What to do if it is difficult to swallow food. Discomfort in the throat when swallowing

The unpleasant feeling of a lump in the throat when swallowing is familiar to many. At the same time, a person experiences discomfort constantly, no matter what he does, or only in a certain position (for example, lying on his back or sitting with his head bowed). This symptom is often accompanied by difficulty in breathing and an associated feeling of fear of death by suffocation, as well as a desire to cough up. Some believe that the lump in the throat appeared after they accidentally choked, while for others this sensation arose by chance, for no apparent reason.

But what, nevertheless, causes the occurrence of this incomprehensible symptom that inspires a sense of anxiety? This is what we will try to understand in this article.

Causes of the disease

The main factors in the development of this condition can be combined into two groups and then, depending on the presence of certain symptoms in the patient, differential diagnosis can be carried out.

The first group includes somatic causes. Their occurrence is due to the direct influence on the body of certain factors, the action of which causes objective sensations. These include:

• goiter (increase in size thyroid gland), which compresses the organs of the neck and makes it difficult to breathe and swallow;
• diaphragmatic hernia;
• the appearance of gastroesophageal reflux (return of food from the stomach back into the esophagus);
• foreign body, neck injury;
• an adverse reaction to taking any drug;
• defeat nervous system causing the development of neurological disorders;
• tumors (benign or malignant);
• obesity.

Tumors in the neck - one of the reasons for the sensation of a lump in the throat

In addition to all of the above, a lump in the throat can be felt due to local development inflammatory processes. These include: increasing lymph nodes with any infection, complication of laryngitis or pharyngitis, the occurrence of purulent tonsillitis, abscesses, etc. Allergy, in particular the beginning Quincke's edema, is also often the reason that a person feels a gradually growing lump. However, this feeling is temporary. After some time, it turns into a spasm and causes an attack of suffocation. This symptom may also occur before the onset of the arrhythmia. After an attack, it usually goes away.

The second group of factors in which it becomes difficult for the patient to swallow include psychogenic causes or psychogenic disorders. They usually occur against the background of depression, neurosis or other mental pathology. In turn, they can be the result of excessive psycho-emotional stress, severe stress or fatigue, lack of sleep and rest, problems with acclimatization, and other reasons.

The appearance of a feeling of heaviness during swallowing can be explained as follows: the fact is that depressive and stress disorders lead to development. It is he who causes the feeling of having a lump.

The mechanism of development of discomfort

The feeling that a person has a lump in his throat is a subjective perception of the brain of signals coming from this zone and is perceived as a constant or intermittent barrier that prevents swallowing and breathing normally.

In total, two outcomes of the development of these symptoms are distinguished, and they depend on how strongly the unpleasant sensations affect the behavior and change the patient's life:

1. The lump will in no way interfere with the normal functioning of all systems and organs of the patient and will not affect his daily behavior.
2. It will become difficult and even painful for the patient to swallow, there will be malnutrition and there will be a fear of suffocation.

The first option makes patients think about possible reasons that something interferes with them, and to be examined by a doctor for the presence foreign body. The second, as already mentioned, is neurotic disorders and requires special attention to patients.

Diagnosis of the causes of a lump in the throat and treatment

No definition of an accurate diagnosis can do without prescribing tests and conducting various surveys. If there is discomfort when swallowing and other irritating factors, the doctor may insist on carrying out:

• various methods of examining the oral cavity, tonsils, tongue, larynx, thyroid gland, lymph nodes;
• general analysis of blood and urine;
• biochemical blood test;
• analyzes for the percentage of certain thyroid hormones;
• x-ray of the neck;
• computed or magnetic resonance imaging upper division spine.

Ultrasound is one of the most reliable methods for diagnosing the thyroid gland.

A patient who is worried about the constant presence of a clod of saliva should be prepared for the fact that he will have to visit doctors from several departments, namely an ENT, a neuropathologist, an endocrinologist and an oncologist. In the event that none of the specialists notes the pathology, the cause should be sought among psychogenic ailments, which means that it is also necessary to visit a psychotherapist.

The main method of treating unpleasant sensations when swallowing is the implementation of autonomic correction, as well as a set of measures to reduce the intensity of neuromuscular excitation and anxiety. In addition, the doctor must eliminate various manifestations of respiratory destabilization, which most often cause fear in patients.

