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What could be the reason for throat tightness, spasms, and difficulty swallowing saliva for the past six weeks?

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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

iCliniq medical review team

Published At April 28, 2023
Reviewed AtJanuary 17, 2024

Patient's Query

Hello doctor,

I am a 45-year-old male of 211.64 lb and 6 feet in height. For the past six weeks, I have been experiencing throat tightness, spasms, and difficulty swallowing saliva. To begin with, spasms lasted anywhere up to six hours, then released but my throat muscles, in particular with swallowing, always felt weak. Three weeks ago I had an endoscopy down the esophagus, including a biopsy, but all came back clear. I went back to eating and drinking normally and everything seemed fine until 10 days ago when the spasms started again. This time the throat continuously felt tight, and swallowing feels difficult (as if the muscles are not working or are not strong enough). Although I do not need to cough, I do feel as if I have excess mucus in my throat, and each time I swallow saliva I hear a gurgling sound at the back of my throat. This sound is new and happened after the endoscopy three weeks ago. My throat can get sore with this too. My throat feels weak and tight when I swallow. The oxygen saturation levels are always measured between 95 to 99 percent. I was taking Omeprazole and stopped after the endoscopy. I started it again after the spasms but have stopped it again. The back of my tongue is also swollen and tight at times. With the endoscopy results showing nothing, and the symptoms reappearing but this time worse and different, I really am unsure what this can be. Kindly help. Thank you.

Answered by Dr. Akshay. B. K.

Hello,

Welcome to icliniq.com.

I read your query and understand your concern. There is no need to worry. Since an endoscopy has already been done, we are sure that there is no anatomical or obstructive pathology in your aerodigestive tract. Since you have difficulty swallowing, I would like to advise certain tests to evaluate esophageal mobility disorders such as: 1. Esophageal manometry. 2. Barium swallow. 3. MRI (magnetic resonance imaging) scan of the neck. Your saturation is also normal, I do not think you are suffering from any major issues. Thank you.

Patient's Query

Hello doctor,

Thank you for the reply. I can manage to swallow solid food and drink, although, after the first couple of swallows, each next swallow becomes more difficult as the muscles feel tight or weak. Also, are there any thoughts as to this new gurgling sound I hear in the lower part of the throat a second or two after swallowing saliva? I am also unsure whether to continue with the Omeprazole in case this is silent acid reflux. Thank you.

Answered by Dr. Akshay. B. K.

Hello,

Welcome back to icliniq.com.

The gurgling sound and the difficulty in successive swallows is a possibility of Zenker's diverticulum which should be ruled out. Even if it is present it can be solved by a simple procedure. Is there a history of foul-smelling breath and does the swallowed food regurgitate when you sleep? Thank you.

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

Dr. Akshay. B. K.
Dr. Akshay. B. K.

Otolaryngology (E.N.T)

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