Question: Hi, I have daily throat tightening, sometimes at night (wakes me up choking on own saliva or mucus). I since worked on my acid reflux (had it for 30 years), anxiety (if this is the problem), but tight throat and occasional closures remain. Allergy blood testing (naturopath) showed carrigeenan, garlic, celery allergies, which are not easy to avoid, but I now cook own food, avoid items with seafood derivative (I discovered it in meats, milk products, toothpaste and most cosmetics). Throat tightness is accompanied by strong tightness of neck, shoulder and other muscles (whole body). Magnesium helps, but temporarily. If I move tendons at the front of throat I hear crunching, but heard it was normal? Gastroenterologist did endoscopy and does not want to deal with this, throat specialist sent me to allergist (still waiting), family doctor thinks it is only anxiety (I don't feel anxious), but I can't swallow well (food is getting stuck a bit, direction of my head turn affects swallowing even water - on certain angles, it hurts). Not sure what to do...

Hi Dr. Shehu,
endoscopy and colonoscopy was clear. It was done 6 mo ago following HPyllori infection treated. No cancer, no polips. It showed that soft tissue was irritated, but that's all. Throat specialist did not see acid damage to the throat. Commented on slow, albeit relatively good swallow reflux, and on tight neck muscles. I had massage therapy, massage therapist complained about tight muscles as well. Throat specialist thinks it may be between acid reflux and was puzzled by tight neck tendons/muscles. Wants me to see allergist as well (scheduled). His best guess was between allergies, combined with acid reflux. My family doctor thinks it is all anxiety. Blood results are semi-good. Last one showed low vit. D, B12, probably due to acid reflux - then active. I went on anti-inflammatory diet for 3 months now (lost 30 pounds, eat mostly cooked, light food, removed a lot of allergens, acid reflux is chronic, but recently really good). Throat closures and tightness still happens, despite my careful approach to food and a not of anti-anxiety approaches (removed anxiety from my daily functioning, I feel really calm, but very tired). I have dark circles under eyes (look really haggard and tired). I sleep well about 7 hrs. I know that carageenan will give me symptoms, so I try to avoid it, but it is everywhere! Even in cosmetics I was using and toothpaste. Also my mid back hurts daily. I am working with a chiropractor who checked muscle strength. He says that neck muscles are weak. He started treating my neck and mid back (some light kyphosis). Long story short - I do everything to diagnose this, because it scares me to have throat tight and difficulty swallowing all the time. Weight is down, I am working to remove all triggers, symptoms persist. While it could still be anxiety + allergies, I guess I would like to exclude any kind of nerve/muscle disease from the possibilities. How would I go about testing for muscular dystrophies? I realize I sound eager, but it is hard to live with a risk of throat closing and not knowing where it comes from. Many thanks for any ideas you could provide.

Incidentally, I was on PPIs following HPyllori twice a day for a month. After this throat symptoms started. My sinuses (nose) would shut, and then throat would start closing at night. I was very scary. I figured I was eating too late, treated those episodes with two trips to the hospital thinking of allergic reaction, but then with antiacids and antihistamine, which worked, but worse with the PPIs. I weaned myself off of the PPIs, for a while used only Gaviscon which worked the best. Now, due to diet, off of any antiacids, stomach behaves well. No reflux (at least for now), no pain, just constipation (not regular, 2-3 days). I take magnesium to help, although it is generally not low (I tested minerals as well). I also lose hair (lost a lot, hairdresser was concerned), probably because I had to stop taking iron for a while trying to fix my stomach. I take iron all my life, my iron is normally low (ferritin XXXXXXX at 20/300), though hemoglobin is ok.

Sorry, I wrote note 3, but don't see it now, so just to finish... Reaction usually starts after meals 1-4 hrs later but can last several hrs. Lot of protein will bring it on sometimes. It could be a reaction to pepsin combined with allergies.

Could you please clarify why you recommend lactulose over magnesium? I wake up stiff in the morning (neck, head, calves, back), magnesium seems to help both issues, albeit temporarily and seems more natural than lactulose.