To begin with, the specialist needs to exclude the presence of organic problems in the patient - diseases of the pharynx and larynx, esophagus, the presence of foreign bodies in them. Excluding everything somatic diseases and other real reasons, due to which the patient may have difficulty swallowing, the attending physician should recommend the consultation of a psychotherapist. The latter will help get rid of an unpleasant feeling in the throat by prescribing medications or by appointing sessions of relaxation and psychotherapy.

Determining the root cause, making the correct diagnosis and course of treatment will allow the patient to say goodbye forever to the annoying feeling and breathe freely.

Or difficulty swallowing is a type of functional disorder of the esophagus in which a person cannot swallow food.

Usually, in the process of eating, we do not think about the process of swallowing. We throw food into our mouths and just swallow, sometimes without even having time to chew properly. Meanwhile, swallowing is a rather complicated process. It includes the root of the tongue, the pharyngeal cavity, soft sky, and circular muscles of the esophagus.

But sometimes we notice that something went wrong in the process of swallowing. There is a feeling that a lump is stuck in the throat. It is also possible the return of food from the pharynx to the oral cavity or pain in the center of the sternum. Why does this happen and what can be the cause of dysphagia? Let's try to understand this problem.

Types of dysphagia

There are the following types of dysphagia:

Oropharyngeal (oropharyngeal). It is characterized by difficulty in the passage of food from the pharynx to the esophagus;

Esophageal. It manifests itself as a violation of the movement of food from the esophagus to the stomach.

Cricopharyngeal discoordination. Inconsistent contraction of the circular fibers of the upper esophageal sphincter.

functional dysphagia. Difficulty swallowing occurs due to disorders of the nervous system.

Symptoms of dysphagia

Symptoms of dysphagia in its different types manifest themselves in different ways. With oropharyngeal dysphagia, there are coughing, feeling of suffocation, profuse salivation, throwing a lump of food into the cavity of the nasopharynx or mouth. This type pathology is also characterized by the inability to swallow food or the need to make efforts to push the food bolus.

With dysphagia of the esophagus, the act of swallowing is not disturbed, but the passage of the food bolus is accompanied by pain in the upper abdomen, heartburn, and sometimes belching. Appears bad taste in the mouth, there is a throwing of the contents of the stomach into the pharynx and oral cavity.

Functional dysphagia occurs with disorders of the nervous system - increased excitability, neuroses, etc. In this case, the symptoms of dysphagia appear episodically. As a rule, they are provoked by one or more types of food (solid, liquid, spicy, etc.). In this case, the food bolus usually does not fall into Airways, but swallowing is difficult, and its movement along the esophagus is accompanied by unpleasant and painful sensations.

Causes of Difficulty Swallowing

Dysphagia, regardless of its type, can occur for the following reasons:

Pathologies of the esophagus (esophageal spasm, inflammation of the esophageal mucosa, reflux disease, acquired or congenital dissection of the esophagus, etc.);

Chemical burns of the esophagus;

Foreign bodies in the esophagus;

Esophagitis and stomach ulcers;

Congenital pathologies of the pharynx (pharyngeal pocket);

benign or malignant tumors pharynx;

In some cases, difficulties with swallowing and passing food through the esophagus can be the result of a stroke, myasthenia gravis, Parkinson's disease, and other pathologies.

Functional (oropharyngeal) dysphagia occurs with neuromuscular diseases leading to paralysis of the striated muscles, simultaneous non-peristaltic muscle contractions, and also to a disorder in the function of the upper esophageal sphincter.

Since dysphagia itself is not a disease, but only a symptom various pathologies, then to identify it true reasons a thorough gastroenterological examination is necessary.

In the event that the cause of dysphagia has not been found with the help of a gastroenterological examination, a neurological examination is performed, revealing the affected nervous structure.

Treatment of dysphagia

As mentioned above, dysphagia can be caused by a wide range diseases, so the doctor prescribes a specific method of treatment depending on its causes. For example, if dysphagia is caused by a tumor in the esophagus, then surgery is necessary, and functional disorder swallowing requires exercises to train the muscles responsible for the swallowing process. At inflammatory diseases throat treatment consists of anti-inflammatory and antibiotic therapy.

