Can't stop swallowing due to unknown cause. Nothing has provided relief. (sinus, infection)
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It could be something like esophageal spasm from LPR (silent reflux). I had it, but luckily it was fixed with reflux medications and dietary modifications. Sometimes that doesn’t work. I think that the ENT is often the best person to treat that because they can do the scope through your nose. I had tremendous anxiety when it was happening as well, so I can empathize.
FWIW, when this was happening to me, I was having HORRIBLE allergies from work. I asked my allergist about it and he was not surprised, as apparently everything is connected. There is a specific sort of allergic reflux where your esophagus is inflamed due to allergens. I was prescribed a daily steroid inhaler at the same time as I started the reflux medicine, and I am not sure if that helped as well. The last winter I was at the job, I used the inhaler again and did not have any significant issues. Apparently for really bad problem, the goal is to get it into your throat, but it seemed to help regardless with swishing out my mouth after to prevent thrush.
My ENT specialist listed LPR as a potential culprit along with the dairy/gluten intolerances. I wish my ENT specialist would be the one conducting my endoscopy, but my primary care doctor said a gastro doctor is better suited to perform it as at my hospital/clinic, the gastro doctors' cameras are longer and able to see lower into my stomach to see if there are any issues there, whereas the ENT's camera only reaches just past beyond my throat. For your endoscopy did they strictly look into your nose? I'm getting an upper GI endoscopy so they're not going anywhere near my nose.
Hmm that's pretty interesting. I don't have any regular signs of allergies like a runny nose or congestion, but I know everyone's body is different and my allergies could be manifesting in the form of inflamed esophagus like you mentioned. Can you elaborate on what you and your allergist discussed to reach that diagnosis of allergic reflux? I want to make sure I bring up what you just said.
I might ask my ENT specialist if he'd be able to perform the endoscopy instead. The gastro doctor I was referred to completely disregarded the swallowing issue and strictly asked questions about the acid reflux. He also ended our visit with "I doubt we'll find anything during the endoscopy, but we can try." He instilled ZERO confidence in me and now I fear that I'll be paying a lot of money for a procedure that will not yield me any results.
Thank you for the suggestion. I will definitely follow through with it and try to simultaneously treat both my physical and mental health. And yes, I have definitely dwelled on what appears like a simple minor inconvenience to others, but to me, this definitely has been worse than any broken bone, fracture, or injury I've ever suffered. One good thing I can say is that my anxiety associated with the excess swallowing has never come close to what it was when it first started. It used to induce constant panic attacks and would keep me from sleeping or would wake me up 2-3 times a night, but I feel that my brain perceives it now more as an annoyance.
Problems that have a psychological component are just as real as problems that are purely physical. And in some cases, there can be an anxiety arising from a physical issue that aggravates it.
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Since anxiety issues are mostly due a hormonal imbalance in the brain (I think), how do those in the mental health field know what hormones I may be lacking or overproducing? Sorry if that's not even a proper question. I'm genuinely curious as to how professionals in the field diagnose or asses patients and if having a physical symptom like in my case makes it easier to reach a diagnosis versus someone who presents none.
The chemistry involved is complicated, and there can be multiple neurotransmitters and hormones involved. Diagnosis will involve assessing the level of your anxiety and associated symptoms, and looking for biological, psychological, and social factors in your personal history that may be contributing to the anxiety.
There are a number of anxiety-related disorders, which differ in their root causes, symptoms, and best approach to treatment. Your assessment will help the professional working with you find the best way to approach your issue.
There are two main systems involved in anxiety: the parasympathetic system, which controls the body's normal at rest state, and the sympathetic system, which is activated if there's danger ("fight or flight"). Stress management techniques like breathing, meditation, mindfulness, etc. attempt to activate the parasympathetic system to quiet an activated sympathetic system. Breathing exercises in particular seem to have a direct effect on the vagus nerve, which is a key component of the parasympathetic system.
I should also mention that the gastro doctor also decided to double my dose of PPIs, which I didn't follow through with of course. I've already been on PPIs for quite some time with no results and I feel that long-term it'll just make me worse as you're not supposed to be on PPIs for that long. I might not even have reflux if the meds haven't worked. It could just be a food intolerance presenting the same symptoms as reflux, but I guess I won't know until I follow through with the endoscopy.
