HomeAnswersOtolaryngology (E.N.T)weaknessI feel something is stuck in my throat, but all the tests are normal. Do i need to do barium study?

For a few months, I have a feeling of something stuck in my throat. Why?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Sneha Kannan

Published At March 25, 2022
Reviewed AtJanuary 17, 2024

Patient's Query

Hi doctor,

I am a 43-year-old male. I am 5'11 and weigh approximately 176.37 lb. I have been living in a country with predominantly cold weather conditions for quite some time. I am married with kids. I am an eggetarian and do not smoke or drink alcohol. I started a feeling of a pill or food stuck in my throat a few months back, just around the time I was put on cholesterol medication, tablet Atorvastatin. After a month, I had muscle weakness, and hence my primary care physician changed the prescription to tablet Rosuvastatin. Once the drug was changed, the symptom of food or pill getting stuck in the throat became intermittent. Parallelly, my primary care physician suggested I consult an ENT, and he ordered an ultrasound of the neck. After the ultrasound was done, my physician said no problems found on the ultrasound that required treatment. I have attached a copy of the ultrasound results. When I visited the ENT doctor, he inserted an endoscope to check my throat. He also noticed the throat functions through the scope while drinking and eating semi-liquid and solid food. He assessed that there was nothing in the throat visible to naked eyes. To examine further, he ordered a CT scan of the neck. I expressed my hesitation to expose myself to radiation from a CT scan. So he ordered an MRI scan and said he could see more details in MRI than CT scan. I have attached the MRI scan report. Both ENT and Primary care physicians reviewed the MRI scan report and said there is nothing they see that could be the cause of concern. The ENT doctor wants me to undergo a "modified barium swallow study." After researching, I found this study to be based on radioactive substances, and hence I have the following queries and need suggestions. I still have an intermittent feeling of something in my throat (primarily on the right side). There are days I do not feel anything (totally normal), and there are days I feel something is in my throat. Usually, I have this feeling when the outside temperature is cold or after a meal or snack. Since the ultrasound scan, endoscope study, and MRI scan did not find anything concerning, do I still need to go through a modified barium swallow study? Since the modified barium swallow study is based on radioactive substances, is there any risk (short-term or long-term) that I need to know before undergoing the test? I have a medical history of hyperactive thyroid, twice in the past few years, which lasted for a few weeks. My endocrinologist asked me to go through a test that required me to take a radioactive pill to evaluate the thyroid gland. Thyroid levels returned to the normal range in six to eight weeks, as expected by the endocrinologist. I was not on any medications. I had to undergo a CT scan thrice to diagnose the causes of abdominal pain in the past few years. I was diagnosed with UTI the first time, appendicitis the second time, and kidney stone the third time. I have not undergone any surgery. I was on Rosuvastatin for two months to manage cholesterol levels. A few years back, I requested my Primary care physician to get my thyroid scanned. They found a benign nodule and said I don't need to do anything. Considering these, could you please suggest if I need to take up a "modified barium swallow study" and if it is worth exposing myself to radiation?

Answered by Dr. Vinay. S. Bhat

Hi,

Welcome to icliniq.com.

Thank you for the detailed history and the images (attachment removed to protect the patient's identity). Globus sensation is the medical term for the sensation of something stuck in the throat or a feeling of the presence of a foreign body in the throat. Since you have had this for quite some time and it is not worsening, I do not think any positive outcome is expected with a barium swallow study, and this test is generally safe. The most common condition causing globus sensation is laryngopharyngeal reflux disorder, a type of acid reflux disorder where digestive acid in our stomach reaches our throat frequently, causing acid-induced mucosal injury resulting in globus sensation. Treatment for this condition will go on for some time. I will suggest acid reflux medications, such as tablet Pantoprazole or tablet Omeprazole, for a minimum of two months. Consult your specailist doctor, discuss with him or her and take the medicines with their consent. Some diet modifications such as avoiding tea, coffee, aerated beverages, chocolates, and late meals also help. Saltwater gargling should be avoided. Your reports are normal, and there is nothing that contributes to your symptoms. But the ultrasound of the thyroid gland shows a small cystic nodule, which is just an incidental finding and does not need any active intervention. Medications you are taking are also not known to cause such symptoms. So in such situations, we always start on a trial of ant-reflux medication, which is generally safe and well-tolerated. After the initial treatment trial, depending on the outcomes, we will decide whether to go for further tests like barium swallow study.

Patient's Query

Hi doctor,

Thank you for your detailed response. I have a follow-up appointment with my ENT in the coming week. If he insists on me undergoing the Barium swallow study, is it safe, or should I avoid it? I usually do not consume tea, coffee, or aerated beverages. I do like chocolates but will not eat regularly. Also, my meal schedule is pretty standard, with breakfast at 7 AM, lunch at noon, and dinner at 7 PM. I will try to take tablet Pantoprazole or tablet Omeprazole for the next couple of months. Can you please suggest the dosage of it?

Answered by Dr. Vinay. S. Bhat

Hi,

Welcome back to icliniq.com.

A barium swallow study is generally safe, and you can get it done if your doctor insists. I suggest tablet Pantoprazole 40 mg or tablet Omeprazole 20 mg twice daily 30 to 45 minutes before food. Consult your specialist doctor, discuss with them and take the medication with their consent. First, take the medications for three weeks, and if there is even a 25 percent improvement, I would suggest you continue the same medicines for two months.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Vinay. S. Bhat
Dr. Vinay. S. Bhat

Otolaryngology (E.N.T)

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