Treatment for difficulty swallowing acute symptoms at the local level is reduced to providing first aid to the patient. At acute attack cough caused by throwing food into the respiratory tract, it is necessary to carefully clear the respiratory tract and make sure that the person does not suffocate.

If dysphagia is manifested by obstruction of a large piece of solid food through the esophagus, the patient should be given drinking water or another soft drink that will make it easier to swallow.

Dmitry Belov

Quite often, specialists are treated with such a symptom in which a person feels a lump in the throat while swallowing. A lump may be felt when swallowing different reasons Let's take a look at them.

Patients express the following sensations with this ailment. Sensation as if something were moving in the throat and gives discomfort; feeling like something hard and dense is pressing in the throat; it is difficult to swallow saliva, it feels like you can choke, etc.

Patients describe their feelings as the presence of a foreign body in the throat, a feeling of touching something or something when swallowed, squeezing, burning, tickling, tickling, soreness, suffocation, discomfort. Many of them have a pronounced cancerophobia (fear that cancerous tumor), since such sensations in the throat when swallowing lead people to the idea of ​​the presence of tumor growth in the upper respiratory tract.

Often a lump in the throat is felt after suffering stress. This type of sensation is not connected with the functioning of the body systems. Depression, stress, excitement cause tension in the muscles in the lower part of the throat, thereby creating a "hysterical lump" that disappears on its own after a few hours.

A lump in the throat can be felt when swallowing in violation of the thyroid gland. Such disorders of the thyroid gland can be associated with inflammation of the gland (autoimmune thyroiditis), with an autoimmune disease (diffuse toxic goiter). In the treatment, iodine-containing drugs are used, which stabilize the condition of the patient's body.

Diseases of the gastrointestinal tract

When swallowing, a lump in the throat can be felt in some diseases gastrointestinal tract. For example, with gastroesophageal reflux disease, when gastric juice enters the esophagus, which irritates the tissues of the pharynx.

Gastritis

Heartburn, belching and a sour taste in the mouth can disturb. Often this is a type of gastritis, for which the appropriate treatment is selected - drugs and diet. Diseases of the liver, pancreas, gallbladder, metabolic disorders, food allergy can lead to gastritis.

Osteochondrosis

A lump in the throat can be felt in the spine, which occurs due to a sedentary lifestyle, sleep disturbances, metabolism, bad habits and other reasons. Treatment is carried out by various methods: acupuncture, laser therapy, manual and vacuum therapy, physiotherapy, electrical stimulation, etc.

Chronic pharyngitis

Chronic pharyngitis is of viral origin, in most cases a lump in the throat when swallowing is felt due to streptococcus, which causes angina. Viral inflammation can disappear gradually by itself, bacterial inflammation is treated with antibiotics prescribed by a doctor. Accompanied by treatment with gargling and warm compresses.

Vegetative-vascular dystonia

Cause this disease there may be vegetative-vascular dystonia, which develops as a result of deviations of the autonomic nervous system. It is complicated by concomitant diseases: peptic ulcer, bronchial asthma, arterial hypertension, ischemic disease hearts. With hyperventilation syndrome, dry mouth occurs, numbness of the tongue, activation of breathing with the danger of choking. Individual treatment includes elimination of hypodynamia, restriction physical activity and emotional stress, family psychotherapy, proper nutrition.

throat cancer

The cause of a lump in the throat is throat cancer. There is a dry cough, hoarse voice, choking while eating. The disease can develop due to alcohol abuse, exposure to chemical substances etc. Treatment of laryngeal cancer requires mandatory surgical intervention.

Other causes of a lump in the throat

Also, the feeling of a lump in the throat can be a consequence following factors. These are trauma, strained coughing, displacement of the cervical vertebrae, the effects of a cold or cough, a hernia of the diaphragm or esophagus, overweight, a violation of the digestive processes in the body, especially with poor nutrition.

The real reasons for the sensation when swallowing a coma in the throat are discovered after a visit to a gastroenterologist. For each individual case with characteristic symptoms individual treatment is applied.

There are times when, for some reason, it becomes difficult for a person to swallow saliva and food. In medicine, this condition is called dysphagia. If she is called colds accompanied by edema, then the problem will pass immediately after recovery. But what to do if it is difficult for a person to swallow, but the throat does not hurt, and dysphagia arose against the background of total absence visible inflammatory processes in oral cavity and throat?

