For many young Indians, digestive discomfort has become almost routine. Long work hours, rushed meals, irregular eating patterns, lack of sleep and rising stress levels mean symptoms like acidity, bloating or chest discomfort are often ignored or self treated.
But there is one specific symptom you should never brush aside: difficulty swallowing. A feeling that food is getting “stuck” in the chest, needing frequent sips of water while eating, regurgitation of undigested food or recurring chest pressure are often brushed aside as acidity or stress-related discomfort. However, persistent swallowing difficulties can sometimes point to an underlying disorder affecting the food pipe, or esophagus.
One such disease is Achalasia Cardia.
Normally, the muscles in your food pipe squeeze food down, and a valve at the bottom relaxes to let it into the stomach. In Achalasia, the nerves and muscles controlling this valve stop working. The valve stays tightly shut, causing food and liquids to pile up in your food pipe instead of entering your stomach.Because the symptoms build up slowly over months, younger patients often normalize the discomfort until it becomes a crisis.
Recently, a patient in his early 30s came to Apollo Hospitals Jayanagar. For months, he felt food sticking in his chest. He ignored it, blaming his busy lifestyle and stress. Eventually, the condition worsened. Undigested food began flowing back into his mouth, chest pain became frequent, and he started losing weight because eating was too painful. During this time, he came to us for advice. To establish an understanding of swallowing difficulty, we administered a number of specialized tests to determine the cause of his difficulty swallowing. These tests functioned as 'eyes' & 'sensors' that allowed us to view additional areas of the client's internal body using a combination of an endoscope & a barium swallow. We first performed an endoscopic procedure that allowed us to view blockage(s) within the esophagus via a small camera. Following this, we had the patient ingest a thin liquid with barium; it displayed on moving X-ray images which allowed us to track the fluid within the client's digestive tract and determine the locations where the fluid became stuck. Finally, a high-resolution manometry test was done using a thin, sensitive tube to measure the squeezing power of his food pipe muscles. Together, these tests confirmed that the food pipe muscles weren't pushing food down and the bottom valve was tightly shut proving conclusively that he had Achalasia Cardia.
While Achalasia is considered uncommon, awareness remains low because its symptoms overlap significantly with more common digestive complaints such as reflux, gastritis or stress-related acidity. This overlap often delays diagnosis. Fortunately, advances in minimally invasive gastroenterology have significantly improved treatment outcomes.
The patient had POEM (Peroral Endoscopic Myotomy), an innovative endoscopic surgical technique performed entirely through the mouth. This eliminates the need for any incisions or scarring on the outside of the body. The procedure itself involves making an incision in a tight ring of muscle at the bottom of the esophagus to allow food to flow through to the stomach in normal fashion once again. Since this procedure is done endoscopically, recovery is generally quicker than would occur with standard surgical procedures. After the procedure, the patient’s ability to swallow has improved substantially, and he has been discharged from the hospital shortly after having undergone the procedure.
One of the greatest worries is that younger adults are progressively returning to the routine of self-medicating and utilising busy lifestyles as a reason for discussing ongoing digestive symptoms in a casual manner. One should seek a medical review if they experience any of the following symptoms:
• Difficulty swallowing solid or liquid foods
• Food continuously feeling stuck in the chest while consuming
• Regurgitation of undigested foods Chest discomfort without heart involvement
• Unexplained weight loss
• Coughing or choking while consuming food
While keeping a regular meal pattern, chewing carefully, staying hydrated, and reducing stress can help support a healthy digestive system, these lifestyle improvements cannot fix structural or muscle-related issues in the food pipe. The main takeaway here is that we should not assume every digestive symptom is purely due to acidity or stress. There are numerous reasons for an individual's swallowing difficulty and this requires an exhaustive medical assessment to determine the correct diagnosis. Catching these conditions early will greatly enhance your quality of life and help prevent the complications that come with delayed treatment.
Disclaimer: The views expressed in this article are of the author and not of Health Dialogues. The Editorial/Content team of Health Dialogues has not contributed to the writing/editing/packaging of this article.
