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Having Oesophageal Pain While Drinking And Eating. Drinking Tap Water. Suggest Medication To Relieve The Pain?

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Posted on Thu, 31 Oct 2013
Question: I have a question concerning my wife...
She has esophagial pain when drinking and eating. She doesn't know if its worse when liquids are hot or cold because she has been drinking tap water and the solids have beem at room temperature. She is not experiencing any fever for what we are aware or any complaints about her allergies This has been going on since Tuesday. Any information will be greatly appreciated.
doctor
Answered by Dr. Vivek Chail (1 hour later)
Brief Answer:
? Pharyngitis

Detailed Answer:
Hi,
Thanks for writing in to us.

I have read through your query in detail.

Your wife might be suffering from pharyngitis. Pharyngitis is inflammation of the pharynx which continues into the upper esophagus– what’s commonly called a sore throat. Pharyngitis is an extremely common problem, resulting in millions of doctor visits annually.

One main concern of people with pharyngitis, and their doctors, is strep throat, or pharyngitis caused by the group A streptococcus bacteria. Strep throat is treated with antibiotics, and can sometimes lead to problems if untreated.

However, only a small fraction of people with pharyngitis have strep throat. Most sore throats are due to viral infections, which antibiotics don’t help Typically strep throat is diagnosed by a health care practioner based on clinical findings or a rapid strep test called rapid antigen detection test. The definitive test for strep throat is a throat culture which takes 24 to 48 hours to complete.

Consult a doctor and taking antibiotics if necessary. Please note that antibiotics will not work in purely viral pharyngitis.

Eating soft foods might be better if there is pain while swallowing.

Hope your query is answered.
Do write back in case of doubts.

Regards,
Dr.Vivek


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vivek Chail (46 minutes later)
She doesn't present a fever and isn't having trouble swallowing. Her tonsils do not appear inflammed and she hasn't complained of a sore throat. However, upon swallowing, as liquids travel to her stomach it causes her a great deal of discomfort when it reaches about 3 inches below the clavicular notches. She does say that soft food is easier to swallow than liquid. Odynophagia caused by something. She states that the pain takes her breathe away and sometimes results in painful hiccups.
doctor
Answered by Dr. Vivek Chail (10 hours later)
Brief Answer:
?esophageal spasm/ ??achalasia cardia.

Detailed Answer:
Hi,
Thanks for writing in with an update.

If there is no sore throat and fever, I will rule out any acute infective condition. After reviewing symptoms, I would like to think of esophageal spasm or achalasia.

1. Esophageal spasms are irregular, uncoordinated, and sometimes powerful contractions of the esophagus, the tube that carries food from the mouth to the stomach. Normally, contractions of the esophagus are coordinated, moving the food through the esophagus camera and into the stomach.

There are two main types of esophageal spasm:

Diffuse esophageal spasm. This type of spasm is an irregular, uncoordinated squeezing of the muscles of the esophagus. This can prevent food from reaching the stomach, leaving it stuck in the esophagus.
Nutcracker esophagus. This type of spasm squeezes the esophagus in a coordinated way, the same way food is moved down the esophagus normally. But the squeezing is very strong. These contractions move food through the esophagus but can cause severe pain.

Esophageal spasms are uncommon. Often, symptoms that may suggest an esophageal spasm are the result of another condition such as gastroesophageal reflux disease (GERD) or achalasia, a problem with the nervous system in which the muscles of the esophagus and the lower esophageal sphincter (LES) don't work properly. Anxiety or panic attacks can also cause similar symptoms.

Your doctor can often find out the cause of esophageal spasm from your medical history by asking you a series of questions. These include questions about what foods or liquids trigger symptoms, where it feels like food gets stuck, other symptoms or conditions you may have, and whether you are taking medicines for them.

2. Achalasia cardia:

Achalasia cardia is actually a motor disorder involving smooth muscle of esophagus.It affects both thoracic and abdominal part of the esophagus.There is a sphincter at the lower end of esophagus called lower esophageal sphincter(LES).This XXXXXXX does not relax normally in response to swallowing causing bulging of lower end of esophagus which results in achalasia cardia.

It can affect at any age
It affects both males and females
The main symptoms are difficulty in swallowing to both solids and liquid food,chest pain and regurgitation
It follows a very chronic course with progressive dysphagia and weight loss

The diagnosis can be confirmed with tests, including esophagus tests (such as esophageal manometry) or a barium swallow. Esophageal manometry uses a small tube attached to instruments (transducers) that measure pressure. A barium swallow is done using X-rays.

Other tests may be done to find out whether chest pain may be caused by gastroesophageal reflux disease (GERD), the abnormal backflow (reflux) of food, stomach acid, and other digestive juices from the stomach into the esophagus.

I would suggest that you consult a gastroenterologist and get evaluated in detail after giving a detailed history of your wife's clinical symptoms.

The above can be thought of as clinical possibilities and the true diagnosis may change/ differ after thorough clinical examination.

Hope your query is answered.
Do write back in case of doubts.

Regards,
Dr.Vivek
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Vivek Chail

Radiologist

Practicing since :2002

Answered : 6874 Questions

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Having Oesophageal Pain While Drinking And Eating. Drinking Tap Water. Suggest Medication To Relieve The Pain?

Brief Answer:
? Pharyngitis

Detailed Answer:
Hi,
Thanks for writing in to us.

I have read through your query in detail.

Your wife might be suffering from pharyngitis. Pharyngitis is inflammation of the pharynx which continues into the upper esophagus– what’s commonly called a sore throat. Pharyngitis is an extremely common problem, resulting in millions of doctor visits annually.

One main concern of people with pharyngitis, and their doctors, is strep throat, or pharyngitis caused by the group A streptococcus bacteria. Strep throat is treated with antibiotics, and can sometimes lead to problems if untreated.

However, only a small fraction of people with pharyngitis have strep throat. Most sore throats are due to viral infections, which antibiotics don’t help Typically strep throat is diagnosed by a health care practioner based on clinical findings or a rapid strep test called rapid antigen detection test. The definitive test for strep throat is a throat culture which takes 24 to 48 hours to complete.

Consult a doctor and taking antibiotics if necessary. Please note that antibiotics will not work in purely viral pharyngitis.

Eating soft foods might be better if there is pain while swallowing.

Hope your query is answered.
Do write back in case of doubts.

Regards,
Dr.Vivek