Kinds

Dysphagia is divided into organic (characterized by damage to the esophagus or pharynx), or functional. In the latter case, the patient has a dysfunction of the esophagus caused by a disorder of the nerves responsible for controlling the functions of the esophagus.

Depending on where the pathological process is localized, the disease is divided into three types:

1. Oropharyngeal dysphagia, in which there is a violation of voluntary swallowing and difficulty in the flow of food into the esophagus.
2. Pharyngeal-esophageal - characterized by a violation of the involuntary fast phase of swallowing and difficulty in the flow of food into the esophagus.
3. Esophageal - accompanied by a violation of the involuntary slow phase of swallowing and difficulty moving food through the esophagus.

Reasons for violation

Almost every person had to deal with temporary difficulty in swallowing, which arose with strong excitement, fear or crying. But the appearance of such a problem can arise for other reasons.

For example, a natural change in the function of the swallowing muscles occurs in old age. The problem can also arise from a complication after surgery on the neck or head. Swallowing problems often occur due to excessive dryness in the mouth or the presence of ulcers in its cavity.

Other reasons for the development of pathology include:

• neurological diseases.
• Obstruction of the esophagus and pharynx.
• Muscle dysfunction.
• congenital diseases.

Neurological causes

The nervous system includes the spinal cord, brain, and nerves. With damage to the nerves that are responsible for the process of swallowing, difficulties arise during meals. So, most often dysphagia occurs when:

• stroke
• the presence of a tumor in the brain;
• multiple sclerosis;
• Parkinson's disease;
• dementia.

This pathology is also observed in patients suffering from severe form myasthenia gravis - a disease in which muscle weakness develops.

Obstruction of the esophagus and pharynx

A blockage (or obstruction) in the throat or esophagus is often the cause of difficulty swallowing. This pathology occurs for several reasons:

• Cancer of the throat or mouth. With successful treatment of the disease, the obstruction disappears.
• The presence of gastroesophageal reflux disease, in which gastric juice flows from the stomach into the esophagus. As a result of this, scars form on its walls, narrowing the lumen and making it difficult to swallow, even if a person has a feeling of hunger, he understands “I want to eat”, but cannot swallow easily.
• Cancer treatment by method radiotherapy- sometimes radioactive treatment leads to the formation of scars in the lumen of the esophagus or larynx.
• Availability infectious diseases, for example, candidiasis or tuberculosis, which lead to inflammation of the esophagus.

Muscle dysfunction

Swallowing disorders can occur due to diseases accompanied by damage to the muscle tissues that are responsible for pushing food into the stomach. These include:

• Scleroderma - with this pathology, a malfunction occurs immune system causing the immune system to attack healthy tissues. If the muscles of the esophagus and larynx are hit, it becomes difficult for the patient to swallow and eat.
• Achalasia of the esophagus - pathology is characterized by insufficient relaxation of the muscles of the lower part of the esophagus, as a result of which the process of moving food and liquid into the stomach is difficult.

congenital diseases

The presence of dysphagia can be diagnosed in children with developmental disabilities.

For example, when a baby suffers from cerebral palsy, in which coordination and movement are disturbed. The cause of the problem is also sometimes a learning disability or a cleft lip or palate (“cleft palate” or “cleft lip”).

Diagnostics

If you have problems with swallowing, you should consult a doctor who will comprehensive examination, establish the exact cause of the pathology and give appropriate recommendations for its elimination.

First of all, the doctor should ask the patient how long ago the problem arose and what diseases he suffered in the past. Then, after a visual examination and palpation of the lymph nodes and oral cavity, the patient will be prescribed instrumental examination which includes:

• Laboratory tests.
• laryngoscopy.
• Biopsy.
• ultrasound internal organs, the dysfunction of which could lead to dysphagia.
• X-ray of the esophagus (is the most exact method establishing a cause).
• MRI of the brain - necessary to detect possible violation nervous system activity and pathological processes occurring in the brain.

To make a diagnosis, special tests are also carried out, monitoring the acidity of the stomach and determining the amount of acid flowing from it into the esophagus. This manipulation is performed using a special device - a gastroscope.

The test is carried out with water. The doctor offers the patient to drink about 150 ml of liquid as quickly as possible and records the number of sips that he will have time to take in a certain time.

