry is the way to go.

Yes, if you are having issues with aspiration its something with the Vocal Folds and or UES. So Yes that will be best to determine. Again, if thats the case you have something with Vocal Folds either Paresis are partial. My right vocal cord is completely paralyzed. Thank god it got stuck in a way that the left can compensate to close with the right otherwise I would aspirate.

@dea:

There are a lot of informative posts here for you to read and learn about all the testing that is out there.

But in my experience, a doctor will hesitate to use them unless
there are symptoms that are persistent and serious.

Most doctors wait and see how much you complain, and it would
help for you to keep track of all the swallowing problems daily.
Say 3 times on Sunday--log the times and type of food
or 4 times on Monday--log the times and type of food.
etc. When you present a listing of persistent uncomfortable
incidents, THEN you may get further evaluation. If you were in a nursing facility or hospital, a nurse would be logging these times. Since you are at home, you need to keep a record yourself so your doctor can see and evaluate whether you are having troubles needing interventions.

The first two symptoms I had that eventually pointed to PN were difficulty swallowing and dizziness. After a basic blood test I saw the ear nose and throat doctor. I had some fluid in my ears, but it didn't end up being the cause of the dizzines. Other tests were also negative.

My acid reflux was suspect for the throat swallowing issue. I had an upper GI about a year before these symptoms showed up and all was normal. So they did an esphogram which consists of swallowing barium and watching it on a monitor. Also normal. (Please note this test is not as reliable as an endoscopy/upper GI)

The tingling in the toes and hands followed shortly thereafter.

Now about 2-1/2 years later I know my body much better. When I get a flare up, symptoms are a mix of all of these PN traits. Not necessarily all of them at the same time, but combinations of them that vary with each flare up.

Fortunately the swallowing issues don't come on much anymore. If it does, then it only lasts a day or two. Same with the dizziness for the most part. There are exceptions in duration, but they are rare.

Difficulty swallowing is a huge concern. It could be a sign of esphogus cancer. It is rare, but deadly. Please have it checked out. An endoscopy is definetly the way to go for testing. Good luck!

When I was going through my problems with swallowing, I suspected the cause was the Fosamax I had been taking as I knew some people had this type of reaction to it; that's why you were supposed to remain upright for at least 30 minutes after taking the pill first thing in the morning. This cause was never confirmed however. I, too, drank the barium while the doctor watched on the monitor, and he told me the suspected problem immediately.

When tracking the daily/weekly episodes, it would probably be a good idea to keep track of the medications you're taking at the same time, for future reference.

will look up doc. smith on my records
 

[The meaning the word had according to my Upper GI meant difficulity in swallowing, not to do with the brain. I am being screened for thoat cancer every six months with biopsy and endoscopy. Also had my thoat dialated to help. He does not know the cause for me as of yet. I am not sure I want the next test. You wear a tube in your nose to your stomach for 24 hours. The thing is there may be nothing they can do, even if they pinpoint the cause of my trouble swallowing. I will look in the spelling of my records. I do have a copy of my biopsy, it is just the drs. writing is not so good. ginnie

Test questions
 

Hello, and thanks for your responce. Please tell me what manometry is, and the TEESST, and the fluoriscope test involves. What is the one that you wear a tube to your nose and stomach for 24 hours? I am being asked to take that one. I am questioning all these tests. thanks ginnie

Hi MrsD
 

I have had two endoscopy and two biopsy for thoat cancer and swallowing problems. I have had this for over 5 years and I am at a stand still. I need to know more about this test he wants me to do and he didn't give me the name of it. You first have a tube to your nose and stomach for a short time, then you wear this tube for 24 hours, was the discription he gave me. I am calling into question all the tests that could help diagnosis me, the less invasive to me the better, as I am batteling other medical problems that are serious at the same time at this problem. I have to have another surgery, and also take my family to court. I am trying to be easy on myself, while still receiving help. I wonder why he ordered or asked me to do this particular test. The name of this test is not on my report. thanks Mrs.D ginnie PS also had throat dialated with no success.

Ginnie,

Here's a link about manometry that makes it easier than explaining.

http://www.nlm.nih.gov/medlineplus/e...cle/003884.htm

The Fluoriscopic swallow study sounds like what you had done when you swallowed the barium WHILE the radiologist watched on a screen. usually they give you thick & thin liquid barium as well as barium pills to swallow and crackers with barium. This way they can see your swallowing with different types of substances.

