Feeling of a Foreign Body When Swallowing: Causes and Solutions - Internal Medicine

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The sensation of a foreign body in the throat, especially when swallowing, can be quite distressing and may have various underlying causes. Given your history of chronic gastritis and esophagitis, as well as your recent thyroid issues, it is important to consider both physiological and psychological factors that could contribute to this sensation.


Possible Causes
1. Gastroesophageal Reflux Disease (GERD): Since you have a history of chronic gastritis and esophagitis, it is possible that you are experiencing symptoms related to GERD. In this condition, stomach acid flows back into the esophagus, which can lead to inflammation and a sensation of something being stuck in the throat. This can also cause a feeling of tightness or discomfort when swallowing.

2. Thyroid Enlargement: Although your doctor mentioned that the thyroid enlargement (goiter) should not cause swallowing difficulties, it can sometimes exert pressure on the esophagus or trachea, leading to sensations of obstruction or discomfort. If the goiter has recently decreased in size, it may still take time for the surrounding tissues to adjust, and you might still feel some residual effects.

3. Psychological Factors: Anxiety and stress can manifest physically, leading to sensations such as a lump in the throat (often referred to as "globus sensation"). This is a common symptom in individuals who have experienced chronic stress or anxiety, and it may not necessarily correlate with any physical obstruction.

4. Mucosal Changes: Chronic inflammation from your previous esophagitis may have led to changes in the mucosal lining of the esophagus, which can create a sensation of tightness or foreign body feeling when swallowing.

5. Dysphagia: This is a medical term for difficulty swallowing, which can be caused by various factors, including esophageal motility disorders, structural abnormalities, or neurological conditions.


Recommendations
1. Further Evaluation: Since your symptoms persist, it may be beneficial to consult with a gastroenterologist for a comprehensive evaluation. They may recommend additional diagnostic tests, such as a barium swallow study or esophageal motility studies, to assess the function of your esophagus and rule out any structural issues.

2. Thyroid Assessment: If you have not had a recent ultrasound of your thyroid, it may be worth discussing with your endocrinologist. They can evaluate the size and structure of the thyroid gland and determine if any further intervention is necessary.

3. Psychological Support: If anxiety is suspected to be a contributing factor, consider speaking with a mental health professional. Cognitive-behavioral therapy (CBT) can be effective in managing anxiety-related symptoms, including those that manifest as physical sensations.

4. Dietary Modifications: Pay attention to your diet and eating habits. Eating smaller, more frequent meals and avoiding spicy or acidic foods may help reduce reflux symptoms. Staying upright for at least 30 minutes after eating can also aid in digestion and minimize discomfort.

5. Hydration: Ensure you are adequately hydrated, as thick saliva can exacerbate the sensation of a foreign body. Drinking plenty of water can help keep your throat moist and ease swallowing.

6. Follow-Up: Regular follow-ups with your healthcare providers are crucial. Keeping an open line of communication about your symptoms will help them provide the best care tailored to your needs.

In summary, while your symptoms may have a multifactorial origin, addressing both the physical and psychological aspects is essential for effective management. A collaborative approach involving your primary care physician, gastroenterologist, and possibly a mental health professional will provide a comprehensive strategy to alleviate your discomfort.