Associated symptoms

You can get a more accurate picture that allows you to identify the cause of dysphagia by the presence of accompanying symptoms. The most characteristic among them is the patient's complaint that previously he had difficulty only swallowing solid food, and now it is difficult for him to swallow saliva and liquids. Other symptoms include:

• Discomfort when moving food that occurs in the throat or behind the sternum.
• Pain during swallowing.
• While eating, a cough appears, and the patient chokes on food.
• Appearance of suffocation.
• Increased salivation.
• During swallowing, behind the sternum there is a sensation of a foreign body, fullness or coma.

Lump in throat syndrome

Patients often complain about the so-called "lump in the throat" at an appointment with an otolaryngologist. This condition occurs for the following reasons:

• The presence of a foreign object in the throat, which is an obstacle to swallowing.
• The disease is chronic pharyngitis.
• The presence of reflux disease, which is characterized by spasms of the pharyngeal muscles resulting from burns of mucous membranes with acidic stomach contents.
• Psychological factors.

The cause of the appearance of a coma in the throat is sometimes stress, fear or great excitement.

Troubleshooting Methods

The choice of treatment depends on the cause of the difficulty swallowing food. As a rule, properly conducted therapy allows you to completely or partially eliminate an unpleasant problem.

Both medical and surgical treatment can be used as methods of therapy.

If the problem cannot be corrected, for example, due to the presence of a tumor or when dysphagia occurred during rehabilitation period after a stroke, patients are advised to adjust their diet. Also, the doctor may resort to multiple expansion of the lumen of the esophagus with the help of a special dilator (bougie).

Adjustment in the diet involves the rejection of alcohol and all foods that lead to irritation of the esophagus - spicy, very hot or too cold dishes, strong coffee and tea, fast food, dry food, fizzy drinks.

• Eat food in small portions.
• Chew food thoroughly.
• Drink enough liquid daily.

Medical therapy

• If dysphagia occurs due to increased acidity, then treatment is carried out with the help of inhibitors. proton pump- drugs, the action of which is aimed at lowering acidity.
• In case of bacterial infection of the esophagus and pharynx, therapy is carried out with antibacterial drugs.
• If the cause of the pathology is a malfunction endocrine system, then the patient is prescribed iodine-containing drugs.
• At muscle disorders resort to massage and physiotherapy.
• If dysphagia has developed due to a strong emotional disorder, then a psychologist or psychotherapist should be involved in the treatment of such a patient.

Surgery

To surgical intervention resorted to burn narrowing of the esophagus, as well as in the presence of a tumor or inflammation.

Possible Complications

The disease in question can lead to serious respiratory failure. Due to compression of the esophagus by a tumor, it seems to a person that he is suffocating, and in fact he can simply suffocate. Neglect of treatment is also fraught with the development of inflammation of the esophagus - esophagitis. In some cases, this disease causes cancer of the stomach or esophagus.

Dysphagia can also lead to dehydration and significant weight loss due to deficiency nutrients. Therefore, do not neglect your own health and take swallowing problems lightly..

We rarely think about how we breathe or blink. The same applies to swallowing. But in order to swallow painlessly and effectively, several very complex mechanisms. At healthy people the body automatically coordinates swallowing and breathing. Despite their common entrance - the mouth, what you swallow does not go to the lungs, and the air that you inhale does not enter the stomach. If this happened, in the first case you would suffocate, and in the second case you would stretch the stomach and tear it.

Opening and closing different ways coming from the throat is carried out by nerves and muscles. If you have difficulty swallowing, it may be due either to damage to the nerves that control swallowing or to changes in the central circulatory system(for example, with a stroke). Muscles can become weak, such as in myasthenia gravis. Further, the esophagus may be occluded by a tumor or infected with a fungus, so that swallowing becomes painful and difficult. An autoimmune disease called scleroderma makes the esophagus stiff, inflexible, and unable to properly push food into the stomach. With an increase in the organs located next to the esophagus, it can be squeezed and narrowed from the outside. Finally, the most obvious and common cause swallowing difficulty is any acute infection throat, in which pain and swelling interfere with swallowing.

Thus, there are many physical conditions that can interfere with your ability to swallow, and some of them are potentially serious. This symptom requires immediate medical attention. Your doctor may consider special tests and x-rays to determine the cause, but you can help him resolve the problem faster if you tell him the following.

