Food Blockage in the Esophagus: Causes, Diagnosis, Treatment, How to Handle Food Blockage in Esophagus

The esophagus or the food pipe is a hollow, long food tube that carries liquid and food from mouth to the stomach. It can become injured or blocked in different ways. If the food pipe gets narrowed or blocked, food is not able to pass into the stomach thus causing various health issues. In this article, we discuss what causes food blockage in the esophagus and ways to treat it.

The esophagus can be blocked temporarily by food or any other foreign object. One of the causes of food blockage in the esophagus is improper swallowing, which is often temporary and the food stuck can be removed through coughing. In most of the cases, it can be removed either by coughing or by slapping the person hard between his shoulder blades by using a first-aid technique. Sometimes, the food may not be removed easily and the person needs to visit a hospital to get it removed through medical procedures under general anesthesia.

However, it is important to know what causes food blockage in esophagus. The major cause of food blockage in the esophagus is narrowing of the esophagus. Narrowing of the food pipe may happen when scar develops after surgery to a food pipe, however, it may also happen, when it gets burnt for example on swallowing a chemical. The narrowing may develop even because of some illness such as Epidermolysis Bullosa or EB.

The other conditions that can cause food blockage in the esophagus also include esophageal spasm or motor abnormalities of the esophagus.¹ In this, the person often feels relieved once the constricted muscles relax and the food is able to pass through the esophagus.

Normally, food blockage in the esophagus can be relieved once the person bends forward, coughs up the impacted food or vomits out. However, if this does not work and if the food blockage in the esophagus is acute, causing great difficulty, often an emergency treatment is needed.

Necessary scans and endoscopy help in the diagnosis of food blockage in the esophagus. A scan known as the contrast scan may show a narrow area of a food pipe.

Contrast scans use a white and thick liquid known as barium that can be seen well on x-rays. At times, a clear liquid is used that looks similar to water, however, may taste like peppermint. This shows up on x-rays too.

In endoscopy, a thin but a flexible tube that contains a light and camera is passed into the food pipe to show where it’s narrowing. This is suggested for confirming the diagnosis of the contrast scan or for further evaluation of the narrowed esophagus when there is a doubt regarding the blockage. This may be in combination with medications during the process.

The first thing to be done in order to handle food blockage in the esophagus is to cough forcefully to bring out the food which is stuck. Alternatively, if there is another person nearby, they can gently hit in the back in between the shoulder blades to help in bringing out the food which is blocking the esophagus. If there is no relief, reach out to the nearby hospital in the emergency department. A gastroenterologist can perform a process to dilate or expand the esophagus. This treatment is used when the narrowing is too severe or the food becomes lodged in an esophagus. In esophageal dilation, you may use one or more devices; small narrow tubes are inserted via the esophagus to suck the blocked food out.

Treatment for blocked esophagus can reduce symptoms, manage complications, and also treat any underlying cause of it. The ways to treat food blockage in the esophagus depend on the underlying cause.

Some of the most effective ways based on the cause include:

Reflux Esophagitis: One of the best ways to treat food blockage in the esophagus is to treat reflux esophagitis. Treatment for it includes the following:

• Over-the-counter Treatments: It includes antacids and the medications that lessen acid production, and the medications, which block acid production as well as heal it.
• Prescribed Medications: It includes the H-2 receptor blockers and proton pump inhibitors. You can be prescribed prokinetics that can empty your stomach.
• Surgery: When the interventions do not work, Fundoplication may improve the condition. A part of the stomach is wrapped that separates the stomach and esophagus. This provides strength to the sphincter.

Eosinophilic Esophagitis – This too is a common cause of food blockage in the esophagus, hence must be treated at once. Treatment for this includes the following:

• Proton Pump Inhibitors: Doctor may prescribe a proton pump inhibitor like lansoprazole (Prevacid), esomeprazole (Nexium), or pantoprazole (Protonix).
• Steroids: Some studies have revealed that steroids may help in treating eosinophilic esophagitis. The same medications that are used to manage asthma can treat it.
• Elementary Diets: Reaction to a food allergen may cause eosinophilic esophagitis. So, removing that food can be an effective strategy of treatment, which is often advised by doctors too.

Drug-induced Esophagitis: One of the ways to treat food blockage in the esophagus due to drug-induced esophagitis is to make necessary modifications in the treatment. Your doctor shall recommend the following:

• Changing the drugs that can cause drug-induced esophagitis and prescribing other medicines.
• Taking the liquid version of the medication
• Standing or sitting erect for minimum 30 minutes after taking the pills
• Drinking a glass full of water along with a pill.

While alternative ways may not be able to help relieve food blockage in the esophagus, certain therapies can help relieve some of the possible causes. Some of the options include:

• Herbal Remedies: Herbal remedies used for reflux or heartburn symptoms include slippery elm, licorice, marshmallow, chamomile, and others.
• Relaxation Therapies: Techniques that calm anxiety and stress can reduce symptoms and signs of reflux or heartburn.
• Acupuncture: It includes inserting thin needles in particular points on the body. Major studies have proved this method to be beneficial.

When you suspect that your food is lodged in the food pipe or you are not able to swallow or have severe chest pain, you must seek emergency medical care.

Stricture or narrowing of the esophagus is a common problem and one of the most common causes of food blockage in esophagus. A physician can uncover the most specific cause of this problem. Appropriate investigations and timely treatment can help. The medical team chooses the best approach from the various ways to treat food blockage in the esophagus. Complications are quite rare and in most of the cases, a satisfactory result happens with an entire clearing of or by way of improvement in the swallowing process. Avoid foods that can trigger this problem. Take over-the-counter antacids that may provide some relief.

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