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Can Stress Cause Unsynchronized Esophageal Spasms? I Recently Had A
Question: can stress cause unsynchronized esophageal spasms? i recently had a barium study done and it showed esophageal dysmotility where my esophagus wasn%E2%80%99t in sync. It didnt show any reflux. Ive been under a lot of stress and have been having anxiety thinking the feeling of the food being stuck in my throat is related to bulbar als. Is this a possibility? the barium test was done with just liquids and didnt show any difficulty swallowing.
Brief Answer:
Yes anxiety could definity cause it.
Detailed Answer:
Hello dear and thanks for choosing "Ask a Doctor" service for your query,
Have seen the details given by you and also the questions and answers given by my fellow doctors.
Firstly let me tell you one thing anxiety stress and thoughts are some thing which could cause any symptom in human body. Gross levels of anxiety are some times associated with severe obsession and this obsession leads to compulsive attitude which means that despite of findings of test to be near normal and every doctor saying that you need not to worry the same thought would occupy your mind again and again and you would start feeling the symptoms.
Unsynchronized esophageal moments could definitely be caused by anxiety. In fact anxiety stimulates the sympathetic and parasympathetic nervous system in body and could cause any disease/Symptom/Feeling.
EI Escorial criteria would be used by a neurologist to rule out bulbar ALS...though I know that it's not a motor neuron disease in your case as it almost always affects speech yet I would suggest you to to go for an EMG and Neurologist so that you could calm down your mind.
Once every things turns out to be ok...Ask your neurologist to consider giving anti OCD and Anxiety suppressive meds for few months like Paroxetine and Clonazepam.
I assure you that they would play wonders.
Hope I was easy to understand my dear patient.
Feel free to follow up.
Thanks.
Yes anxiety could definity cause it.
Detailed Answer:
Hello dear and thanks for choosing "Ask a Doctor" service for your query,
Have seen the details given by you and also the questions and answers given by my fellow doctors.
Firstly let me tell you one thing anxiety stress and thoughts are some thing which could cause any symptom in human body. Gross levels of anxiety are some times associated with severe obsession and this obsession leads to compulsive attitude which means that despite of findings of test to be near normal and every doctor saying that you need not to worry the same thought would occupy your mind again and again and you would start feeling the symptoms.
Unsynchronized esophageal moments could definitely be caused by anxiety. In fact anxiety stimulates the sympathetic and parasympathetic nervous system in body and could cause any disease/Symptom/Feeling.
EI Escorial criteria would be used by a neurologist to rule out bulbar ALS...though I know that it's not a motor neuron disease in your case as it almost always affects speech yet I would suggest you to to go for an EMG and Neurologist so that you could calm down your mind.
Once every things turns out to be ok...Ask your neurologist to consider giving anti OCD and Anxiety suppressive meds for few months like Paroxetine and Clonazepam.
I assure you that they would play wonders.
Hope I was easy to understand my dear patient.
Feel free to follow up.
Thanks.
Above answer was peer-reviewed by :
Dr. Prasad
Hi Dr,
Thank you for the reply. I have been very anxious and stressed out, im taking zoloft, effexor and xanax at night. I have see a neurologist who did EMG of legs and arms and it was negative, along with a normal exam. I know bulbar onset ALS can affect swallowing so that’s why I worried about this diagnosis and it’s causing me so much stress. My voice isn’t affected. Why do I feel food and pills stuck in my throat then? If I truly had bulbar ALS would the barium test show it even though it was just with liquids?
Thanks
Thank you for the reply. I have been very anxious and stressed out, im taking zoloft, effexor and xanax at night. I have see a neurologist who did EMG of legs and arms and it was negative, along with a normal exam. I know bulbar onset ALS can affect swallowing so that’s why I worried about this diagnosis and it’s causing me so much stress. My voice isn’t affected. Why do I feel food and pills stuck in my throat then? If I truly had bulbar ALS would the barium test show it even though it was just with liquids?
Thanks
Brief Answer:
Need few more details.
Detailed Answer:
Hi again,
Please tell me the level where you feel things are stuck.
1)At level of mouth.
