Throat Tightness and Chest Discomfort: Causes and Solutions - Pulmonology

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Throat tightness, chest tightness, and tension in the upper back and chest cavity?


Recently, while eating snacks and laughing, I felt something foreign enter my throat and get stuck at the level of the Adam's apple.
My voice changed, and I started to cough violently after only a few words, but it seemed like I couldn't cough anything out.
At that moment, I kept swallowing to push down the cough and the foreign object (I stopped coughing, but I'm not sure if the object disappeared).
After swallowing, I immediately felt tightness in the muscles from under my jaw to my collarbone, experienced abnormal swallowing (a sensation of difficulty when the Adam's apple rises during swallowing), dizziness, and tightness in the back of my head, which made me lean my head forward to relieve the discomfort.
I also felt pain (spasms) at the lower edge of my ribs when breathing, and my right chest felt like it couldn't take in air.
A chest X-ray showed no abnormalities, and a CT scan of my throat diagnosed inflammation but no foreign object.
I would like to ask the doctor if not properly addressing the foreign object stuck in the throat could lead to symptoms like mine.
Is there any adverse effect on the body from forcibly suppressing the reflexive cough when trying to expel the foreign object? If there is no foreign object in the throat, what could my symptoms indicate? In Taiwanese, does "煞到" refer to the symptoms I'm experiencing? I hope the doctor can clarify these points for me.
Thank you! I appreciate your service that allows public consultation, but honestly, the medical advice you provide needs improvement.
Additionally, there are many posts deleted under the pretext of not valuing online medical resources, which makes me very dissatisfied with your operational system and problem-handling attitude.
Do you think that those of us who post here have not sought conventional medical channels (like visiting clinics or hospitals) or researched relevant information before posting for fun? Do you think we come here to waste your so-called online medical resources to save on medical expenses? I have already stated in my previous posts that after seeing many doctors and undergoing multiple tests without finding a cause, and with medications yielding no results, I had no choice but to post.
I am well aware that online consultations cannot provide doctors with a clear understanding of symptoms, which is why I have done my best to share everything I know, my experiences, and the ineffective treatments I have undergone, hoping to gather opinions and guidance from doctors of various specialties and experiences (after all, I believe that medicine should not draw overly clear boundaries between specialties, as this can create more blind spots that hinder treatment).
I seek a more accurate diagnosis rather than blindly seeking treatment.
However, due to your restrictions on duplicate posts and content that falls outside the physician's specialty, you arbitrarily delete the inquirer's posts and deprive them of their rights.
Are you suggesting that I continue to endure pain and go back and forth between various hospitals and clinics as if it were a mere formality? (Every time I visit a clinic, it feels like I'm just complaining to the doctor, and I end up with a bunch of medications, unsure of whom to trust or which medications to take.
The gastroenterologist prescribes anti-reflux medication; the ENT says to take cold medicine; the psychiatrist recommends antidepressants and muscle relaxants; the pulmonologist suggests bronchodilators.) Do you understand the feeling of despair in life when someone is tormented by illness and finds no help? Having to run around among these "incompetent doctors," it not only doesn't help but often makes things worse.
Is this a waste of healthcare resources? Do you believe that healthcare resources are more important than the online medical resources you provide? Honestly, sometimes the answers on your website are less helpful than just searching the internet or talking to someone in psychiatry! I wonder if some doctors are overly cautious in answering questions or simply do not want to engage actively? Please seriously consider the purpose of establishing online medical consultations and how to improve your system!

Luo Xiansheng, 20~29 year old female. Ask Date: 2017/04/17

Dr. Huang Yiwen reply Pulmonology


Dear Mr.
Luo: Thank you very much for your support of the Taiwan e-Hospital.
The purpose of this platform is to help the public clarify doubts or provide preliminary advice.
Of course, the medical field is quite complex, and some questions may not be answered satisfactorily or may be difficult to understand; this is unavoidable.
However, if the information provided is not detailed enough, please feel free to reach out for further communication; this door is always open.
Regarding the issue of foreign body ingestion, it is best to perform a laryngoscopy or bronchoscopy.
The former should be done by an otolaryngologist, while the latter should be performed by a pulmonologist, as bronchoscopy allows for a more in-depth examination of the airways.
If not addressed, it may lead to chronic coughing, which may not always be visible on imaging studies.
In Taiwanese, the term (煞到) is somewhat similar to choking, but not exactly the same; it can only be described as similar.
We hope this resolves your concerns.
Changhua Hospital cares about you.

Reply Date: 2017/04/17

More Info


Understanding throat tightness and chest discomfort can be quite complex, especially when symptoms arise suddenly and are accompanied by anxiety and discomfort. Based on your description, it seems you experienced an acute episode of choking or the sensation of a foreign body in your throat while eating, which led to a cascade of physical symptoms including tightness in the throat, difficulty swallowing, dizziness, and chest discomfort.


Possible Causes
1. Acute Pharyngeal Irritation: The sensation of a foreign body in the throat can lead to irritation and inflammation of the pharynx. This can cause a reflexive tightening of the throat muscles, leading to difficulty swallowing (dysphagia) and discomfort.

2. Anxiety and Panic Response: The experience of choking can trigger a panic response, which may manifest as tightness in the chest, difficulty breathing, and feelings of dizziness. Anxiety can exacerbate physical symptoms, creating a feedback loop where anxiety increases discomfort, which in turn increases anxiety.

3. Muscle Tension: The tightness you feel from the jaw to the collarbone may be a result of muscle tension due to stress or anxiety. When we are anxious, our body tends to tense up, which can lead to discomfort and pain in various areas, including the neck and chest.

4. Gastroesophageal Reflux Disease (GERD): If you have a history of acid reflux, the sensation of a lump in the throat (globus sensation) can be related to reflux irritation. This can also contribute to chest discomfort.

5. Esophageal Spasm: In some cases, swallowing difficulties and chest pain can be attributed to esophageal spasms, which can occur after an episode of choking or irritation.


Addressing Your Symptoms
1. Stay Calm: If you experience a choking sensation again, try to remain calm. Panic can exacerbate the feeling of tightness and discomfort. Practice deep breathing techniques to help manage anxiety.

2. Hydration: Ensure you are well-hydrated, as dryness can exacerbate throat discomfort. Drinking warm fluids may help soothe the throat.

3. Avoid Irritants: Stay away from foods that may irritate your throat or exacerbate reflux symptoms, such as spicy or acidic foods.

4. Consult a Specialist: Since you have already undergone imaging studies that did not reveal any significant abnormalities, it may be beneficial to consult an ear, nose, and throat (ENT) specialist or a gastroenterologist for further evaluation. They can assess for conditions like GERD or esophageal motility disorders.

5. Cognitive Behavioral Therapy (CBT): If anxiety is a significant component of your symptoms, consider seeking therapy. CBT can help you develop coping strategies for managing anxiety and its physical manifestations.

6. Relaxation Techniques: Engage in relaxation techniques such as yoga, meditation, or progressive muscle relaxation to help reduce overall tension in your body.


Conclusion
Your symptoms of throat tightness and chest discomfort are likely multifactorial, involving both physical and psychological components. While it is understandable to feel frustrated with the healthcare system, it is essential to continue seeking appropriate care and to communicate openly with your healthcare providers about your symptoms and concerns. They can help guide you through the process of finding a diagnosis and effective treatment. Remember, you are not alone in this, and there are resources available to help you manage your symptoms and improve your quality of life.

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