What Causes Persistent Difficulty In Swallowing?

Posted on Sat, 24 Oct 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sat, 24 Oct 2015 Answered on

Mon, 16 Nov 2015 Last reviewed on

Question : What could be causing the difficulty in my swallowing? I am fearful of cancer. I have been having difficulties swallowing for the past 4 months. I was put on omeprazole, however, these past two weeks it has become MORE difficult to swallow. I had a barium swallow test conducted. Please see report.

Answered by Dr. Vivek Chail (-3 hours later)

Brief Answer:
Aberrant subclavian artery still remains the probable cause pending tests

Detailed Answer:
Hi XXXX,
Thanks for writing in to us.

I have read through your query in detail.
Please find my observations below.

1. The condition which you have is rare and from birth. Usually there are no symptoms in most people but those who have symptoms complain of dysphagia which us difficulty in swallowing.

2. As there are no symptoms, the patients are usually unaware and do not seek treatment. However in those who have symptoms like you, it is important to confirm the condition by doing a CT scan thorax and also do an endoscopy if required and then proceed with treatment as suggested by the doctor.

3. In most symptomatic patients the difficulty in swallowing is due to compression of the esophagus from the outside. This is treated surgically which treats the symptoms.

4. Cancer is usually a condition which causes irregular filling defect in barium swallow and you do not have that finding.

5. Other symptoms of cancer in esophagus are sudden loss of weight and appetite, painful or difficulty in swallowing, fatigue and weakness, lumps over the neck region. Therefore cancer is a lesser possibility in your case.

Hope your query is answered.
Please do write back if you have any doubts.

Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Vivek Chail (9 hours later)

Thanks doctor.

Here are a few questions-

1. Do you agree with the radiologist's findings? What else could it be? An aneurism?

2. If I have been living with this, why has it gotten worse all of a sudden?

3. I had a significant fall in the bathroom around the same time I started feeling this difficulty in swallowing. I slightly fractured my nose and sprained a few ligaments in my arms and legs. Could this have anything to do with it or is it coincidence?

Answered by Dr. Vivek Chail (12 hours later)

Brief Answer:
Please find details below

Detailed Answer:
Hi,
Thanks for writing back with an update.

1. I agree to the radiologists findings of the suspicion of aberrant right subclavian artery and GERD. There is no obvious features of an aneurysm but the CT scan is investigation of choice for you to confirm the finding of aberrant right subclavian artery and should there be any rare possibility of aneurysm. The presence of an aneurysm is extremely less likely for you.

2. You require CT scan to know the exact nature of the problem with aberrant right subclavian artery and the endoscopy is to evaluate the GERD condition.

3. The artery was probably causing small pressure on esophagus which increased after the fall. Trauma to chest might cause dormant conditions to become symptomatic and this cannot be ruled out going by your presentation of symptoms clinically. GERD can also add to your discomfort.

Please do write back if you have any doubts.
Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar