Hi. Thanks for your query. Noted the history and understood the concerns. Difficulty in swallowing food can be due to many factors and since you have not mentioned the site of difficulty whether throat, upper chest or lower chest it is difficult for me to tell you the exact cause. Well, the investigations needed are the same irrespective of cause. Barium swallow under fluoroscopy guidance to see the passage of barium in real time helps a lot. Upper GI endoscopy, biopsy, fluid sampling, esophageal manometry all help to get the cause. Routine investigations of blood, stool and urine. CT scan of the chest if there is any doubt about cancer or so. Once the exact cause is found it is easy to get a proper management. It is also needed to know whether Hiatus hernia is causing the problem primarily or GERD with severe esophagitis or stricture formation. Continue Esomeprazole. Get a prescription for an antacid and Domperidone. Soft bland diet, small frequent feeds.