Naked Science Forum
Life Sciences => Physiology & Medicine => Topic started by: SippnCoffe on 12/08/2011 01:22:47
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I am having a very strange symptom of gurgling in my throat, to a greater or lesser degree, each time I swallow water or even a barely noticed swallow of saliva. I think it may be Zenker's Diverticulum. My doctor has ordered a barium swallow for me. I am very hesitant to have this procedure for the following reason. During my lifetime I have had numerous spinal xrays during diagnosis of scoliosis at age 11, and the monitoring of the curvature, then the follow-up to the surgery, then a two "I'm worried the curvature may have changed" xrays during my adult life. Also, the normal dental xrays, and then recently (due to a misunderstanding) two panoramic dental xrays in the span of two weeks. Plus two knee replacements in this past year and the attending knee xrays before and after surgery. Whew! I learned from a radiology department head that just from my scoliosis xrays that I have a 16% greater risk for breast cancer. I am concerned about the additional exposure from a barium swallow procedure. I would like to suggest to my family doctor that I should see a specialist who could determine whether an endoscopy might diagnose my problem without having to have the radiation exposure. Can you give me any guidance with this? Oh, also, 25 years ago or so, I had an endoscopy and a bend in my esophagus was discovered. I am wondering whether this gurgling may be caused by a new, additional bend in my esophagus.
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Scoliosis, multiple joint replacement, structural changes in the “bent” oesophagus, and now with oesophageal dysmotility.
They could all be caused by a systemic auto-immune disease,
(connective-tissue disease (http://www.nature.com/gimo/contents/pt1/fig_tab/gimo40_T1.html), aka collagen-vascular disease).
Esophageal motility disorders may occur as manifestations of systemic diseases, referred to as secondary motility disorders
http://en.wikipedia.org/wiki/Esophageal_motility_disorder#Esophageal_motility_disorders
If you haven’t already done so I’d suggest you see a rheumatologist.
BTW an endoscopy would not be an adequate substitute for a barium swallow : it wouldn't show the swallowing action.
http://en.wikipedia.org/wiki/File:Normal_barium_swallow_animation.gif
e.g. if the swallowing problem was neurological (a wiring fault) it wouldn't be detectable via endoscopy, but could show up on a movie of the swallow.
In the spastic disorders of the esophagus, endoscopy is often normal.
http://www.nature.com/gimo/contents/pt1/full/gimo29.html
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Thank you for your response. I do see a rheumatologist for my rheumatoid arthritis. I see her again in November and will mention this esophagus problem to her, too. I also checked with my family doctor again today with the question of whether an endoscopy would be best to try first. Her response was the same as yours. So,one other question: Can you give me some sense of the relative dose of radiation I will be receiving with this barium swallow? I try so hard to avoid xrays and I feel that I can't avoid this one. I would like to go in with a realistic idea of how much more, yet again, I am being exposed and adding to my already relatively high lifetime total exposure. Like everyone, I fear cancer and don't like having to increase my risk.
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I'm sorry I can not offer any further advice to that which has already been given by RD but I do want to wish you well and hope that you will return to this thread and let us know how you are !
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If this table here
http://www.morton.co.za/Web/content.aspx?page=42
is right then the dose is roughly the same as a year's worth of natural background radiation.
So, it's not something to do for fun on a wet afternoon, but it's not a major risk.
Best of luck.