Sarcoidosis May Affect Esophagus, Causing Difficulty in Swallowing
Written by |
Sarcoidosis may cause anomalies in the esophagus and subsequently lead to difficulties in swallowing, according to a new case report.
The physicians who conducted the study say involvement of the esophagus in sarcoidosis is “extremely rare” — with only 24 such cases documented to date — but that patients must be promptly diagnosed and treated to avoid further complications.
The study, “Dysphagia Caused by Extrinsic Esophageal Compression From Mediastinal Lymphadenopathy in Patients With Sarcoidosis,” appeared in the journal Clinical Gastroenterology and Hepatology.
Physicians followed a 58-year-old man who was admitted to the gastroenterology department after complaining of worsening swallowing difficulties for the past seven months.
“It was marked by only solid foods ‘getting hung up’ in his chest at a frequency of several times per week without any choking or gagging sensation,” the team wrote.
The patient had gastritis — a bacterial inflammation in the stomach — one year earlier, but had been successfully treated. He also complained that his voice had become hoarse over the past three months, but had reported no chronic heartburn, regurgitation, blood vomiting, cough or weight loss. In fact, his physical exam was normal.
Doctors then examined his esophagus and identified multiple lesions that caused narrowing of the lower esophagus but, according to the report, not to a great extent.
With an endoscopic ultrasound, however, doctors obtained a biopsy of the esophagus, which revealed the presence of enlarged and irregular-shaped lymph nodes that corresponded to the lower esophageal lesions they had seen before. Further analysis of the biopsy helped doctors diagnose the patient with sarcoidosis.
The man started taking prednisone (20 mg/day); he responded well and his symptoms began improving.
“Before treatment, the patient used to experience [swallowing difficulties] for solid foods several times per week,” doctors wrote. “However, after one month of treatment, he did not encounter an episode of similar symptoms even after tapering off steroid therapy. On three-month follow-up, an esophagogram revealed normal swallowing and normal esophagus, demonstrating an unremarkable recovery in our patient.”
The team also wrote that, in similar cases, sarcoidosis may result in perforation of the esophagus. To avoid this risk and limit morbidity and mortality, patients should be immediately diagnosed and treated.
Kre8tiveSoul
Sarcoidosis is different for everyone and 24 people isn't a solid enough number for me to believe that Prednisone will stop those symptoms if anything it masks it. Sarc survivors know that remission can be short lived and when it returns, it never attacks in the same places. Because most of the medical world didn't know what this disease was in the 80's, 90's and the early milenium most sarcees were misdiagnosed and because steroids seem to keep it at bay, it was to become the answer to all of our woes but we, who have survived since 1998 and know the side effects that steroids cause are skeptical and would love to see your data published on these studies...who knows I may have been one of the twenty four because I have all of those symptoms and I can tell you that Prednisone doesn't work for me. I take maca root, adrenamin, b12, and a multi-vitamin. I eat flaxseed, ginger and drink lemon infused water. I work out and stay active and that's what works for me. I feel that esophagitis in sarcees is caused by heavy medication use and no nutritional plan. I haven't taken Prednisone since 2009 and I am in full remission.
Tim McCarthy
I have situations, when I eat, it feels as if a air pocket is coming up my trachea. It takes anywhere from several seconds to several minutes before it clears up. It even happens when I drink water.
ItsAdam
I have issues with this, and I always have "cold" like symptoms, which are totally dismissed as being related to Sarcoidosis.
I hope this becomes a thing and I can seek some form of treatment.
I think as a whole awareness for Sarcoidosis needs to be increased, and hospitals have to stop "pushing" you on to other "experts" for different areas, you have a different Dr for Heart and for Liver and for Lungs, which is just meh.
Carol Shaw
My sarcoidosis was found on my esophagus. Am I considered one of the 24? I was diagnosed exactly 13 years ago! There are times I still have difficulty swallowing. I just live with it! I am not followed on a regular basis for sarcoidosis. Wish I could find a doctor that understands my situation!!
Kevin gray
I have issues with swallowing of small amounts of fluid. SALT team are happy with my muscles so I use hold and swallow technique. Problem lies when I forget. I also struggle with swallowing of my own sputum which causing a coughing/ choking episode. I have neurosarcoidosis with large fibre neuropathy and extensive SFN.