Sunday, July 29, 2012

For AEK - My GI Procedure

I had a GI procedure about a week and a half ago. I have had this problem for at least 10 years where I get particularly meat stuck in the back of my esophagus. It isn't like the food goes down wrong, it just gets stuck. Sometimes it felt like there was a bone or something in the back of my esophagus preventing food from going down. I had always reasoned I took too large of bites, and it is probably true.

In April I ended up in the ER because I couldn't get any food or water down - the meat was stuck, and I threw up anything I tried to get down- that always happens. I have found over the years drinking a large amount of water really quickly helps push the meat down when this happens. My regular doctor told me he wanted to schedule me a GI procedure to scope my throat and see if there was something causing it. So here's what I learned...

The procedure was a blast getting to be under anesthesia... I remember burping constantly during it since there was an object being put down my throat.

The doctor said she dilated my esophagus to help enlarge it to make sure that food goes down easily. I had no idea that was possible - The Guy's boyfriend reasoned it was soft muscle. It seems to me that would be a temporary fix.

She said that I had some acid reflux damage and put me on a pill to heal and deal with that. She said to take 2 omeprazoles a day before breakfast and dinner to deal.

She said that it could also be a food allergy and asked me the type of foods that it happens with - breads and meat. She reasoned maybe gluton. She referred me to the allergist for that. Grrrr. I am not giving up my breads.

She said that I also have 2 things going against me - I have allergies and I'm an asthmatic. Like there are receptors on your skin that when aggravated by something in the environment cause you to break out, you have those in your throat too. People with asthma and allergies are often extra sensitive and have more receptors, which can cause an issue. She said it could be food or anything from the environment like dust getting into my throat causing me pain. She said the omeprazole should take care of that.

So far so good... hopefully this continues.


fan of casey said...

Mike: I hope your treatment works. I could not help but chuckle seeing "gluton" and your earlier acknowledgment that you eat too big bites. I know you meant to say "gluten" -- it just seemed like a freudian slip.

Aek said...

Well, that sucks. When you had said it felt like the meat was getting stuck, I thought you had some diverticulum or fistula or something - good thing that wasn't the case! The omeprazole is a proton pump inhibitor, and generally helps most people with reflux issues.

Do you also have eczema? That'd complete the triad of asthma, allergy, and eczema.

Best of luck with it all!

Anonymous said...

Mike, there was a certain amount of quackery in your doc's explanation. It is unlikely that your swallowing issues are caused by allergies, that is the most far fetched explanation. Food allergies great enough to swell the esophagus would also cause breathing problems, and an obvious breakout on the outside of your body (swelling and hives), the reaction would not be limited to your esophagus.

Two more likely explanations: You have a disorder or malformation of the nerves to the musclulature of the esophagus, which causes spasms or swallowing problems or both. Really not much to treat this, nothing can re-establish the nerve supply, some people are born with the condition, some develop it when the immune system attacks the nerves for some reason, and also seen in the elderly. Achalasia is another possiblity, but unlikely since it involves the lower espohageal sphincter being to closed to tight, the opposite of acid reflux.

Another possible cause and perhaps the most likely is simply acid reflux. The EGD test you had did find evidence of reflux, which means your lower esophageal sphincter is too relaxed and allows stomach acid to regurgitate into the esophagus. You will need to take medication for life to treat this (for symptom relief and to prevent cancer), if your problem is mild to moderate you can take over the counter ranitidine (150mg morning and night, can increase to 300mg morning and night), when you finish your course of omeprazole.

Omeprazole is actually more effective, but has a higher side effect profile, some serious like kidney problems, bone fractures, higher incidence of certain types of pneumonia, and there is a debate about it causing some heart problems. It will not cause problems in the short term. Ranitidine on the other hand is a safer long term choice, and you can get a month's worth over the counter at Walmart and the other stores for $4/month.

Other: You mention a history of asthma. If you haven't had a comprehensive lung function test, it is a good idea to make sure you really have asthma. Especially if you take daily meds to treat it, because of the potential side effects of the meds. Too many people are diagnosed by just telling their doctor of a few symptoms, then they get labled with a disease they may not have.