Difficulty when swallowing, side effect?

I only noticed this since starting meds, I will check with doctor but has anyone else had this problem? It feels swollen and when I eat I have to take a drink otherwise I feel I make choke....

Cheers

[lulul]

Hi Wilby

As far as I am aware this is not usual..what meds are you on?? I am a specialist speech and language therapist and part of my role is to assess dysphagia (disorder of swallowing). Most of our swallow function is governed by muscle control and strength rather than joints etc( although your jaw can be affected in RA but would only have an impact on swallowing if your chewing action was limited.) Do you feel like food gets 'stuck' in your throat? Do you have coughing fits with eyes watering etc Have you lost alot of weight or had recurrent chest infections? ( If there is swelling in the larynx this can feel swollen and impinge on swallow function as movement of the larynx during swallowing is laboured but in my experience is rare). Have you tried altering your food texture slightly? It helps to have soft moist food which you can sink a fork into. Use gravy/custard/sauce to moisten meals. Chew well and tuck your chin down during swallowing. If it continues seek medical advice and disclaimers etc apply!!! Sometimes just a sore throat/infection can make swallowing difficult also but is short lived once the infection clears.

[Hidden]

Hi Lulu,

I am on MXT, sulfaslasine, hydorxychloroqine and naproxen! excuse any spelling mistakes oh and a few steroid injections...

No cough or chest infection and yes, feels like it's getting stuck. My jaw/joint has been affected but as you say swallow function is muscle not joint so was am a bit muddled about this one! no weight loss or gain and I'll have to give up on certain food, especially bread, thankfully chocolates fine! It started 8 weeks or so ago (only on meds for 13ish weeks) but gradually getting worse.

I wondered if it was just inflammation liked to RA but not sure how it all works. I do suffer from a lot of indigestion and maybe that may be damaging somehow?

Thanks Lulu, good to have your expertise

[Gina_K]

Hi Lulu,

If you are a bit anxious can cause difficulty swallowing, like lump in throat?

[Hidden in reply to Gina_K]

think I'm too greedy to be anxious when eating

sure it feels swollen

[Hidden]

think you require some omeprazole or ranitidine to protect stomach from meds.. also these supress acid production at source,, the fancy name for them (proton pump inhibitors).. just means they do what described.. lump in throat called also be stress reaction se gp in either case

alison

[Gina_K in reply to Hidden]

I take omeprazole (losec) before diclac, to protect tums

[Hidden]

Not a side-effect that I'm aware of - as always, if in doubt contact your rheumy team and/or gp. It sounds like it's gone on more than long enough and as it's worsening and affecting your food choices I would contact the clinic on Monday!

Meanwhile, eat safely,

Cece x

[Hidden in reply to Hidden]

I managed to find info on Naproxen side effects and oesophagitis,, also explains why I've been getting 'ringing' in my ears!

I'll check it out with doc but will take some gaviscon in the meantime... unless alison you could reccomend something better from over the counter?

every day, I'm thankful of this site and all who advise! x

[Hidden in reply to Hidden]

Hi Angela

I tend to get this if I take 500mg of Naproxen. I might be wrong or it could just be me, but the things are so ruddy big they start to dissolve at the back of my throat before I can swallow the damn things. They then irritate all the way down until the amount of water I guzzle sends it safely on its way! If you don't realise the throat and oesophagus can become quite inflamed (which you then put down to sore throat!) and you continue to add to the problem!

Answer: snap the bloomin' things in two ... much easier to swallow!

Hope you feel better soon,

Lyn x

[Hidden]

I take stomach meds and gaviscon when I feel symptons like yours but if I still get them while on stomach meds I take gaviscon also.

Sorry for short reply hands bad today xx

[Hidden]

gaviscon is different it is just used for indigestion does not protect stomach!! you can buy ranitidine tablets over the counter v cheap if you have a supermarket pharmacy eg asda or sainsburys their own brand though below preccription strength for legal reasons while suffice!!, go to gp for prescription best. you can buy an expensice relation of omeprazole over the counter called pantoprazole same family but at £9 for about ten tablets I wouldnt bother .. ranitidine over counter v cheap only £1.75 or so but its only 75mg a fraction of the prescription stength// if it straight indigestion gaviscon ok but this quite expensive to buy.. see dr and get prescription best x

[Hidden]

gaviscon shouldnt not be taken within an hour of taking omeprazole is it will stop the omeprazole working.. for reference. ra- fibro xx

[lulul]

Gastric difficulties, which is what the above meds help with, are different to oro-pharyngeal dysphagia which is actually difficulty moving the bolus from the mouth through the phaynx and into the oesophagus. Gastric meds won't help if difficulty is at the orophayngeal stage although reflux can impede partially. I would keep a food diary and record your intake and mark which foods are problematic. Then see your GP for advice. Good luck hun x

[Hidden]

Thanks all!

Spoke to the pharmacist today and she told me judt to wait until I see the consultant (friday).

