The Medical Consumer's Advocate

This letter originally appeared in Dr. Hoffman's column on allHealth.com.

Well, don't that just stick in your craw!

A young man writes that, several months ago, he had an episode of difficulty with swallowing. It was accompanied by severe pain. Subsequently, small bits of undigested food would "come up."

A: One possible explanation for what you experienced is something known as esophageal spasm. To understand spasm, you need to understand a bit about how the esophagus works. Food does not descend into your stomach by gravity (with a little practice, you can swallow while standing on your head– great party trick!) Rhythmic muscular contractions push the wad of chewed food (bolus is the medical term for this lump of chewed food) down the esophagus into the stomach. If the muscles of the esophagus cramp, or spasm, the bolus becomes lodged in place. This is very painful. Often, the bolus of food cannot be washed down with water, and must be vomited; occasionally, it must be surgically removed.

There are many other possible explanations for what happened to you. For example, a Zenker’s diverticulum is an outpouching from the esophagus which can trap food. People with this problem may spit out bits of undigested food even hours after a meal. This is not typically a painful problem.

More worrisome still, tumors of the esophagus can cause a variety of swallowing problems, as can tumors that are near enough to the esophagus to press on it.

Your next step should be to discuss this problem with your internist. He/she will need to perform a thorough history and physical exam, and will probably also order a radiographic swallowing study (such as a barium swallow.) Most swallowing problems are very treatable, so I would not delay in pursuing further care.

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The Medical Consumer's Advocate

This letter originally appeared in Dr. Hoffman's column on allHealth.com.

Well, don't that just stick in your craw!

A young man writes that, several months ago, he had an episode of difficulty with swallowing. It was accompanied by severe pain. Subsequently, small bits of undigested food would "come up."

There are many other possible explanations for what happened to you. For example, a Zenker’s diverticulum is an outpouching from the esophagus which can trap food. People with this problem may spit out bits of undigested food even hours after a meal. This is not typically a painful problem.

More worrisome still, tumors of the esophagus can cause a variety of swallowing problems, as can tumors that are near enough to the esophagus to press on it.

Back to The Question and Answer Page

More information available on other diseases of the ears, nose and throat!

Click here if you have questions, comments or criticisms for Dr. Hoffman.

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