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Dry throat and difficulty in swallowing saliva.ENDOSCOPY.

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Hello Doctor, Iam 30 yr old male. 5 months back i had difficulty swallowing saliva (all times and still persists) , sore throat comes and goes,it felt like when i swallow saliva... it passes through a speed breaker and then goes, very rarely i had slight pain.

I consulated ENT doctor and the doctor took xray, endoscopy and said there is no infection. Gave 'Lactic Acid and Bacillus Fortified with Vit. C' for two weeks and no improvement. I went to doctor again after a month, doctor gave some 'Vanprox (Rabeprazole Sodium with Domperidone Capsules)' twice a day before food for 3 weeks... some 5% improvement. Before taking this tablet there was no burp and after, i have atleast 4 to 5 burp every day.

I lost hope and then another doctor suggested its acidity and gave 'Pantoprazole tablet: pantocid' once a day. 6 days over, there is some improvement say 20% some time and sometimes throat becomes tight making it feel 5 % improvement...its fluctuating.

So its been 5 months and i am very concerned. i still have difficulty swallowing saliva and also nowadays i have slight throat pain (not all times). I was also said after blood test as sub clinical hypothyroidism, the TSH value came recently as 8. (4 months back TSH value was 5.5). BUt i have no hypothyroid symptomes other than Swallowing saliva difficulty. I also have cavities in upper both wisdom tooth with no pain.

Request you to please suggest whats the problem. Since 5 months, many crazy thoughts passing my mind.

Also, should i consult, an endocrinologist or gastroenterologist or what test should i take to find the cause for this swallowing saliva difficulty. Should i have to take ultrasound, other tests by an endocrinologist to confirm this is not bcoz of thyroid (TSH 8). Please help.

P.S: Medical History: I did a full body checkup couple of months back and all came Normal. Only TSH value came as 8 last week. My mother has Diabetes, Blood pressure and father has asthma. I dont have any pain while swallowing. The only thing is everytime i swallow saliva, its difficult like its passing through a thick layer, some small ball stuck, throat dry. It started 3 weeks after i had a vomitting once due to some food and this swallowing saliva persisting for 5 months now.


Category: ENT Specialist

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Category: ENT Specialist
Dr. Sunil Jalan is online now

Expert:  Dr. Sunil Jalan replied 4 Days.

Hello.
Thank you for your query at DoctorSpring.com.
I can understand your concern. You have difficulty in swallowing saliva since the past 5 months and have found some improvement with Pantocid. As your endoscopy (Laryngoscopy) and X-ray are normal, there is no obvious pathology in throat. Since you are young and are getting benefit with anti-reflux treatment(Pantocid), it is most likely that you have GERD (Gastro-Esophageal Reflux Disease).

I have the following suggestions.
-You can continue with the same medication, Pantocid, minimum 30 minutes before a meal, for 1 to 3 months.
-For GERD, you need to strictly follow the following lifestyle modifications : Avoid excessive spicy food, cold drinks, fast food, smoking and alcohol. Avoid coffee, maximum 2 cups of tea in a day. Drink plenty of fluids including water. Undertake physical activity like walks every morning and evening. Don’t lie down immediately after lunch or dinner. You can lie down only 2 hours after any meal.
Head end of bed should be elevated by keeping a pillow underneath the head end of mattress.
If your symptoms are not improving you may need to consult a gastroenterologist for Oesophagoscopy(Upper GI scopy). If you do not any other symptoms of hypothyroidism including weight gain/ excessive sleepiness, constipation, cold intolerance, pigmentation of skin then we can consider it as subclinical hypothyroidism. If you have any of these symptoms, then we can start low dose of Eltroxin 25 micrograms, once in the morning and can repeat TSH after 3 months. You can take the opinion of an endocrinologist for the same.
Hope this helps. Feel free to ask queries.
Best regards.
Dr. Sunil Jalan, MBBS, DLO, MS, DNB (ENT), DAA, MBA (HM).


Dr. Sunil Jalan
Category: ENT Specialist
Experience: 
DAA (Diploma in asthma and allergy) : Christian Medical College, Vellore, 2012
D.N.B (ENT), 2011
Residency - M.S. (Master post graduate degree in otorhinolaryngology),  Christian Medical College, Vellore, 2009
D.L.O. (Diploma in otorhinolaryngology) - Christian Medical College, Vellore, 2007
Medical School - M.B.B.S, S.P. Medical college, Bikaner, 2004
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