1. Your saliva glands are very active and causing you to need to swallow.
2. You have a stomach issue or an issue with your esophagus and you are swallowing air to protect the issue.
I am not a doctor, but a person with a wildly high IQ.
1. Your saliva glands are very active and causing you to need to swallow.
2. You have a stomach issue or an issue with your esophagus and you are swallowing air to protect the issue.
I am not a doctor, but a person with a wildly high IQ.
Could very well be both. Now I need to figure out whether the two are linked or not. Sometimes excess saliva isn't an issue. It fluctuates depending on how anxious I am feeling or if I'm paying attention to the saliva in the mouth or not.
Also, my allergy panel came back and I'm apparently really allergic to something, but I don't know how to decipher blood readings, so I'll have to talk to my allergist in 2 weeks and see what the allergy is and if it could be linked to my swallowing. Never have had issues with congestion, a runny nose, etc.
Hmm that's pretty interesting. I don't have any regular signs of allergies like a runny nose or congestion, but I know everyone's body is different and my allergies could be manifesting in the form of inflamed esophagus like you mentioned. Can you elaborate on what you and your allergist discussed to reach that diagnosis of allergic reflux? I want to make sure I bring up what you just said.
I might ask my ENT specialist if he'd be able to perform the endoscopy instead. The gastro doctor I was referred to completely disregarded the swallowing issue and strictly asked questions about the acid reflux. He also ended our visit with "I doubt we'll find anything during the endoscopy, but we can try." He instilled ZERO confidence in me and now I fear that I'll be paying a lot of money for a procedure that will not yield me any results.[/QUOTE]
I agree with the GI doctor. The probability is pretty high that they won't find anything based on what was said by you on describing the symptoms along with the GI's comments.
Eosinophilic esophagitis shows different symptoms (dysphagia) in atopic (allergic) people that requires blood work along with a esophageal biopsy showing eosinophils (white cells associated with allergies) the same cells elevated in blood along with high antibodies associated with allergies (IgE).
ENT's do not do upper endoscopies involving the esophagus on down. That is the turf of the GI doctors. An ENT can not go down that low and is not board certified involving gastrointestinal pathology. There is some overlap with lower Gi diseases presenting at the throat level like ulcerations but they are not qualified to do scopes in the upper and lower GI tract.
Since you have a neurotic personality I would have you think twice about not having the procedure done only to be hounded by the fact later on. You need to think ahead. It is expensive but there needs to be an orderly sequence of the investigation. Nobody can promise anything only that what does happen will all be taken in by your mind consciously or unconsciously and the only way to control it is be doing a logical sequential evaluation.
I agree with the GI doctor. The probability is pretty high that they won't find anything based on what was said by you on describing the symptoms along with the GI's comments.
Eosinophilic esophagitis shows different symptoms (dysphagia) in atopic (allergic) people that requires blood work along with a esophageal biopsy showing eosinophils (white cells associated with allergies) the same cells elevated in blood along with high antibodies associated with allergies (IgE).
ENT's do not do upper endoscopies involving the esophagus on down. That is the turf of the GI doctors. An ENT can not go down that low and is not board certified involving gastrointestinal pathology. There is some overlap with lower Gi diseases presenting at the throat level like ulcerations but they are not qualified to do scopes in the upper and lower GI tract.
Since you have a neurotic personality I would have you think twice about not having the procedure done only to be hounded by the fact later on. You need to think ahead. It is expensive but there needs to be an orderly sequence of the investigation. Nobody can promise anything only that what does happen will all be taken in by your mind consciously or unconsciously and the only way to control it is be doing a logical sequential evaluation.
Immunoglobulin E, Total:1,090 IU/mL Standard Range: 6 - 495 IU/mL
My blood work just came back and this was at the top of the list. I'm not sure how to read blood work, but does that mean I have a high number of antibodies? And does that possible hint at possibly having eosinophilic esophagitis or would I need to follow through with the endoscopy in order to get a biopsy done and confirm high level of white blood cells? I'm looking at the symptoms associated with it and it shares a lot with GERD that I have been dealing with like burping, throat swelling/discomfort and excess saliva. Might explain why the PPIs haven't done much to alleviate these symptoms.