2)At level of pharynx.
3)At level of esophagus.
Please reply.
Secondly was an endoscopy done?
Waiting
Need few more details.
Detailed Answer:
Hi again,
Please tell me the level where you feel things are stuck.
1)At level of mouth.
2)At level of pharynx.
3)At level of esophagus.
Please reply.
Secondly was an endoscopy done?
Waiting
Above answer was peer-reviewed by :
Dr. Prasad
Hi Dr,
I'm feeling it stuck at the level of the mouth and pharynx. An endoscopy wasn't performed, just a barium swallow study.
I'm feeling it stuck at the level of the mouth and pharynx. An endoscopy wasn't performed, just a barium swallow study.
Brief Answer:
Poor investigation choice..Barium swallow not meant for you.
Detailed Answer:
Hi there,
A barium swallow would detect any obstruction etc at level of esophagus while you are feeling problem at level of you mouth and pharynx.For you investigation of choice is laryngoscopy(In which doctor with the help of very high definition cameras would visualise your pharnx area as well as upper esophagus.
Barium study won't show problem at level of pharynx or mouth.
Hope you got it.
Do follow up if you have any further query.
Regards!
Poor investigation choice..Barium swallow not meant for you.
Detailed Answer:
Hi there,
A barium swallow would detect any obstruction etc at level of esophagus while you are feeling problem at level of you mouth and pharynx.For you investigation of choice is laryngoscopy(In which doctor with the help of very high definition cameras would visualise your pharnx area as well as upper esophagus.
Barium study won't show problem at level of pharynx or mouth.
Hope you got it.
Do follow up if you have any further query.
Regards!
Above answer was peer-reviewed by :
Dr. Prasad
Hi Dr,
I appreciate the reply. The dr did state that it did show the swallow function was normal and there was no obstruction or mass above the esophagus. I am just concerned if my symptoms are consistent with bulbar ALS (feeling food stuck after eating and when taking pills). I don't cough or choke during meals or when drinking liquids.
I appreciate the reply. The dr did state that it did show the swallow function was normal and there was no obstruction or mass above the esophagus. I am just concerned if my symptoms are consistent with bulbar ALS (feeling food stuck after eating and when taking pills). I don't cough or choke during meals or when drinking liquids.
Brief Answer:
Very unlikely to be bulbar ALS.
Detailed Answer:
Hi there,
At early stages of Bulbar amyloid lateral sclerosis disease, a reduction in the size and duration of tongue movements was seen, while as speaking ability further deteriorated, the speed of tongue movements further slowed and the speed of jaw movements increased.
These results indicated that tongue movement can be an appropriate marker of early changes in bulbar function. “A decrease in tongue movement size with disease progression may serve as a potential diagnostic marker for early detection of bulbar involvement.
Its a clinical diagnosis which means that examination of patients speech voice deglutition and respiration is done by the examining doctor.
This comes under speciality group of Neurology.
Your cranial nerves would be examined clinically by the neurologist(if they are functioning well or not).
You speech would be examined by various ways by neurologist.
An MRI brain would help to exclude any other mimicking problem.
So as you can understand it's a diagnosis of exclusion.
Frankly speaking the symptoms related to speech are first to occur followed by deglutition problem(Every thing progresses very rapidly as you neurons are dying fast) and is followed by death due to respiratory failure in 2-3 years.
As per your reply your ENT said that there is nothing wrong with your throat however close examination would reveal weakness(severe) of facial muscle..Muscles related to tongue and hence deglutitionis a problem and drooling of saliva is there.
The intensity of symptoms are very rapid.
From how long are you feeling difficulty in swallowing?
Does the problem intensity is same or is increasing rapidly?
Any history of frequent respiratory infections?
Please reply.
Regards!
Very unlikely to be bulbar ALS.
Detailed Answer:
Hi there,
At early stages of Bulbar amyloid lateral sclerosis disease, a reduction in the size and duration of tongue movements was seen, while as speaking ability further deteriorated, the speed of tongue movements further slowed and the speed of jaw movements increased.
