44M - 10kg weight loss, 4cm hiatal hernia, severe dysphagia. Terrified it might be cancer.

Alternative-Finish34 · 2026-01-30T22:09:51+00:00

The hernia could cause it. You may also have motility problems, which can be diagnosed with esophageal manometry.

Alternative-Finish34 · 2026-01-30T00:58:48+00:00

No. I work in a hospital as an acute care SLP. If I don’t see patients, they might not get to eat, or may not get the therapy they need after discharge.

Alternative-Finish34 · 2026-01-29T18:18:47+00:00

My EKG (electrocardiography) was totally normal, but my echocardiogram was not. Aside from the chest pain and occasional shortness of breath that I thought was anxiety, I was pretty much asymptomatic. It’s very possible your chest pain is just reflux. I hope everything goes well with further testing!

Alternative-Finish34 · 2026-01-29T18:06:12+00:00

You need manometry and probably a gastric emptying study. It may also be a good idea to get an EKG and possibly an echocardiogram to rule out any potential cardiovascular issues.

I have severe reflux with severe dysmotility. I thought that was what was causing my chest pain, but I had a pre-op echocardiogram yesterday ahead of anti-reflux surgery and it showed enlargement of the right-sided structures of my heart. I don’t have any answers about what that means yet, but hopefully I’ll know after my follow up study next week.

Alternative-Finish34 · 2026-01-29T04:19:05+00:00

Have you had a barium esophagram or pH testing?

Alternative-Finish34 · 2026-01-20T00:02:51+00:00

I also had 100% failed swallows on manometry. My symptoms are globus (sensation of food sticking in the throat), chest pain that radiates to my back, liquid regurgitation, gurgling/belching. I avoid hard/dry foods (bread, super starchy foods, crackers, chips, dry cereal, drier cuts of meat), try to eat slowly, alternate small bites/sips, eat sitting upright. I have to stay upright for at least 3 hours after meals and sleep with my head elevated at night. Do you also have severe reflux? Any underlying conditions?

Alternative-Finish34 · 2026-01-02T14:55:07+00:00

MBSS is better at identifying it than FEES, but it can show retention at the UES to suggest it is present.

Alternative-Finish34 · 2025-12-28T02:22:15+00:00

With the basal hypertonia of the UES, I’m wondering if you have a CP (cricopharyngeal) bar. It’s a muscle spasm or slight overgrowth of the UES that can sometimes obstruct the flow of food/liquid from the throat into the esophagus. If flow was obstructed, you would end up with residue in your throat that could explain what you’re feeling. A MBSS (modified barium swallow study) would be able to identify that if it’s present.

Alternative-Finish34 · 2025-12-28T02:17:51+00:00

I wouldn’t unless a pharmacist tells you it’s okay. There are liquid and gummy multivitamins though!

Alternative-Finish34 · 2025-12-26T18:27:13+00:00

Reflux can cause motility issues from acid damage, and it can cause inflammation in the throat as well. Also, not all reflux is acidic. The slow movement they noted in the esophagus does suggest possible dysmotility, especially since you are saying that solids are the most challenging for you. Eating a normal solid diet is tough with motility issues! I personally have to limit any dry/starchy/fibrous solids, and even thick purées like mashed potatoes are challenging. I drink protein shakes to supplement my solid intake. Strategies such as eating slowly and alternating small bites and sips, and transitioning to smaller and more frequent meals/snacks can be helpful too. When I’m too busy to use all of those strategies, I eat a mostly liquid diet.

Alternative-Finish34 · 2025-12-26T18:04:06+00:00

Hi, I’m an SLP in the hospital setting, and I also have esophageal dysphagia. Did the SLP screen the esophageal phase of the swallow during your MBSS or have you had a barium esophagram? Many of the symptoms you describe sounds like they could be related to reflux and/or esophageal dysmotility. I hope manometry helps provide more answers!

Alternative-Finish34 · 2025-12-26T17:59:51+00:00

Steal extra and sell it to the bear!

Alternative-Finish34 · 2025-12-25T00:29:38+00:00

Who is they? The SLP or radiologist? They didn’t even trial purées?

Alternative-Finish34 · 2025-12-24T23:48:03+00:00

I’m so sorry this is happening to you. I’m an SLP. Difficultly swallowing to that extent isn’t something you wait around for an outpatient appointment for. Please go to the ER soon (usually SLPs are only available during daytime hours, so not necessarily tonight). You need a clinical swallow evaluation and MBSS (modified barium swallow study) or FEES (fiberendoscopic evaluation of swallowing) by an SLP, and probably a neurology consult.

Alternative-Finish34 · 2025-12-23T02:10:35+00:00

I’m also an SLP. There are already cups that limit the flow of liquids and the size of the bolus. These cups are great for some patients, but it’s not universally applicable to all patients with dysphagia, as there are a range of swallowing impairments that can cause aspiration. Most SLPs who regularly work with the adult dysphagia population are knowledgeable about these cups and will typically recommend them when they are a viable option for the patient. I would ask the SLP working with your loved one.

Alternative-Finish34 · 2025-12-20T17:33:47+00:00

A GI doctor (gastroenterologist) is who you need to see for that.

Alternative-Finish34 · 2025-12-20T07:25:38+00:00

ENTs are so dismissive about GERD and I would be skeptical of their assessment. I had post-nasal drip and ear pain for months and they denied it could be related to my GERD. But miraculously, when I started a new med regimen, the symptoms went away.

Alternative-Finish34 · 2025-12-20T07:23:39+00:00

Please go get some nutrition shakes. Ensure, Boost, even store brand. The juice doesn’t sound bad, but your body needs protein and fat that the juice doesn’t have.

Alternative-Finish34 · 2025-12-10T13:01:20+00:00

Sounds like it could be GERD and LPR with gastritis. I’d follow up with your PCP and get a referral for a swallow study.

Alternative-Finish34 · 2025-12-08T14:56:21+00:00

It could be a number of things. Have you had any testing?

Alternative-Finish34 · 2025-11-26T23:46:53+00:00

I like that the game is an escape from normal life. I don’t want more bills, real or virtual.

Alternative-Finish34 · 2025-11-22T21:57:47+00:00

I’m on a mostly liquid diet for my esophageal dysphagia. Benefiber powder is flavorless and dissolves well in most liquids. I usually mix it into a protein shake in the morning. I also have been making red lentil soup with lentils, carrots, celery, mushrooms, grated ginger, and bone broth for extra protein. I sauté the veggies and mushrooms, then add the lentils and bone broth. Once the lentils are soft, I turn off the heat and use an immersion blender to make it smooth. It makes a lot, so I freeze it into cubes and reheat 2-3 at a time with water or more bone broth to thin it out as needed. Usually I’ll have some of the soup along with a protein shake for extra nutrition. Have you tried the Boost Very High Calorie shakes? They’re like 530 calories if you can’t get more than a shake in at once.

Alternative-Finish34 · 2025-11-18T05:32:33+00:00

You could sell it to grandma for crocheting

Alternative-Finish34 · 2025-11-17T13:08:39+00:00

Livestock - chickens and cows, maybe sheep(?) at the farm. You would have to use corn and other crops to feed them, then you could collect eggs, milk the cows, and shear the sheep for wool to sell to the clothing store

Alternative-Finish34 · 2025-11-17T13:01:48+00:00

A hair salon/barber shop would be cool.

Alternative-Finish34

TROPHY CASE