The FEESST link has lots of info with links on the left with more information.

http://www.feesst.com/

Hope this is helpful.

Hi adelina
 

So sorry you are sick! I absolutely hate getting the stomach flu. I hope you get better soon. It is hard on a person when more than one issue presents. Yes I like leaning the terms too. Mostly to get an understanding on what the doctors tell us. I can't make an informed answer unless I understand what is required. I am one of these people who has to evaluate if I should have a test or not and then be evaluated after the education. I have never submitted to a test unless I understand first. Get well soon and I hope the rest of this coming spring allows you to stay healthier. ginnie

thanks enbloc
 

I have had a tube in my nose to take a look around. do you know if this FEESS is a worse sensation than that> I was OK during that one, and didn't choke. They numbed my nasel passages. I am considering this FEESS rather than the Manometry. Which one is harder on a person. My doctor will let me decide what I want to do. ginnie

It really all depends on what they suspect is the problem. If they believe it's motility, then the manometry would be best. It's uncomfortable, but a good test for this.

I have not had the FEESST. I have had the PH probe, the fluoriscope swallow, and the manometry. The fluoriscope is easiest and accurate for mechanical problems and to check for aspiration.

Yes they did the first test, but that wasn't the question I answered.m

...
 

Ah, all that answers... I am really worried now... I like to believe that these swallowing incedents are result of pn beeing worse...So I hope increased dosage of lyrica would do some good... Praying and hoping it is going to be so...grrr

Hi dea
 

I hope you do find an answer. I do have barretts' esophagus, which was partly to blame for my swallowing issues. I take a double proton pump inhibitor, to allow myself to heal. It isn't easy to live with the swallowing issue. I really hope you heal and get resolution to the condition. ginnie

janet staples
 

i have difficulty swallowing but have multiple system atrophy, other symptoms are tremors in right hand, sudden drop in blood pressure, aspiration when swallowing.
:)

Hi to you all... I am now really worried. Beeing through the internet and saw that it might something to do with GERB which was diagnosed also but long ago...I took Controloc for several months and some simptoms came back, but nothing to worry about. Could it be GERB making my swallowing problems arise?? What do you think? It is like, I am eating some hard food like meet or bread and then it looks like I cannot swallow it, like it is going to stuck down somewhere ... heart starts beating really fast cause I get scared...big scare.... my God..what could it be???

Hi dea
 

Be calm....I am here. Try not to worry so your heart rate goes up. I checked into the emergency room and they didn't find out what was wrong with me. what you should do is make an appt. with an upper GI doctor. I want you to know that everything that was done to me to find out what was wrong was easy! OK? Gerds can and does cause further trouble. If you are taking nexium and other anti acids and they are not working all the time, you should see your doctor. I developed something that did scare me, called berretts esophogus. It took me 5 years of complaining for someone to take me serious. So this doctor did. It was not in my head at all. I eroded the lining to my stomach and my esophagus. I am now on a special med to calm my stomach and let it heal. I have had two biopsys. NO WORRIES!!!!!! This proceedure didn't hurt. The first was to put a tube with a camera down my nose. DID NOT HURT. They numb your nose and thoat, didn't feel a thing. I also get put out for the endoscopy, no worries OK??? I will be on this medication for a long time I expect. You may just have bad GERDS. This can be controlled, but you need to get this checked out. I don't want to scare you, I am just telling you the truth. Let me know if you are OK with this. I will be here to answer any questions to comfort you. ginnie

Thanks Ginnie... i will visit doctor. But problem is I have a small baby and it is difficult to go even to doctor cause hubie works all day so baby is with me all the time. Don't have anyone to look after him while i am gone... to complicated..
but I will do something. I was just wondering if anyone had the same problems and has GERB as diagnosis as well... Thank you for your comforting but honest post... you helped me... I am worried all the time to sufficate... I kno w I am too scared and also thought it might something to do with anxiety... All sorts of things are going through my mind right now..
Thanks .. Dea

Hi dea
 

It is OK in this country to bring the baby with you for your initial doctors visit. Put her in the stroller and off you go. However if you require testing, that requires your husband, or someone else to drive you home from the testing clinic. That is standard proceedure. Maybe a church can help out, with a member who can do this for you. It might me worth your while to advertise for a Nanny for a short time while you go through this process. There is always a way to work through the problems. Let me know what you come up with and I will keep thinking. Other people have had problems with Gerds in much the same way I have. So it is important to be screened. I wish you all the best and I will keep in touch with you. ginnie