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Increasing Episodes Of Choking While Swallowing, Coughing, Wheezing. Do You Recommend A Swallow Test?

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Posted on Sat, 8 Sep 2012
Question: Hi. 59yo male with increasing episodes of choking because things have gone down the wrong hole while eating, drinking swallowing, saliva too - he can barely breathe with this occurs and then much coughing and wheezing and burbing for several minutes until he can get a decent breathe in. Do you recommend a swallow test?
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Answered by Dr. Dr. Naveen Kumar Nanjasetty (1 hour later)

Hi

Thanks for the query

After going through the description I do feel the gentleman could be suffering from either nerve related problems or growth in the upper esophagus.

Both the above mentioned problems are common in this age group. There could be weakness of the Laryngeal nerve innervating the larynx. This causes loss of sensation over the voice box leading to repeated choking and chest infections. The weakness of the nerves could be either due to damage in the brain over the area related to the nerve or growth in the neck pressing the nerve.

Secondly, malignancies are common in this age group which needs to be thoroughly evaluated.

I do not suggest barium swallow test because he can aspirate the barium meal and land up in XXXXXXX trouble. Hence the best choices of investigations are oesophago-gastro-duodenal scopy (OGD scopy), laryngoscopy and MRI of the brain and the neck.

Hope I have answered your query; I will be available for the follow-up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
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
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Answered by
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Dr. Dr. Naveen Kumar Nanjasetty

Otolaryngologist / ENT Specialist

Practicing since :2001

Answered : 2543 Questions

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Increasing Episodes Of Choking While Swallowing, Coughing, Wheezing. Do You Recommend A Swallow Test?


Hi

Thanks for the query

After going through the description I do feel the gentleman could be suffering from either nerve related problems or growth in the upper esophagus.

Both the above mentioned problems are common in this age group. There could be weakness of the Laryngeal nerve innervating the larynx. This causes loss of sensation over the voice box leading to repeated choking and chest infections. The weakness of the nerves could be either due to damage in the brain over the area related to the nerve or growth in the neck pressing the nerve.

Secondly, malignancies are common in this age group which needs to be thoroughly evaluated.

I do not suggest barium swallow test because he can aspirate the barium meal and land up in XXXXXXX trouble. Hence the best choices of investigations are oesophago-gastro-duodenal scopy (OGD scopy), laryngoscopy and MRI of the brain and the neck.

Hope I have answered your query; I will be available for the follow-up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon