12 year old with difficulty swallowing solids

Patient

Q: I have a 12 year old female that has trouble swallowing food. We have tried to have her eat smaller amounts of food with more liquids and chew longer when eating. She still feels as though she is choking and her esopahgus is narrowed. She has the urge to cough to relieve her symptoms, but does not help. She has had a neck and chest x-ray and revealed no object present. No other test schedule and she still cannot tolerate any solid food at all, only liquids for past week.

Doctor

A:   She should be seen by a doctor as soon as possible because she apparently has a problem with her oesophagus. The cause could be mechanical; it could be a mass or structure outside the oesophagus compressing on it, and/or intrinsic narrowing of the oesophagus itself. There are a number of causes (e.g. fungal infections, strictures, inflammatory conditions, tumors, etc); the cause should be identified then treated. Neck and chest xrays will only detect foreign objects and bony structures; the oesophagus cannot be well demonstrated and she may need more advanced imaging procedures (endoscopy). I do hope this helps and I wish you well always.

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