What Causes Gagging While Swallowing?

Posted on Thu, 10 May 2018

Question: Ism javing problems swallowing small to medium sized pills, and seem to have reflux when laying semi flat. Liquid sems to come back up into my esaphagus when I lay back to sleep and it causes me to cough and swallow it back. What can I do ???? Thanks. XXXXXXX M

Answered by Dr. Ramesh Kumar (1 hour later)

Brief Answer:
please go for repeat endoscopy.

Detailed Answer:
Hello,
Thanks for the query.

As you are a post throat cancer survivor your symptoms can be suggestive of achalasia. It is a type of esophageal (the food-pipe) motility disorder in response to swallowing.

The food-pipe is separated from the stomach by a muscular sphincter called lower esophageal sphincter. Sometimes, impaired relaxation of this sphincter can also be responsible for the feeling of food struck in the stomach. The degeneration of nerves as a result of chemotherapy and radiation often contributes to such symptoms.

Tests suggested are-
High-resolution esophageal manometry. Using a catheter inserted into your esophagus, muscle contractions in your esophagus are measured when you swallow water.
Endoscopy- To visualize esophagus and stomach.

They should be done at the earliest.

Let me know if I can assist you further.

Regards!

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Ramesh Kumar (46 minutes later)

Dr XXXXXXX ...Thanks for the response. If it is a weak lower esophageal sphincter, is there a solution for this problem. 10 years ago I was diagnosed with Larnyx cancer which was seemingly caused by GERD, and successfully treated with radiation 2 1/2 years ago. I assume that it is a weak or nonoperational lower sphincter. Could that be the same problem reoccurring, and is there a solution, either non surgery or surgery possibly, and is it a satisfactory conclusion. Who would perform that type of surgery? Thanks XXXXXXX Miller

Answered by Dr. Ramesh Kumar (11 hours later)

Brief Answer:
follow up.

Detailed Answer:
Hello XXXXXXX
Thanks for follow up my dear patient.
See my dear patient i can just assume the problem because i can’t physcially examine you neither i can clinically evaluate you.So i can just give you a probable diagnosis which i feel can be your case after going through your history.
Whether XXXXXXX is involved or not depends on report of endoscopy.
Whether radiation etc has caused nerve damage depends on report of mannometry.
Surgery is the last resort treatment and is not usually needed.
Symptoms can be very well controlled by medications.
But firstly you have to go for endoscopy and mannometry.
Thanks!

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Ramesh Kumar (41 hours later)

Dr XXXXXXX I believe that my UES is the problem as when I swallow I can feel the process of swallowing is behind my Adam's apple in upper esophagus. This is also where the radiation was closely directed when treating my larynx nodes 2 1/2 years ago. Could this be an UES malfunction, I understand swallowing is a complicated process. Is there a test for this function and what specialist should I consult. I live in XXXXXXX CO, is there a specialist in my area that you could recommend. Thank you so much for your advice. XXXXXXX Miller

Answered by Dr. Ramesh Kumar (9 hours later)

Brief Answer:
Follow up.

Detailed Answer:
Hello my dear patient,
Yes it is possible.
Upper esophageal sphincter is clinically termed as cricopharangeal sphincter and is supplied by part of vagus nerve.Radiation therapy in that specific area might cause nerve damage.As you can feel problem in swallowing it would be a good idea to visit an Ear nose throat specialist who would check you with laryngoscope and if required endoscopy etc would be done further.
Initially we have to rule out whether problem is there with esophagus or larynx.So initially visit a ENT and once cleared from their side you have to follow up with gastroenterology.
Department of ENT university of XXXXXXX medical school or XXXXXXX XXXXXXX

Hope i was helpful.
Feel free to follow up.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Ramesh Kumar (5 hours later)

Dr. XXXXXXX ....Thank you for your most informative advice. I will follow up with ENT. I am impressed with the HealthCarr website,the immediate knowledgeable response and the professionals such as yourself. Out of curiosity, might I ask where are you located, Dr Kumar? Thanks again. XXXXXXX Miller

Answered by Dr. Ramesh Kumar (35 minutes later)

Brief Answer:
Thanks!

Detailed Answer:
Thank you so much for words of appreciation my dear patient.
I am currently practising only online due to my old age and some serious health issues(Can’t use my left side properly ).Alas had a stroke 2 years back.
Even I highly appreciate the efforts of this site.
Excellent platform to share knowledge and help patients understand things better and that too from any part of world.

I wish you a very happy life ahead hope I was helpful.
Follow up with what ENT suggests you!

Regards!

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Ramesh Kumar (1 hour later)

Dr XXXXXXX Continued. My father had long happy life after his stroke, as I pray that you will as well. I laud you for continuing sharing you experience and knowledge to help others on the planet. God Bless. XXXXXXX Miller

Answered by Dr. Ramesh Kumar (56 minutes later)

Brief Answer:
Thank you Jack!

Detailed Answer:
Thank you so much for wishes dear.
I wish you a very happy life ahead.
Get well soon!
Regards.

Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Raju A.T