If difficulty occurs at the very beginning of swallowing, the cause lies in the pharynx (the area that runs from the back of the tongue to the beginning of the esophagus). You may have strep throat, tonsillitis, an abscess, or fungal infection, but damage from stroke and polio will also cause a similar phenomenon. Poor muscle function, such as in myasthenia gravis, can also make it very difficult to start swallowing. A similar effect will have an increased thyroid compressing the esophagus.

If you start swallowing normally but then have trouble pushing the food further down, then something is wrong with your esophagus.

He can be:

a) narrowed by a tumor in himself,

b) squeezed by a tumor from the outside - either enlarged glands, or an enlarged aorta (the main arterial vessel emerging from the heart),

in) the esophagus simply does not push food through properly.

If you have difficulty swallowing both liquids and solids, you usually have an infected infection or swelling inside your esophagus. However neurological disease or loss of elasticity of the esophagus will also give similar symptoms.

If you can easily handle solid food, but poorly with liquid, the cause is not in the esophagus, but in the nerves or muscles of the pharynx. If some of the liquid you are trying to swallow leaks out of your nose, you have paralysis of the swallowing mechanism, most likely due to a stroke.

If it is difficult to swallow solid food, but everything is in order with the liquid, then the esophagus itself or the area around it is mechanically blocked.

If your throat narrows when you are nervous and you have difficulty swallowing, or if you always seem to have a lump in your throat, and full examination found nothing, you emotional disorder called the hysterical ball. This happens much more often in women than in men.

The more time passes after you have swallowed, before difficulty or discomfort, the lower the cause of the problem is located. For example, if everything is fine for the first 15 seconds, but then there is a feeling of blockage, then either there is a blockage in the lower part of the esophagus, near the stomach, or you have a diaphragmatic hernia, in which food is burped from the stomach back into the esophagus.

If swallowing gets worse over weeks or months, esophageal cancer is very likely.

If difficulty swallowing comes and goes, most likely nervous breakdown or spasm. Conversely, the physical blockade is permanent and worsening.

If swallowing is easier when the head is tilted back, the problem is in the pharynx, not in the esophagus. Look at it yourself.

When swallowing is not only difficult but also painful, there may be some backflow of acid from the stomach into the esophagus (esophagitis), a spasm, an ulcer, or a scratch on the rear surface throats: You may also have swallowed a fish or chicken bone, which tore off the mucosa of the esophagus.

Do you spit up food minutes or hours after eating, especially when lying down? Your esophagus has either lost elasticity or has a diverticulum, a sac in its wall. The food you swallow fills up the diverticulum and you are forced to spit up to relieve yourself. If this is the case, from your mouth you may have bad smell from decaying food in the bag.

If you had a hoarse voice weeks or months before swallowing difficulties began, then the disorder took over. vocal cords. But if the opposite happened, i.e. the hoarseness following difficulty swallowing is strong evidence for cancer of the esophagus pressing on the nerve that controls the vocal cords. Dilation of the aorta in the chest will also give similar symptoms.

Do you find it difficult not only to swallow, but also to walk? This speaks of general illness such as amyotrophic lateral sclerosis, myasthenia gravis, or some kind of brain disorder.

If you have swelling in your neck, the enlarged thyroid gland may be pressing against your esophagus.

If your fingers hurt cold water and you, in addition, it became difficult to swallow, one might assume autoimmune disease- scleroderma.

There are many symptoms described in this book that can alarm you, but in fact they are quite commonplace. Swallowing disorder does not belong to the latter. It requires careful examination within the shortest possible time after discovery.

symptom and treatment. If you have difficulty swallowing:

What can he mean?	What to do with him?
Throat infection, tonsillitis, abscess, trauma.	Antibiotics for infections. Treatment of symptoms after trauma.
Nerve damage (polio, stroke, tumor).	Recovery therapy.
Muscular disorders (myasthenia gravis).	Medical treatment.
Scleroderma (autoimmune disease).	Same.
Compression of the esophagus by neighboring structures (glands, tumor, enlarged aorta).	Appropriate treatment, including surgery.
Disease of the esophagus (infection, tumor).	surgery or medication.
Emotional disorder (hysterical ball).	Treatment by a psychiatrist.
Spasm, diaphragmatic hernia.	Medicines.
Diverticulum.	Operation.