Feeling of Foreign Body in the Esophagus: Diagnosis and Next Steps

Feeling of a foreign body in the esophagus?

In cases of esophageal foreign body sensation, aside from endoscopy, are there other diagnostic tools available? Recently, after eating fish, I experienced a sensation of a foreign body in my esophagus.
An endoscopy was performed, but no foreign body was found.
The doctor diagnosed me with an esophageal ulcer and prescribed medication for it.
After three days, I felt swelling and the foreign body sensation persisted.
When I returned to the doctor, they palpated my neck and suspected lymphadenopathy, prescribing antibiotics which reduced the swelling, but the foreign body sensation remains very pronounced.
Which specialty should I consult or what further tests should I undergo?

A Bin, 20~29 year old female. Ask Date: 2015/07/19

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello, you should first visit an otolaryngologist to rule out any bones lodged in the throat.
Then, you may need to undergo an endoscopy; if something is indeed stuck in the esophagus, it can be removed using instruments.
Sincerely, Dr.
Chi-Feng Chen, Attending Physician, Gastroenterology Department, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2015/07/19

More Info

When experiencing a sensation of a foreign body in the esophagus, especially after consuming fish, it can be quite distressing. Your situation, where an endoscopy (gastroscopy) did not reveal any foreign object but indicated an esophageal ulcer, suggests that the sensation may be related to the ulcer or inflammation rather than a physical obstruction. However, the persistent feeling of something stuck in the throat, along with the swelling in the lymph nodes, warrants further investigation.

In addition to endoscopy, there are several other diagnostic tools that can be utilized to assess esophageal conditions:
1. Barium Swallow Study: This is a radiologic examination where you swallow a barium solution, which coats the lining of the esophagus. X-rays are then taken to visualize the esophagus and identify any abnormalities, such as strictures, ulcers, or foreign bodies that may not have been seen during the endoscopy.

2. CT Scan: A computed tomography (CT) scan of the neck and chest can provide detailed images of the esophagus and surrounding structures. This can help identify any swelling, abscesses, or other abnormalities that may be contributing to your symptoms.

3. Esophageal Manometry: This test measures the rhythmic muscle contractions in your esophagus when you swallow. It can help determine if the esophagus is functioning properly and if there are any motility disorders that could be causing the sensation of a foreign body.

4. Ultrasound: A neck ultrasound can be useful to evaluate the lymph nodes and surrounding tissues for any abnormalities. This is particularly relevant given your report of swollen lymph nodes.

5. Allergy Testing: If there is a suspicion of an allergic reaction contributing to the swelling or discomfort, allergy testing may be warranted.

Given your symptoms and the previous findings, it is advisable to consult with a gastroenterologist, who specializes in digestive system disorders. They can evaluate your symptoms in the context of your medical history and previous tests and recommend the most appropriate next steps. If there are concerns about the lymph nodes, a referral to an ENT specialist or an oncologist may also be appropriate, especially if there is a suspicion of an underlying infection or malignancy.

In the meantime, it is essential to follow your doctor's advice regarding medication for the ulcer and any prescribed antibiotics. If symptoms worsen or new symptoms arise, such as difficulty swallowing, severe pain, or fever, seek medical attention promptly.
In summary, while endoscopy is a critical tool for diagnosing esophageal issues, other imaging studies and tests can provide additional insights into your condition. It is essential to work closely with your healthcare provider to determine the best course of action based on your specific symptoms and medical history.

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