Food that feels stuck on its way down, anywhere between your throat and your stomach, is a swallowing problem with a medical name, dysphagia, and tests can look for what is causing it. If the sticking has not got better after a few days, or it comes and goes, phone your doctor's office and book an appointment, and ask there about seeing a swallowing therapist before you keep washing bites down with a drink.
Why bread and meat stop halfway down when soup does not
Bread and meat sticking while soup goes down is trouble with solids only, and that pattern may indicate a physical blockage. A stricture, one such blockage, is scarring that narrows the esophagus, the tube that carries food from your mouth to your stomach. The opposite pattern may indicate something else:
| What gives trouble | What it may indicate |
|---|---|
| Solids only, while liquids go down | A physical blockage, such as a stricture or a tumor |
| Liquids, but not solids | Nerve damage, or a spasm of the esophagus |
Either pattern can point a provider toward a cause, and neither is a diagnosis you can make at home.
Dry bread and meat are also among the early signs a swallowing problem may give, along with dry crackers, chicken and very hot or cold foods, and the trouble can come with any eating or drinking or only with certain foods and liquids.
Problems in the esophagus itself often cause swallowing trouble, and the possibilities may include:
- an abnormal ring of tissue where the esophagus meets the stomach, called a Schatzki ring
- abnormal spasms of the esophagus muscles
- cancer of the esophagus
- achalasia, in which the muscle bundle at the bottom of the esophagus fails to relax
- a stricture, which may be due to radiation, chemicals, medicines, chronic swelling, ulcers, infection or esophageal reflux
- something stuck in the esophagus, such as a piece of food
- scleroderma, in which the immune system mistakenly attacks the esophagus
- tumors in the chest that press on the esophagus
- Plummer-Vinson syndrome, a rare disease in which webs of membrane grow across the opening of the esophagus
- eosinophilic esophagitis, in which a type of white blood cell builds up in an allergic response and may narrow the esophagus
Reflux can be behind the sticking even if you have never had heartburn. Not all adults with reflux disease have heartburn or regurgitation, and its other symptoms may include chest pain, nausea, and problems swallowing or pain while swallowing (see Heartburn at night, and the warning signs that need a doctor).
When drinking to shift a stuck bite is safe
Keep drinking to shift a stuck bite only once a speech or swallowing therapist, a speech-language pathologist who treats swallowing problems, has said it is OK for you; until then, do not try to wash solids down with sips of liquid. Even with that OK, do not mix solid food and liquid in the same bite.
Food or liquid swallowed the wrong way may lead to choking or be breathed into your main airway, which can lead to pneumonia, so learning to eat and drink safely matters while food is sticking.
If a stuck bite leaves you feeling as if you are choking, phone your doctor's office right away. If you cannot speak or are having a very hard time breathing, you are choking, which is a 911 emergency.
A provider should check a swallowing problem that persists or comes back, and alongside that, some general tips may help at meals:
- Keep mealtimes relaxed, and sit up as straight as you can while you eat.
- Take small bites, less than a teaspoon of food each.
- Chew well, and swallow each bite before you take the next.
- Hold off talking until you have swallowed.
- Stay sitting upright for 30 to 45 minutes after you eat.
It may also help to ask family members not to talk to you while you are eating or drinking.
What you miss by avoiding the foods that stick
Leaving bread and meat off the plate does nothing to find the cause of the sticking, and the treatment for a swallowing problem depends on that cause. Changing what you eat can be part of managing a swallowing problem: a provider may suggest changes to your diet, and you may need to learn new chewing and swallowing techniques.
With a swallowing disorder, it can often be difficult to take in enough calories and fluids to nourish your body. If your weight is meant to be coming down anyway, for example on a weight-care plan, weight lost to smaller meals around the sticking looks on the scale exactly like weight lost on purpose. Unexplained weight loss is among the symptoms of swallowing problems, so the doctor you see about the sticking needs to know about your weight plan too.
What an appointment can do about a narrowing
At an appointment, tests can show whether something is narrowing your esophagus, and a narrowed area can then be widened. The tests your provider orders look for something blocking or narrowing the esophagus, problems with the muscles of the esophagus or with the swallowing mechanism, and changes in the lining of the esophagus.
One test that is often done is an upper endoscopy. A flexible tube with a light on the end goes in through your mouth and down your esophagus to your stomach, and you are given a sedative so that you feel no pain. Other tests may include:
- a barium swallow, also called an esophagram, and other swallowing tests
- blood tests
- a chest x-ray
- esophageal pH monitoring, which measures acid in the esophagus
- esophageal manometry, which measures pressure in the esophagus
- a neck x-ray
- fiberoptic endoscopic evaluation of swallowing, a test that a speech-language pathologist carries out
The same kind of procedure can also treat a narrowing. With an upper endoscopy, the provider can dilate, or widen, a narrowed area of your esophagus, and some people need it done again, sometimes more than once. Swallowing treatment with a speech-language pathologist can help, medicines can help some people, and others may need surgery.
At the appointment, say which foods stick, how long it has been happening, whether it comes and goes, and which foods you have stopped eating because of it.
Which signs cannot wait for an appointment
Phone your doctor's office right away, instead of waiting for a booked visit, if any of these happens:
- you have a fever or shortness of breath
- you are losing weight
- your swallowing problems are getting worse
- you cough or vomit up blood
- you have asthma that is becoming worse
- you feel as if you are choking during or after eating or drinking
Losing weight is on that list with no exception for weight lost on purpose, so if you are losing weight on a plan while food sticks, phone anyway, tell the doctor about your weight plan, and let them judge how much of the loss it explains.
Choking is a 911 emergency: a very hard time breathing because food or another object is blocking the throat or windpipe. Someone who can still speak and is coughing hard needs no first aid, because a strong cough can dislodge the food, though anyone with them stays ready to act right away if it gets worse. If they cannot speak or are having a hard time breathing, the person with them tells someone else to call 911 while starting first aid, or, if no one else is there, shouts for help and starts first aid. Once the food is out, the person who choked should still see a doctor, because complications can arise.
Chest pain, or heaviness or pressure in the chest, may come with a swallowing problem, and it can also be a heart attack. The chest discomfort of a heart attack can feel like pressure, squeezing, fullness or pain, or like heartburn or indigestion, and shortness of breath is sometimes the only symptom. Chest pain with shortness of breath, or pain in your jaw or arm, could be a sign of a heart problem. If any of these could be your heart, call 911, even when you cannot tell whether it is a heart attack; that includes shortness of breath, which is on the list above too.
For NicoCares patients, a message in the Spruce app is the way to tell your care team that solid food keeps sticking and which foods you now leave out; a change to your weight plan is up to the physician who writes it. NicoCares sets no reply time for Spruce messages and does not offer emergency care, so for any sign in this section, phone your own doctor's office or call 911 first, and message the care team after.