I did push back the endoscopy back another few weeks to allow myself time to try out my new diet and see if that helps. I also want to discuss the findings of my blood test with an allergist and my ENT specialist in the next 2 weeks to see if they have a new approach to this now that it appears I have high antibodies. I just moved to this new house about 5 months ago and the previous house I lived at had a terrible mold problem and I was constantly exposed to the mold on my walls for about the 3 years I lived there. Not sure if this has contributed to my high antibodies, but when I have mentioned it in my doctor's visits, it hasn't sounded an alarm or raised their concern.
For anyone who still cares or is wondering, I am still dealing with the constant swallowing, but have made slight improvements. Started a dairy and gluten free diet on the 28th of April and I recently broke my diet for one day on the 27th of May to reintroduce it into my system to see if it really is the culprit and the swallowing has increased the past couple days so I do feel that it's playing a role in the swallowing, but I'm still not convinced it's the sole reason. I also began taking Zinc supplements about 2-3 weeks ago and it feels as if though I've made the most improvement with the Zinc + gluten/dairy-free diet. When I'm at work, I'll only swallow like every thirty minutes up to an hour and a half, which at that point it's just normal, but when I'm at home the constant swallowing returns, so I am convinced a large part of this is mental since I'm less distracted at home than I am at work, but I will say the Zinc supplements have lessened the compulsive thoughts almost entirely at work. I just wish it did the same at home. I will also say the intensity of the swallowing has also lessened a little bit, which is good.
Still getting an endoscopy done on the 22nd to hopefully rule out any other potential causes since I still feel there is something physically wrong with my throat like an abnormal amount of tightness and sounds my throat makes. Forgot to mention previously that sometimes when I swallow my throat will make a weird croaky/gargling sound as water or saliva travels down my throat. Also, when I get hungry, my lower throat/upper chest area makes a sizzling sound almost like the sound of Pop Rocks candy in your mouth - weird I know.
I guess since I have almost a month out from my endoscopy, I'll hit the reset button and try the diet again to see if it even is worth the effort and money continuing since buying a lot of fresh produce and gluten-free item gets a bit pricey and it's been difficult coming up with new ideas for meals and haven't had too much time to experiment between work and school.
Really hope to return to normalcy at one point in my life again.
The IgE levels are essentially to show how allergic you are as the IgE antibodies are associated with allergies and you are definitely allergic to things in general. It is a marker for allergy burden. The question now is are those allergies located in the esophagus as the cause of the problems or simply not associated. Eosinophils are a type of white blood cells that is associated with allergies and so that is another marker for somebody who has a lot of allergies.
The doctor will determine upon doing the procedure if anything appears abnormal and will do biopsies depending on what he sees. He might not do anything if he doesn't see anything abnormal.
The IgE levels are essentially to show how allergic you are as the IgE antibodies are associated with allergies and you are definitely allergic to things in general. It is a marker for allergy burden. The question now is are those allergies located in the esophagus as the cause of the problems or simply not associated. Eosinophils are a type of white blood cells that is associated with allergies and so that is another marker for somebody who has a lot of allergies.
The doctor will determine upon doing the procedure if anything appears abnormal and will do biopsies depending on what he sees. He might not do anything if he doesn't see anything abnormal.
That's exactly what my allergist said as well. My allergist is 50/50 on whether I have eosinophilic esophagitis or not since food tends to get slightly stuck when I eat or I have to swallow quickly and forcefully because I feel like it'll get stuck. I did a prick test for 50 different allergies and I don't have any allergies to dairy or wheat, but since the diet has helped, both my ENT specialist and allergist believe I may have some sort of sensitivity without necessarily having an allergy. I might try soy or other things in my elimination diet next.
Been in a way better place mentally too, although everyday feels like a drag with this symptom. I'm creeping up on 2 years in August, but this is by far the most progress I've ever made so I hope I can continue this momentum. My family has noticed a significant change in my behavior post-diet and supplements. I didn't realize that I was barely speaking a few words a day to my family due to how depressed/anxious I'd been with the swallowing, but I'm engaging in conversation a lot more and I guess all I can do now is wait for the endoscopy and hope I get answers.
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