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Ask the Medical Expert Archives 2000-2004

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Frequent Choking
July 2000

Q. My husband frequently chokes while eating and recently had to be brought to the emergency room. What conditions could be causing this to get increasingly worse? The doctor in the ER suggested some sort of scope procedure, what do you think?

A. Your husband has dysphagia, which is difficulty with swallowing. There are several causes, but usually the problem lies in the esophagus (the food pipe that connects the mouth to the stomach). A narrowing of the esophagus such as a stricture or a web (extra tissue that partially blocks the esophagus) may be the cause. Also, an abnormality with the muscle contraction of the esophagus may cause this (termed motor disorder, such as Achalasia). Also, severe acid reflux may cause dysphagia. Tumors may also occlude the esophagus. Risk factors for esophageal tumors principally are smoking and/or alcohol abuse. I would strongly agree that an upper endoscopy is warranted. This is done under sedation where a flexible scope is inserted into the mouth and gradually advanced into the esophagus and stomach to check for the above disorders. Upper endoscopy is superior to a barium swallow/upper GI radiology study for diagnosis.

Good luck.

Ref: http://medir.ohsu.edu/~ohsuhtxt/niddk/digest.html

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