Very severe pain after swallowing - what could it be?

[Shiveringinthecountry]

Hi all,

I have a hiatus hernia that hasn't caused problems until a year or so ago, but now I'm waiting for a barium swallow because of episodes of regurgitating food (ugh) with no acid, and (more recently) a couple of episodes of explosive vomiting after swallowing food. My GP wonders whether perhaps I have an oesophageal pouch or something similar. I had an endoscopy within the last year due to the regurgitation but nothing except my hernia and some gastritis were found.

Anyway, I've just been eating a pizza and I think I swallowed a bit of crust that maybe needed a little bit more chewing, accidentally. The pain on swallowing it was agonising. It was very localised, in the place where I imagine the top of my stomach is i.e. where food would enter my stomach after swallowing. It was so extremely painful that I almost shouted out, and had to hold my breath and clench everything until it passed. I think I frightened the cat.

That was about 20 minutes ago and it's easing off now. It hasn't totally gone, though. The pain is right in the middle, at the level I mentioned above, all the way through from the front to my back. It's going in waves now.

I don't think this is any kind of emergency, but I'm wondering what could have caused this. If it's just inflammation then surely it must have come on very fast as I've not felt any kind of painful twinge on swallowing before this. Thinking back, is the kind of agonising pain I sometimes had as a teenager (that's 40+ years ago now) when my mum had made chips at home and I swallowed one before it cooled down.

If it's still sore in the morning I'll ring my GP and ask whether they can call me (they're very good, fortunately), but in the meantime if anyone has experience of this I'd be very grateful to hear about it. I suppose I'm worrying that I'm having some kind of exacerbation of my hiatal hernia/possible pouch thing.

Gastritis

Thanks @BettyBlueHat. Could it be that painful and just come on out of nowhere?

Does anyone else have any idea about this? I've been to bed and slept but the pain has woken me up and I've had to get up again. It's coming in waves like a cramp would, but it's right in the middle of my back. It's not my gallbladder. I had that out 30 years ago 😢

My mum has oesophageal spasms which apparently feel like this. She also has a hiatus hernia and gastritis.

I have oesophageal spasms due to a hiatus hernia but they are higher up in the middle of my chest. They can be extremely painful. I find sipping hot water, as hot as I can tolerate, when it first starts usually relaxes it and eases the pain.

Thank you very much @FacingTheWall and @steppingcarefully.

It hasn't gone away, and on waking at 6am this morning to take my Levothyroxine on an empty stomach I had a small sip of water and when I swallowed the pain was excruciating again. Now it's going round and round in waves.

@steppingcarefully When this happens to you do you ever feel a sore spot when you swallow? I've had water and now I'm sipping coffee, and each time I swallow it feels like the liquid goes over a sore spot (sore enough to make me cringe) each time I swallow.

Will ring the GP this morning. Thank you again for replying x

How are you doing @Shiveringinthecountry ?
It sounds like quite a scary experience...

Thanks for asking @Mysa74 👍

It's been quite a rollercoaster sort of weekend!

I had an urgent endoscopy on Saturday and was diagnosed with a rare condition called 'corkscrew oesophagus'. Instead of working as they should, the muscle contractions (peristalsis) that are meant to move food down the oesophagus to the stomach become unsynchronised, causing distortion to the oesophagus. Apparently it's also known as 'rosary bead oesophagus'. The oesophagus goes into spasm, and it can be agonisingly painful, as it is for me. At one point on Sat morning as I was waiting to go in for the endoscopy I had pain so bad that for the only time in my life (despite having had awful gall bladder issues in my 30s) I'd have said 'ten' if asked where the pain fell on a scale of 1-10.

I've not been able to eat any solid foods since last Weds, but have found some soups that will go down without agonising pain. I've spent the whole weekend reading about it and now have a plan with my GP for referral to a gastroenterologist with experience of these motility problems. It seems I'll need a further test called manometry, to measure the pressure at various points in my oesophagus. Then a plan can be made about the best way forwards, which is likely to involve significant and lasting dietary changes and quite possibly surgery.

I've included some detail in case anybody else in the future comes looking for an explanation for symptoms like this. Any such person should go and read about Achalasia and Diffuse Oesophageal Spasms (DES). There's a fantastic support group called Achalasia Action.

Thanks again for asking, @Mysa74, and I hope you're having a good day :-)

I’m glad you’ve got a diagnosis now and hopefully something can be done to help you manage it. Good luck.

Wow, none of that sounds like fun Shivering. I'm glad you've got a nice fast diagnosis, not that it's nice of course, but at least now you've got a plan of action and a group of people to compare notes with... Good luck!

Thanks @steppingcarefully and @Mysa74 😁