These results indicated that tongue movement can be an appropriate marker of early changes in bulbar function. “A decrease in tongue movement size with disease progression may serve as a potential diagnostic marker for early detection of bulbar involvement.
Its a clinical diagnosis which means that examination of patients speech voice deglutition and respiration is done by the examining doctor.
This comes under speciality group of Neurology.
Your cranial nerves would be examined clinically by the neurologist(if they are functioning well or not).
You speech would be examined by various ways by neurologist.
An MRI brain would help to exclude any other mimicking problem.
So as you can understand it's a diagnosis of exclusion.
Frankly speaking the symptoms related to speech are first to occur followed by deglutition problem(Every thing progresses very rapidly as you neurons are dying fast) and is followed by death due to respiratory failure in 2-3 years.
As per your reply your ENT said that there is nothing wrong with your throat however close examination would reveal weakness(severe) of facial muscle..Muscles related to tongue and hence deglutitionis a problem and drooling of saliva is there.
The intensity of symptoms are very rapid.
From how long are you feeling difficulty in swallowing?
Does the problem intensity is same or is increasing rapidly?
Any history of frequent respiratory infections?
Please reply.
Regards!
Above answer was peer-reviewed by :
Dr. Raju A.T
Hi Dr
Thanks for the reply. Ive noticed this issue for about 2 weeks now and difficulty swallowing pills for 2 days. No history of frequent respiratory infections. I’m very focused on swallowing now, when I’m eating and taking my pills. It’s almost like I developed a phobia for eating. Would I have a bigger issue swallowing liquids or solids for Bulbar als?
Thanks for the reply. Ive noticed this issue for about 2 weeks now and difficulty swallowing pills for 2 days. No history of frequent respiratory infections. I’m very focused on swallowing now, when I’m eating and taking my pills. It’s almost like I developed a phobia for eating. Would I have a bigger issue swallowing liquids or solids for Bulbar als?
Brief Answer:
Very big issue(a mammoth task).
Detailed Answer:
Hi there my dear,
In ALS your nerve cells called neurons starts to die off as a result of which not only does swallowing a pill but even controlling your saliva from drooling or even controlling moments of your tongue becomes a mammoth task.
That's why from my side I feel very likely it's gross anxiety coupled with obsession.
However you could visit a neurologist for the same and get your cranial nerves facial nerves etc checked physically.
A MRI could also be done.
If every thing is ok treatment under a pyschologist is recommended.
An endoscopy could also be done to rule out any problem not detected by barium swallow.
Bulbar ALS is a clinical diagnosis. Investigations are not of much use and prognosis is very poor.Most of the people unfortunately passes away in a year or two due to respiratory failure.
But I don't think you have it however it's always good to get yourself examined dear.
Thank you
Very big issue(a mammoth task).
Detailed Answer:
Hi there my dear,
In ALS your nerve cells called neurons starts to die off as a result of which not only does swallowing a pill but even controlling your saliva from drooling or even controlling moments of your tongue becomes a mammoth task.
That's why from my side I feel very likely it's gross anxiety coupled with obsession.
However you could visit a neurologist for the same and get your cranial nerves facial nerves etc checked physically.
A MRI could also be done.
If every thing is ok treatment under a pyschologist is recommended.
An endoscopy could also be done to rule out any problem not detected by barium swallow.
Bulbar ALS is a clinical diagnosis. Investigations are not of much use and prognosis is very poor.Most of the people unfortunately passes away in a year or two due to respiratory failure.
But I don't think you have it however it's always good to get yourself examined dear.
Thank you
Above answer was peer-reviewed by :
Dr. Raju A.T
Hi Dr
Thanks for the input, how are cranial and facial nerves tested?
Thanks for the input, how are cranial and facial nerves tested?
nevermind I googled it, I did have some of these tests done on me.
Ive been to multiple neurologists who dont suspect this diagnosis but at the time I didnt have these issues with swallowing.
Are you confident that what Im experiencing isnt due to bulbar ALS?
Ive been to multiple neurologists who dont suspect this diagnosis but at the time I didnt have these issues with swallowing.
Are you confident that what Im experiencing isnt due to bulbar ALS?