She wouldn't give me anu gastris meds as I;m not meant to take then at same time of day as sulpfa and hydrox which I take morning noon and night....

Now you mention it Lulu, I think it doese get worse if I drink coffee, although thats not hard to swallow maybe it's irritating it in the first place.

I suppose I just expected it to be hand in hand with RA.

Cheers xx

[Hidden in reply to Hidden]

as my eariler post i did suggest seeing GP we can advise in out own right but we are not meant to be an outright substitute for gp or consultant advice.. Suspect the following issues.. ra meds are specialist topic most pharmacy staff have no specialist training the training body to my disgust have no training modules. cpd or e-learning material on ra or its meds!!. Im going to an imflammatory bowel workshop its was june 14th but has been moved to june 21st.. I have to do nine items of professional development a year.

the drugs issue was prob cos the pharmacist didnt want to issue advice cos the gp had your complete medical records she and us on here for obvious reasons do not.. the other issue is tablet juggling more complicated as the naproxen and the sluphasalzine have usually an enteric coating, which means the dug isnt realeased until it hits the stomach cos the drugs are quite harsh on body tissues,now acid is produced by the stomach and the prazole drug inhibit acid production to stop symptoms of acid indigestion, hiatis hernia and barretts oesphagus so there beccomes a balancing act with which tablets to take, when and how. A very experinced gp or regular pharmacist who has acess to all your medictions should be able to do a medicences use review.. out of interest I was eying up course. on this medicenes use review at worcester it was on the thirteenth of june day before the date of my original course these are held in the evenigs. but with the distance , driving and my faigue levels cancelled.. you need to find an experinced GP who knows you and your medical history or a pharmacist who has been qualifed for at least five years.. some of the newer pharmacists lack the depth of knowedge as do I !it comes with experince.. or my case Im going to learn about RA with aim to helping myself and others on here

[Hidden in reply to Hidden]

Thanks again Alison,

I did get the impression the pharmacist didn't know but I suppose they don't want to take any risks. My GP tends to leave any concerns to my consultant also.

I was at the dentist last week, although very nice, she was unsure about meds and how I may be effected when it come to teeth/gums and jaw.... with 1 in a 100 having RA, we're not that unique surely!! i'm surprised pharmacy staff don't undertake CPD as you say in this area..

What I experience is very similiar to Tricia's reply below.

I have Amy trying to swipe at the keyboard and will have to go,

last thing, interesting about the coating on meds and why

cheers xx

[Hidden]

Even though I take nexium as my ppi and use gaviscon I have very rarely felt as if I have indigestion however I have a hietus hernia and barretts osophegus. My first symptoms of these were trouble when speaking losing my voice very quickly with an odd sensation near tonsill area also bad stomach pains worsened with certain foods and I can't really remember any other symptoms but thanks for the advise summer my gp never told me that even though I asked after reading notes for nexium

[Hidden]

as long as an hour left between gaviscon and prazoles its ok. we label are meds in that way at hospital and ciounsel patients to that affect also. typcoal taking times prazole morn before breakfast then gaviscon when required aftr a meal by obvious definition you get your min of an hour between and your nexium esomeprazole ppi. impressed you used the word ppi.. you done your home work..

xx

[Tricia-P]

hi Wiliby

I have this and I've been told it is inflamation around the osaphagous as RA is inflamatory it can effect ligaments cartlidge and other organs. Nice.

I find I have to have cold water by my side when I eat and I can get the feeling any time it might happen all the time for a few days then just once say at dinner, then not again for a couple of days. I have even had the feeling that I was choking when I was eating mashed potato and before you say anything no it wasn't lumpy. So as all advise has given you has been excellant you are not alone I get it as well.

Triciaxx

[Hidden in reply to Tricia-P]

wow tricia !help me learn plwase that is fantastic stuff, I need to learn as much as possible. i always glug loads of water and take my meds loads!! in twi batches ten appart.. small ones like steroids and loose stand alone codeine 15mg tabs,, then the larger ones eg if you take naproxen or sulphasalazine 2nd.. I DONT take these two meds, my ant inflam of my choice is arcoxia but doesnt suit some people we are all difffernt this is small ans vaguely apple shaped

[Andrea_Shapiro]

I've noticed this. I panic & flap my arms a bit. My throat is very dry: I put it down to morphine sulphate. I never experienced this prior to Oramorph & Morphgesic. I told my GP that I wasn't happy about the pain relief, but she was insistent upon higher level. I take a pint of water to bed with me. I still experience choking when I go to swallow, frightens the hell out of me.

[jelly4toes]

just wondered if you got to the bottom of this problem.I amfinding I have a very very dry mouth a lot of the time and also trouble swallowing food tablets etc.I also keep finding that my teeth are decayin when I always take care of them.I think its something called sjorgans,ignore my spelling.It seems to be a common feature of people with RA.My Rheumy is keeping an eye on it.I think that it definitely is