From the Guidelines
Food can get stuck in the esophagus due to several reasons, most commonly narrowing of the esophagus (strictures), abnormal muscle contractions, or underlying conditions like eosinophilic esophagitis, with eosinophilic esophagitis being the most frequent diagnosis in up to 46% of patients presenting with food bolus obstruction.
Causes of Food Impaction
- Narrowing of the esophagus (strictures)
- Abnormal muscle contractions
- Underlying conditions like eosinophilic esophagitis
Importance of Evaluation
If you experience food getting stuck frequently, you should see a doctor for proper evaluation, as food bolus obstruction is the first presenting symptom in 30% of patients who are ultimately diagnosed with EoE 1.
Prevention and Management
When eating, take smaller bites, chew thoroughly, and avoid rushing meals to reduce the risk of food impaction. Drinking fluids with meals can help food pass smoothly. For those with known esophageal issues, medications like proton pump inhibitors (such as omeprazole 20-40mg daily) may help manage underlying causes like acid reflux, and maintenance therapy with topical steroid reduces the risk of recurrent food bolus obstruction 1.
Emergency Situations
If food becomes completely stuck causing inability to swallow saliva, seek immediate medical attention as this constitutes an emergency requiring endoscopic removal, and urgent referral to gastroenterology for endoscopic intervention to treat the food bolus and diagnose EoE if present is recommended 1.
From the Research
Causes of Food Impaction in the Esophagus
- Food impaction in the esophagus can occur due to various reasons, including the size and type of food, as well as underlying esophageal pathologies 2, 3.
- Studies have shown that large food bits, particularly meat, can get stuck in the esophagus and require removal by endoscopy 2, 3.
- Esophageal pathologies such as esophagitis, strictures, hiatal hernias, and Schatzki's rings can increase the risk of food impaction 3.
- Eosinophilic esophagitis, a chronic and progressive immune-mediated esophageal disorder, can also lead to food impaction due to inflammation and fibrosis in the esophagus 4, 5.
Risk Factors for Esophageal Food Impaction
- Males are more likely to experience esophageal food impaction, with a higher incidence of underlying esophageal pathologies such as esophagitis and strictures 3.
- Diabetes mellitus has been associated with food impaction in some studies, although more research is needed to determine the strength of this association 3.
- The type of food consumed can also play a role, with meat being the most common type of food to get stuck in the esophagus 3.
Pathophysiology of Esophageal Disorders
- The esophagus is a complex organ that relies on a coordinated interplay between nerves and muscle fibers to transport food from the pharynx to the stomach 6.
- Esophageal disorders such as achalasia, functional esophageal disorders, and gastroesophageal reflux disease can cause dysphagia and other symptoms due to motor disorders, hypersensitivity, and inflammation 6.
- Eosinophilic esophagitis is an immune-mediated condition that can result in significant dysphagia and associated luminal narrowing due to inflammation and fibrosis in the esophagus 4, 5, 6.