Difficulty swallowing

Warm drinks, lozenges and some patience — infection-related irritation usually settles.

Avoid late/heavy evening meals; reflux measures often help.

Knowing that swallowing works often takes pressure off the lump feeling.

Progressive, painful or weight-loss-associated problems should be examined.

Swallowing trouble that begins with solid food and grows over weeks to months points to a narrowing; trouble with solids and liquids at once, fluctuating over years, points rather to a disorder of movement. New swallowing trouble lasting two to three weeks, especially with weight loss, leads to a scope. About one in twenty adults has it at times; over seventy it is nearly one in eight.

Acid blockers help if a narrowing has arisen from reflux — they do not widen the narrowing, only dilatation does. In eosinophilic oesophagitis, swallowed steroid preparations work. In a disorder of movement, acid blockers do not work; there it is about the muscle. What applies in every case: eat sitting upright, small mouthfuls, chew well — and with a stuck mouthful do not drink on top of it, because that raises the pressure.

Temporary, painful swallowing with a cold is usually harmless.

A globus feeling without real sticking is common and harmless.

Rising acid can irritate the throat and gullet.

Worsening over weeks, with weight loss → get it assessed.

Anaemia together with difficulty swallowing is a warning sign and a reason for endoscopy, not for waiting.

A marked iron shortage can itself cause difficulty swallowing, through a change in the lining of the upper gullet.

An enlarged thyroid presses on the gullet and gives the feeling of a lump in the throat.

Raised with an inflammation in the throat or the gullet. With fever and severe pain that belongs looked at quickly.

Gums that bleed at the lightest touch are among the first signs of a lack. It is rare today but occurs with a very one-sided diet and with alcohol.

Without B12 the insulating layer of the nerves is not maintained. A lack causes tingling, numbness and unsteadiness in the dark — and it is one of the few reasons for nerve trouble that can be fully undone if found early.

The nerves cover their energy needs through thiamine. It runs short with alcohol, after stomach operations, with long-lasting vomiting and under water tablets.

The jawbone that holds the teeth undergoes the same building up and breaking down as any other bone. What counts for the hip counts for it.

Here both count: a lack harms the nerves, and too high an intake over months harms them as well. Supplements therefore belong taken in a dose that has a reason.

A long-standing iron deficiency can form fine webs in the gullet that solid food catches on. Ferritin is among the first values here — and the tablet itself is taken sitting up with plenty of water, never lying down.

Large tablets are a topic in themselves here: effervescent powder or drops arrive where a 1000 mg tablet sticks and irritates the lining.

Clearly worthwhile and well supported when deficient — vegan, older adults, certain drugs. No energy boost without a deficiency.

An enlarged thyroid presses on the gullet from the front and causes a lump and tightness that increases when lying down. Feeling and ultrasound say more here than the blood value — which can be entirely normal with a goitre.

Solid food sticks with a narrowing while liquid still passes. If both stick it is more likely the movement of the oesophagus. This distinction is valuable for the work-up.

Until the cause is clear this lowers the risk of a blockage. Meat and dry bread are the most common triggers for an obstruction.

Small bites, sitting upright, with fluid — until the cause is clear. Whether solids stick first or liquids do too is more valuable for the work-up than any adjustment.