OpenHealth Q&A

It sounds like you are experiencing persistent swallowing difficulties, which can be quite concerning. Based on your description, it's possible that your symptoms are related to your hiatal hernia or perhaps an issue with esophageal motility. Let’s break this down further.

Summary of Key Points

• Allowing your swallowing difficulties to persist for seven months without an identified cause can be frustrating.
• Normal results from your gastroscopy and nasofibroscopy are reassuring but don’t provide a complete explanation for the symptoms you've described.
• The hiatal hernia and esophageal motility results may play a role in your swallowing issues.

Explanation

Swallowing difficulties can arise from various factors, including structural problems (like your hiatal hernia) or function-related issues with how muscles in your esophagus work. Silent reflux could also contribute to mucus production in the throat, but since you're not experiencing burning sensations, this might not be the primary cause.

The manometry results indicate that your upper esophageal sphincter pressure is normal, but the lower esophageal sphincter (LES) results show negative pressures, which could imply a dysfunction in how it closes properly, possibly allowing for reflux or impacting swallowing.

Next Steps

1. Modify Diet:

   • Start with softer foods that require less chewing and easier swallowing, like mashed potatoes, soups, or smoothies. This may help you feel more comfortable while eating.

2. Hydration:

   • Drink plenty of fluids with meals to assist the swallowing process and help clear any food that feels stuck.

3. Chewing Carefully:

   • Ensure you chew foods thoroughly before swallowing. Smaller bites may also help prevent the sensation of food being lodged.

4. Positioning:

   • After eating, try to remain upright for about 30 minutes to aid digestion and minimize any pressure on the esophagus.

5. Medical Follow-Up:

   • Although you have seen specialists and undergone several tests, consider following up for a comprehensive review of your swallowing difficulty. Discuss your symptoms in detail and explore potential treatments, such as medications that address esophageal motility or further evaluations regarding the hiatal hernia.

6. Monitor Symptoms:

   • Keep a diary of your eating habits, noting any particular foods that exacerbate your symptoms or times when swallowing difficulties worsen. This can provide valuable information for your healthcare provider.

If your symptoms worsen or you develop new symptoms such as weight loss, chest pain, or difficulty breathing, it’s essential to seek medical attention promptly. Please feel free to reach out for more advice or information; I'm here to help!