Sensation of Food Sticking In the Throat: Is GERD to Blame?

Whendiagnosing and treating oral-pharyngeal swallowing disorders, we must be mindful of the relationship between events occurring in the lower esophagus particularly at the lower esophageal sphincter (LES) and the status and function of the upper esophageal sphincter (UES). Althoughthe physiological mechanisms at workhave yet to be fully determined, it is understood that manypatients with gastroesophageal reflux disease (GERD) complain of symptoms well above the LES, often in the neck. A 2004 study by Brent Roeder et al found that 31 of 46 patients with LES disturbance and GERD referred their symptoms proximally.¹

What to Do When Patients Complain of Food Sticking in the Throat

Patients quite commonly complain of food sticking in the throat when visiting a speech-language pathology clinic. These same patients may have a normal videofluorographic swallow study.

In these cases, clinicians are advised to do the following:

• Take a thorough history asking questions that relate to GERD

• Screen the esophagus with the patient standing and swallowing a solid food bolus (i.e. a piece of bagel or a marshmallow)

GERD May Be the Cause of SwallowingComplaints

As speech-language pathologists, we usually focus on the oral and pharyngeal stages of swallowing. However, we must be cognizant that GERD may cause oral-pharyngeal complaints particularly when a patient says, food sticks in my throat.

SLPs need to recognize that patients with long-standing cervical dysphagia complaints may never have been effectively evaluated for GERD, which might be the source of their difficulties. Even patients with suspected GERD may not have had the proper examinations to detect their reflux.

Why Managing GERD is Important

Untreated GERD has a significant negative impact on a patients quality of life. While there is no strong evidence that treatment of GERD eliminates the symptoms of food sticking in the throat, the management of reflux is necessary to minimize the risks for other medical complications.