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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor
Category: Medical
Satisfied Customers: 33066
Experience:  MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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I have a catch in my throat when I swallow. I have noticed

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I have a catch in my throat when I swallow. I have noticed that my "adams apple" appears shifted to the right about 1-1.5cm. I have chronic allergies and smoke. Am I screwed?

Greetings.

 

Since how long are your symptoms?

Do you have any weight loss, loss of appetite, evening rise of fever, night sweats?

Any significant past medical or surgical history?

 

Dr. Arun

Customer: replied 7 years ago.
No significant medical/surgical hx, no recent weight loss, or loss of appetite, fever or night sweats. Hx of Gerd, asthma/rad and smoking. Please be candid with me I have a medical background.

Hello,

 

Just GERD can explain all of your symptoms. Most of the people would be worried about the cancer with your medical history, personal habits and symptoms, but cancer would constitute less than 15% of total cause with your manifestations. So I would be candid but also like to tell you that this is a possibility but not the only one. There are other causes too with your symptoms and only GERD can explain all of these, as I mentioned. The other causes to look for, would be;

 

1) Achalasia

2) Pharyngeal diverticulum

3) Tracheal cancer

4) Esophageal cancer

5) Diffuse esophageal spasm

6) Lower esophageal ring

7) Eosinophilic esophagitis

8) Peptic stricture

 

So an esophagoscopy and a larygosocpy would be essential to ascertain the cause and clinch the diagnosis.

 

Please feel free for your follow up questions.

 

Dr. Arun

Customer: replied 7 years ago.
What would you say about the tracheal displacement? When I swallow food or drink there is little or no symptoms, but when swallowing dry I feel it the most. Also, I forgot to mention that I have a palpable "mass" at the head of my eighth or tenth rib next to my sternum.

Please let me know what you think.

Hello,

 

A tracheal displacement can occur due to the muscle spasm, which is the commonest cause for it. Only a very advanced cancer which had profound symptoms may have displaced it, but then that is not common cause for tracheal cartilage shift. The other disorders like neuromuscular problems are the other cause for the tracheal cartilage shift.

 

A palpable mass at the 8-10th rib is difficult to comment about. In all likelihood they cannot be related to either the vocal cord or tracheal cancer or esophageal cancer as they do not have any connection to this site. The lumps here are likely to be a lipoma, lipofibroma, fibrolipoma or a neurofibroma.

 

It is pleasure and privilege assisting you.

 

Dr. Arun

Customer: replied 7 years ago.
Thank you,

What about a lung or bronchial mass?

Hello,

 

You are very welcome.

 

A lung or bronchial mass do not give palpable mass on the chest wall and is not the way to present. A palpable mass on the chest wall is highly unlikely due to the visceral cause.

 

I hope this was helpful to you. If it was, please remember to ACCEPT the answer so I can get compensated for my work. if you have any more questions, please feel free to ask. I am truly privileged to help you, and I want to make sure that you are satisfied with the answer. Good luck!

 

Dr. Arun

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