Swallowing difficulties, hiatus hernia and oesophagitis

[Mummatotwo1922]

Hello! I’ll try to be concise, but concise isn’t my middle name…

difficulty swallowing started almost overnight 12 months ago. I actually posted on here at the time so you might be able to go back and see the thread. Anyway I was referred for urgent endoscopy which showed a 2cm hiatus hernia but nothing else. Advised to take gaviscon before bed.

I saw ENT a week or so later who put the camera down my nose to look at the larynx etc, all clear

I have had a barium swallow which showed ‘some minor cricopharyngeal discoordination, and some lower cervical osteophytes causing an impression on the posterior oesophagus, and slow transit of the biscuit bolus through the mid oesophagus. ENT did not think these issues would be contributing to my dysphagia, but he’s referred me for video fluoroscopy.

Ive had a brain MRI to rule out neurological causes. I’ve just had a repeat endoscopy which showed the hernia and also grade 1 oesophagitis which I didn’t have the first time. My issue is I don’t feel like I have reflux, so I don’t overly know what my triggers are and what to avoid. I’ll be starting to take a PPi in the meantime to get ontop of it but ideally I wouldn’t want to be on PPI long term so would rather try to change my diet - just not sure how when it’s silent reflux!

I’ve also been diagnosed with POTS this year due to issues with my heart rate, and I’m under gastroenterology for abnormal liver function tests. They have just referred me for a fibroscan with a view to possibly doing a liver biopsy if indicated.

i dont know what I’m looking for by posting this but I’m just feeling a bit fed up. 12 months ago I was healthy, now I have unexplained difficulty swallowing, abnormal liver function and a chronic condition. Has anyone been through similar and have any words of wisdom? Anything for me to google and to look into that my various consultants might not have done yet?

thanks 🩷

I had an almost identical experience 18m ago.
Difficulty swallowing, no reflux, but what felt like heart pain..made me dizzy and was scary,
Eventually got referred for an endoscopy and a swallow study.. the study showed poor oesophageal motility and oesophagitis and a 3cm hiatus hernia.

I was put on omeprazole. The usual standard dose did nothing to help and it wasn't until I was on double the dose that things started to settle. I also gave up anything acidic or spicy. No red wine, no tomatoes (I have an allotment and it was a bumper crop so I'd eaten a LOT of tomatoes. No fizzy drinks no chocolate.... just bland food. It took 6 months on the double dose before I realised I felt a lot better!
I now only take PPIs every few days. It does try to come back, but it's a lot better than it was!
I also have an unexplained neurological condition...no idea if it;s connected to my swallowing difficulties as the departments never talk to each other!

I hope yours starts to improve soon!

I have a hiatus hernia and was on and off PPI for ages. I can’t take them anymore as I have microscopic colitis (possibly linked to the PPI?). I also had stage 2 oesophagitis.

I tried the Acid Watcher Diet and it really did help. The issue (according to the book) is that the backwash from your stomach also includes pepsin which is a protein digesting enzyme which can impact your oesophagus. Pepsin needs an acid environment so every time you eat acidic foods it can do a bit more damage. A month or so of limiting acid food and drink allows everything to heal.

Oh my go0dness. I could've written your post myself. Also in same position as you and so many similar results etc

Can I pm you please

Have you seen a speech and language therapist?? A videofluoroscopy is a good idea but they are led by SLT, not doctors and should only be interpreted by them or else it is useless and only following a really robust case history and assessment. There’s a lot to unpick there but a lot will depend on your symptoms. I’m a dysphagia specialist and I would want to talk to you a lot first before doing anything as your barium swallow tells me a lot already!

Yes of course

Hello,
thanks for the input! I have been referred for vfss but my friend who is a slt at the same hospital isn’t sure they will accept my referral as the barium swallow was ‘normal’ according to ENT. The wait is also 48 weeks and I have only just been referred to them 🫣

Thanks so much for the reply, apologies I’ve been busy over Christmas so only just got around to looking at replies!

that’s really interesting that it took double the dose for you to feel a difference. I really should start a PPI again but I’d need to chat to cardiology to see what I can take alongside the meds for my heart and blood pressure. What did your difficulty swallowing feel like? Mine seems to be more with the initiating the swallow and I honestly don’t know if I’ve just got a bit of a discoordinated swallow now as I’ve been compensating for so long!

Yes.. it was initiating swallowing that becme difficult and it felt uncomfortable going down. I never actually choked thank heavens (had that experience as a child and never want to repeat it!)
Having said all that the swallow study (unpleasant but not as scary as I anticpated..you have to swallow a wide ng tube and then take sips of water and eat tiny bits of bread while they measure ) didn't actually give me a solution..just labled the problem! I also had a 24hr probe..like an ng tube but more uncomfortable as it has wire inside which measured the reflux at home. That was less pleasant as I could feel it all the time and had to eat and drink with it.. was glad to get that out the next day!
PPIs have been the solution for me but also I am very mindful of what I eat and drink ..and how I eat now. Not that I was ever a guzzler but now I know my food doesn't go down easily I'm careful!