Monday, October 25, 2010

Trouble Swallowing? Read This

Some of the most frightening experiences I've ever had were when food got stuck in my throat and I couldn't breathe. I've had the Heimlich Maneuver done to me a few times and have had to go to the hospital once I could breathe, but couldn't get the food to go up or down. The doctors injected me with Valium; when that didn't work on one occasion, they had to mechanically push down the calcium pill that was stuck. (Calcium causes muscle contraction; that may have had something to do with it being stuck so badly.) Since I seem to have found something that has ended my trouble swallowing food, I'm sure you'll understand why I feel like I've found the holy grail.

A few years ago, my swallowing problem got to the point that food was getting stuck in my throat a couple of times a week. A gastroenterologist did an endoscopy and found an esophageal ulcer, or hole in the lining of my throat. Food and phlegm were getting stuck there. I also had an acute infection of H. pylori, the bacteria that causes most stomach ulcers, and acid reflux. For some people, an esophageal ulcer or damage from acid reflux may be the cause of their trouble swallowing.

When I asked the gastroenterologists' nurse what caused someone like me, a thin person who ate small, low-fat meals, to have such bad reflux, she said, "Nobody knows." That's not true. Back in 1972, Dr. Atkins' Diet Revolution stated, "Nothing clears up on this diet [the Atkins Diet] more predictably than does heartburn."(1) Indeed, a low-carb diet cured my GERD, or heartburn, this year.

Nevertheless, I was still left with trouble swallowing even after the ulcer healed. Then I tried taking epsom salts for, ahem, a condition at the other end of the GI tract. Sausage, lettuce, fish, bacon--foods that used to get stuck regularly--all went down smoothly when I used the epsom salts. When I stopped, food got stuck again.

According to some abstracts of medical papers I've read, epsom salts reduce or even stop peristalsis, the muscle action involved in swallowing. It seems counterintuitive that epsom salts would help swallowing--unless the muscles in the throat are too tight. Magnesium, which along with sulfer is part of epsom salts, is a natural muscle relaxant. A case report similar to my situation was published in the journal Mineral and Electrolyte Metabolism(2):

Esophagography evidenced a disorder of esophagus motility [ability to move food] with diffuse multiple spasm, reminiscent of the ‘corkscrew esophagus’. A link with the severe hypomagnesemia (Mg 1.1 mEq/l, normal range 1.6–2.1) was suspected, and a therapy with oral pidolate of Mg (1.5 g/twice a day) was started and continued for 4 months. This was associated with a slow progressive normalization of the Mg plasma level and reverted radiographic esophageal findings with disappearance of dysphagia [trouble swallowing].
I'd been taking a magnesium supplement, but at 250 mg per day, it might not have been enough. I now take 500 mg per day of magnesium oxide/magnesium gluconate and 1/2 teaspoon of epsom salts per day. To make the epsom salts palatable, I mix about 8 oz water, a big pinch of Splenda, a few squirts of lemon juice, and 1/2 teaspoon of epsom salts and stir vigorously for a minute. If you want to use epsom salts, try a small dose at first--too much can upset your stomach and have a laxative effect.

UPDATE, December 3, 2010: This week, I had something get stuck, and this is what worked for me: I put some epsom salts under my tongue and squeezed the muscles on the back of my neck (it's an acupressure relaxation technique). It took a minute, but the bite went down, and I had no trouble during the rest of the meal. For emergencies, I've taken some empty capsules and filled them with epsom salts and carry them with me in a little pill box.

Sources:

(1) Dr. Atkins' Diet Revolution by Dr. Robert Atkins, 1972, p. 284.
(2) "Hypomagnesemia and Smooth Muscle Contractility: Diffuse Esophageal Spasm in an Old Female Patient" by Silvia Iannello, Maurizio Spina, Paolo Leotta, Marcella Prestipino, Sebastiano Spina, Nunziato Ricciardi, Francesco Belfiore, Mineral and Electrolyte Metabolism, 1998;24:348-356.

7 comments:

Anonymous said...

Lori,

If this helps, problems with swallowing may also be linked to poor alignment of the neck vertebrae or tight neck muscles. I had a lot of problems with swallowing last year and the early part of this year. I worked on losening tight neck muscles and the problem has all but disappeared. Find a good bodyworker to work on your alignment if you suspect there may be problems there.

Lori Miller said...

Thanks for the tip. I recently wrote a post about neck pain (http://relievemypain.blogspot.com/2010/09/getting-rid-of-your-pain-in-neck.html). I don't think that my swallowing problems were related to neck pain but I can see how it might be a problem for other people. I'm glad you found a solution.

Pramod Korwar said...

Lori,
Thanks for this great post. I have been suffering from swallowing issues for about 7 years. It is not as severe as yours was perhaps. I started using magnesium oil (about 400mg every day) about 4 weeks ago and ingesting 1/2 tsp of epsom salt which I started about 2 weeks ago. Swallowing has improved slightly but not considerably.

How long did it take for you to overcome the swallowing issue? How are you now? Any other advice for me?

Thanks
pk

Lori Miller said...

Pramod, I take a magnesium supplement (I can tell you the exact dosage when I get home tonight).

I don't know if it applies to you, but my father had trouble swallowing after he had a stroke. He improved with some physical therapy.

Lori Miller said...

400mg of magnesium citrate.

Magnesium oxide and epsom salts are mostly laxatives, though I'm not sure if 1/2 t of the latter is enough to do much of anything but put a bitter taste in your mouth.

Pramod Korwar said...

Thanks for your speedy replies. I started using magnesium oil(Mag Chloride) since it is supposed to be absorbed by your body the fastest and the body is supposed to be replenished in 4-6 weeks. I will try this for a couple of more weeks to see how it goes and switch to Mag Citrate. Either way I am confident Mg will cure my swallowing problem. I will update later. Thanks again.

Lori Miller said...

My pleasure. To answer your other questions (I was busy at work earlier), my swallowing improved within a few days of starting magnesium supplements. When I was having problems, though, eating while reading (and not paying attention to my eating) could make something get stuck in my throat. Eating some butter helped it go down. Needless to say, I chew my magnesium supplements and all other pills I take.

A few things that may or may not apply to you can impede magnesium absorption or make you burn through a lot of it: stress, calcium intake, alcohol intake, vitamin D intake, and cardiac surgery.

If you have acid reflux (sour taste in your mouth, especially when you bend over), sour feeling in your stomach, burning throat, heartburn), I recommend a low-carb diet. I've written about acid reflux elsewhere on my blog (it's the first on my most popular post list to the right on the main page: "My GERD is Cured"). Some years ago, I stopped stopped taking acid blockers and suffered from acid rebound. It took some time for my throat to heal from that, and for months I had to be very careful about what I ate so that I didn't get acid reflux again.