Brief Answer:
Follow up.
Detailed Answer:
Hi there,
You can see on you tube examination of facial nerves and other cranial nerves supplying tongue and mouth.
2)Your current doctor does not say it's Bulbar ALS.
Your multiple neurologists say it's not ALS.
On this platform doctors from various parts of world say it's not ALS.
Frankly speaking I too know it's not Bulbar ALS(and I really thanks God for that young man).
As I said when a disease involves central nerves it progresses rapidly and patient detoriates with in months.In my life I have seen 4-5 cases of ALS .None survived more then 3 years and disease progression was damn fast like symptoms from 0 to 100%palsy in 8 weeks.This is how problem with central nerves behaves.
So I am really very happy for you that though you are over skeptical about ALS yet you don't have it.
However as I said you should have proper treatment with pyschologist and pyschaitrist so that this paranoia/Obsession could be treated.
What examinations have been done by your neurologists?
They did MRI?
Did they examined you physically?
What was their opinion in your case?
Had any one suggested you for proper psychological councelling?
What had these doctors suggested you/Their diagnosis?
Waiting.
Follow up.
Detailed Answer:
Hi there,
You can see on you tube examination of facial nerves and other cranial nerves supplying tongue and mouth.
2)Your current doctor does not say it's Bulbar ALS.
Your multiple neurologists say it's not ALS.
On this platform doctors from various parts of world say it's not ALS.
Frankly speaking I too know it's not Bulbar ALS(and I really thanks God for that young man).
As I said when a disease involves central nerves it progresses rapidly and patient detoriates with in months.In my life I have seen 4-5 cases of ALS .None survived more then 3 years and disease progression was damn fast like symptoms from 0 to 100%palsy in 8 weeks.This is how problem with central nerves behaves.
So I am really very happy for you that though you are over skeptical about ALS yet you don't have it.
However as I said you should have proper treatment with pyschologist and pyschaitrist so that this paranoia/Obsession could be treated.
What examinations have been done by your neurologists?
They did MRI?
Did they examined you physically?
What was their opinion in your case?
Had any one suggested you for proper psychological councelling?
What had these doctors suggested you/Their diagnosis?
Waiting.
Above answer was peer-reviewed by :
Dr. Raju A.T
Hi Dr
Im a 34 year old female, not sure if you are aware of that.
I haven’t had an MRI, have had neurological exam, EMG both legs and R arm- normal. I am taking zoloft, effexor and xanax at night. Been on this medication regimen for 8 days.
My neurologist tested strength, eye coordination, reflexes, looked at my tongue, asked to walk on heel and toes. All was normal. I saw an ENT who used a nasoendoscopy last tuesday and stated everything looked OK. My voice is unchanged and i dont have weakness or twitches in my facial muscles. My throat feels dry.
What worries me is when the pills get stuck and feeling the food getting stuck after eating. This all started after having a sore throat for 2 weeks, then my swallowing issue started.
This is what has me convinced I have bulbar ALS.
Im a 34 year old female, not sure if you are aware of that.
I haven’t had an MRI, have had neurological exam, EMG both legs and R arm- normal. I am taking zoloft, effexor and xanax at night. Been on this medication regimen for 8 days.
My neurologist tested strength, eye coordination, reflexes, looked at my tongue, asked to walk on heel and toes. All was normal. I saw an ENT who used a nasoendoscopy last tuesday and stated everything looked OK. My voice is unchanged and i dont have weakness or twitches in my facial muscles. My throat feels dry.
What worries me is when the pills get stuck and feeling the food getting stuck after eating. This all started after having a sore throat for 2 weeks, then my swallowing issue started.
This is what has me convinced I have bulbar ALS.
Brief Answer:
Follow up.
Detailed Answer:
Hi there,
I would recommend you to go for an Endoscopy. If it's normal it's not Bulbar ALS.
Regards!
Follow up.
Detailed Answer:
Hi there,
I would recommend you to go for an Endoscopy. If it's normal it's not Bulbar ALS.
Regards!
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Above answer was peer-reviewed by :
Dr. Nagamani Ng
Answered by
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