Throat Problem in Body Builder

Patient: For 6 months I have had a constant pressure/choking sensation in the mid to lower right side of my throat. Also upper right sided chest pressure (close to the sternoclavicular joint, that comes and goes. I have never had heartburn. I have had a barrium swallow, upper endosocopy with biopsy, ct scan of the chest, chest x-ray, laryngoscopy, blood tests and urine exams. All have showed clean results except the endoscopy did show tightness in my upper esophogaus, for which the g.i doctor has prescribed nexium and form of mouthwash (prednisone, lytocane, nystatin, and carofet assuming the problem is acid reflux. And the barium swallow showed an air pocket on the right side of my throat. However I have been on nexum 40 mg’s twice a day and the mouth wash for 3 months and have found no relief. I am a bodybuilder and all these problems began after costochondritis which was brought on by really heavy bench pressing, It is very horrible to experience this choking sensation all day. Help please

Doctor: I truly understand your concern about the chocking sensation that you have been feeling for a period of time.  According g to your previous evaluation, GERD was suspected and the treatment was started, however if you don’t feel any improve, other causes have to be considered.Since you are a Body Builder, in my opinion the presence of increased muscle contraction in your neck muscles might be one of the causes of pain and chocking sensation that could be related to incorrect posture during bench press. You could correct this by contracting your abs during this type of exercise; this will take the stress out of your neck. Other causes such as esophageal spasms might need to be ruled out by motility studies by your physician.Heavy lifting and strenuous exercise have been linked to costochondritis which is one of the most common causes of chest pain. This is the inflammation of the cartilage that connects the ribs to the sternum. Causes pain and tenderness in the locations that you mention, often sharp, though also dull and gnawing pain usually increases when taking deep breaths and coughing.The continuous stress that you put on your body might be contributing for this inflammation to persist. Certainly a physical evaluation will rule out this possibility, the reproducible tenderness you feel when you press on the rib joint is a constant feature of costochondritis. Without this tenderness, a diagnosis of costochondritis is unlikely, you could try this yourself simply by applying pressure where you feel the pain, if you feel the same tenderness, it might be the cause and if this is the case rest and anti-inflammatory drugs might be needed. I wish you a prompt recovery.