My father failed is barium swallow test, everything he swall.

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Patient: My father failed is barium swallow test, everything he swallows goes into his lungs. I have been told that a peg tube is not an option because he has a history of etoh abuse so basically he will just be allowed to die because he can’t eat by mouth? Is this true that if you have a history of etoh abuse that you can not have a peg tube inserted for nutrition?

Symptoms: He also has some liver failure going on as a result of the alcohol abuse.

Doctor: Hi.Sorry to know that your Father has TO (tracheo-esophageal) fistula allowing anything swallowing going into lungs. T he barium or for that matter anything that goes into lungs would have been too toxic and cause dreaded complications.As per the history you have provided, ETOH abuse has caused liver failure also, and hence there may be the complication of esophageal varices large enough not to use PEG tube.Secondly the fistula might be very high up in the esophagus making the stenting difficult to be viable option.Please post the photos of Barium if available.Please let me know the medical condition that your Father is in at the moment – about the condition of the lungs, liver, cirrhosis, portal hypertension, kidney condition and anything else that you can share.Alcohol abuse alone is not a contra-indication for the stent/peg tube.Alternate methods of Jejunal feeling tube, parenteral nutrition and so on can be tried, if the condition of the patient allows (difficult due to co-morbidities if your Father have.Pleae give feedbask.I hope this answer helps you, please feel free to ask for further relevant queries if you feel that there is a gap of communication.

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Dr. Jimmy Obaji M.D.

Dr. Jimmy Obaji completed his residency in Family Medicine at the University of Manitoba. He currently operates a walk-in-clinic in downtown Toronto.

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