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19 years
What is the cure or therapy of this nerve?
Sep 13, 2014

Dr. Zakia Dimassi Pediatrics
The fact that you're experiencing discomfort during swallowing, known as dysphagia, needs to be investigated. A detailed history of the symptoms (including time of onset, frequency, severity, associated symptoms, factors that improve or worsen the pain, current medications, any surgeries) and a thorough physical examination are indispensable to identify the source of the pain.
Your symptoms are most likely coming from the esophagus. Possible causes include:
1- Esophageal motility disorders (that is to say, the muscles in the esophagus are not contracting properly to propel the food bolus or fluid downward):
- Achalasia: no downward muscle contraction wave to push food into the stomach
- Diffuse esophageal spasm
- Eosinophilic esophagitis: a kind of allergy of the esophagus
2- Mechanical obstruction of the esophagus:
- Peptic stricture: if you have acid reflux, the esophagus could get injured and the healing process may result in the formation of a stricture that narrows the esophagus, hence the discomfort/pain upon swallowing
-Lower esophageal rings
-Esophageal webs
Extrinsic compression (eg, caused by an enlarged mass pushing against the esophagus, such as an enlarged part of the heart
- A mass in the esophagus
Two rare and much less likely possibilities are:
1- Chronic inflammatory polyneuropathy: a condition in which there is nerve swelling and inflammation to the nerves outside of the brain or spinal cord, which may lead to a loss of movement or sensation. Progressive weakness and impaired sensory function to the arms and legs develop over time. The symptoms of chronic inflammatory polyneuropathy are caused by damage to the myelin sheath, a substance that coats nerve fibers allowing them to conduct nerve impulses. Symptoms of chronic inflammatory polyneuropathy include facial weakness, difficulty using the extremities, weakness of the extremities, breathing difficulty, hoarseness, swallowing difficulty, bowel or bladder problems, joint pain, muscle atrophy, and loss of function or feeling in the muscles.
The choice of treatment is determined by the severity of the symptoms. Corticosteroids may be used to help reduce inflammation. Other options include immunosuppressant drugs, intravenous immunoglobulin, and plasmapheresis. Physical therapy is important to improve muscle strength, function, and mobility.

2- Relapsing polychondritis: an entitiy that causes inflammation of the cartilage in the body. Organs that contain cartilage become swollen, including the eyes, heart and blood vessels. The underlying cause for relapsing polychondritis is poorly understood, but the immune system, which normally fights infection, mistakenly attacks the cartilage throughout the body.
Symptoms include pain, redness, and swelling of the ears, nose and joints. Additional symptoms of relapsing polychondritis include back pain, neck pain, hoarse voice, eye pain, blurry vision, and cataracts.
The mainstay of treatment is nonsteroidal anti-inflammatory medications, and medications that suppress the immune system.
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