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Allergies and choking

06/22/2007 10:34AM

Question:

I have currently seen an M.D. (Otology and Neurology Specialist) for tinnitus. During the visit the doctor examined my throat and found that it was swollen inside. This led to a barium swallow test. While taking the test, I started choking on the liquid I had to swallow. I told the technician I often choke on food and liquid. In addition, I told her that I have this constant phlegm/mucus in my throat (around the epiglottis area) and around my vocal cords that I can never entirely get rid of and I have a constant minor soar throat). The technician said it looked like my swallowing was okay but, noted it went down very fast. The fact that I choked on the liquid in her presence led her to believe that I probably get food or liquid caught in that area more often than most people. The only advice she could give me was that I may have weak neck muscles (could be, I had a thyroidectomy about 3 – 4 years ago) and that I should take smaller bites of food and smaller drinks of liquid. I am choking on food and liquid more and more often. It is beginning to scare me. I have mentioned my problem with mucus/phelgm to other doctors, but with little response other than looking at the abvious, allergies (I do have allergies). The phlegm/mucus is in my throat, but could it also be in my air pipe interfering with my epiglottis? Every morning it is a battle to clear my throat to take my medications and most often it feels like the pills are stuck in my throat. I think the constant clearing of mucus/phelgm could be causing the swelling of my throat. Is there any kind of medication I can take to clear up the mucus/phelgm? Can you think of any possible reasons why my epiglottis is not working properly other than allergies?Any foresight you can give me to share with my doctor will be greatly appreciated.

Answer:

The problems you are experiencing, that is increased mucus in the throat and difficulty swallowing, are most often caused by acid reflux.  It is not uncommon for acid to reflux from the stomach, as you probably know.  When this causes inflammation in the esophagus (the tube that carries food from the throat to the stomach), it creates heartburn.  You may not have heartburn if your esophagus is not inflamed.  However, the acid can spill into the throat which then causes a number of problems.

The acid irritation causes an increase in mucus production that pools in the throat.  This would be worse in the morning, and would lead to the symptoms you describe as well as chronic throat clearing and even hoarseness.

The acid reflux also causes the muscles at the opening of the esophagus to tighten.  This impairs their ability to relax during swallowing, sometimes preventing food and liquid to pass easily, hence causing difficulty swallowing.

I suggest you consider taking something for reflux, such as prilosec now available over the counter.  It may require weeks to months of therapy to see results.  However, an evaluation by a general ENT physician (rather than a neurotologist) would be wise.

For more information:

Go to the Ear, Nose, and Throat Disorders health topic.