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1. SBflyer99 says:

   December 5, 2010 at 5:41 pm

   WHEN TO SEE YOUR DOCTOR

   You have difficulty swallowing that persists more than a day or two.

   * You choke when you try to swallow.

   * You also have ear pain and you are coughing up blood.

   What Your Symptom Is Telling You

   Swallowing is one of those things you hardly think about—until you have trouble doing it.

   But you think about it plenty when it hurts to swallow, eating becomes awkward because it is hard to swallow or you feel a strange sensation or "lump" in your throat.

   Swallowing is as natural as breathing. Your throat muscles go through this motion hundreds of times a day both to take in food and drink and to move along the flow of saliva and mucus your body continually produces. When you swallow, the circular muscle at the upper end of the esophagus, called the sphincter, relaxes, allowing whatever has gone through your mouth and throat to pass on into your digestive system.

   Since it takes relaxation of the sphincter to make this process run smoothly, it stands to reason that a body that is not relaxed as a result of tension, stress or stage fright can tighten the throat. As the saying goes: "That's hard to swallow."

   Other reasons for a swallowing difficulty can be just as innocuous. Chronic irritation of the throat—particularly by dry indoor air in winter—can make it hard to swallow, especially when you first wake up. And if you're not drinking enough fluids, your throat will become dry, making swallowing uncomfortable. And difficulty swallowing is part of the package of a sore throat or the flu.

   If you're a smoker, consider cigarettes the prime suspect. If you're a smoker and your swallowing problems are also accompanied by hacking and pain, consider it a serious symptom that needs evaluation by a doctor.

   Feel like you have a lump in your throat? It's quite likely the cause is acid reflux, a glitch in the digestive system in which stomach acid leaks back into the esophagus because of a sphincter muscle that doesn't always want to stay closed when it should. You can figure that acid reflux is your problem if you also have heartburn.

   In rare instances, swallowing difficulty can be caused by a physical abnormality, such as a spasm of the sphincter muscle. And acid reflux can interfere with swallowing if you have an ulcer. Difficulty swallowing can sometimes be the first sign of a tumor.

   Symptom Relief

   If you're a smoker and you are having trouble eating or swallowing, you should get checked out by your doctor. Also, any suspicious swallowing symptom that you cannot connect to stress, the air or your personal habits should be brought to the attention of your doctor. But for those things that you can control, here's what to do.

   De-stress yourself. Stress and tension can sometimes make life itself hard to swallow. Anything that brings on relaxation—exercise, massage, meditation, yoga, deep breathing—can all release the pressure on your throat, says Michael Benninger, M.D., chairman of the Department of Otolaryngology-Head and Neck Surgery at Henry Ford Hospital in Detroit. Putting a warm compress on your throat during tense moments can also ease the uneasiness in your throat.

   Humidify and hydrate. Because many swallowing problems are caused or made worse by dryness in the throat, putting extra moisture—both inside and outside the body—can be helpful, says Dr. Benninger. Most experts recommend drinking at least eight full glasses of water daily. "And check your furnace gauge," says Dr. Benninger. "You need about 35 to 40 percent humidity in the air. A bedroom humidifier will help. Though the benefits of warm and cool humdifiers are still being debated, the cool-mist models feel better to the throat."

   Treat the reflux. If you suspect you have acid reflux, there are plenty of things you can do to control the condition, including cutting out caffeine, alcohol, chocolate, wine and tobacco, says Dr. Benninger. (For other tips on banishing reflux, see Heartburn on page 249.)

   Examine your anatomy. Although physical abnormalities are rare, your doctor may want to put you through a few tests to rule them out, says Charles Krause, M.D., chief of medical affairs at the University of Michigan Medical Center in Ann Arbor. In one test you drink a chalky liquid containing barium so that your throat and esophagus can be x-rayed. If the cause proves to be a spasm of the esophageal sphincter muscle, the first approach would be a prescription for muscle relaxants, says Dr. Krause. Next, the muscle can be relaxed by insertion of a stretching instrument, a procedure that's usually done in the doctor's office.

   "This often brings permanent relief," Dr. Krause says. In more severe cases, a surgeon can divide the sphincter muscle so it will stay relaxed.

   Congenital problems and a condition called Zenker's diverticulum—in which the lining of the esophagus forms a pouch that interferes with swallowing—may also be corrected surgically.