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Kristian

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Hello all,

I am a 34 year old male who just completed a Barium Swallow study. I visited an ENT due to intermittent sore throats and was told that I had some enzymes in the back of my throat that weren't normal for someone my age. I was set up for a Barium Swallow and the results were as follows:

>>
1. Decreased epiglottic tilt and motion with increased pharyngeal residual.
2. Substantial spontaneous reflux.
3. Sliding small hiatal hernia..

Findings: Decreased motion of the epiglottis is noted. The esophagus was slow to clear. Increased pharyngeal residuals are noted. Extensive spontaneous reflux is elicited. Small hiatal hernia is present.
<<

I spoke with a physician friend and was told that generally decreased epiglottic tilt is found in stoke patients (haven't had one) or in diseases such as ALS.

My speech still seems to be clear (not drunk as I have read). And I am not choking on fluids or solids (yet?). Just clearing my throat.

I have a follow up with the ENT scheduled -and possibly a neurologist?

Had anyone here experienced this as a first sign of bulbar ALS? Any advice?

Thanks and scared.
Kristian
 
The reflux from the hiatal hernia are the more likely cause of your dysfunctional epiglotis.
 
I don´t think you need a neurologista, arwaxru is right, the reflux is causing you to clear your throat. I have a thyroid mass in the base of my tounge and that gives me the feeling I have to clear my throat a lot and I to have a reflux problem. The doctor allready found out your problem(hiatal hernia).
That´s just what I think.
 
I suspect that your physician "friend" is Dr. G88gle and not a real person. If it does happen to be a real person, kick him in the testicles and tell him that a real ALS patient sends his love to a doctor that doesn't know bulbar ALS from ABC-TV. Then, find yourself a new friend.

If you want more accurate information about what's likely to be happening to you, do a search for laryngopharyngeal reflux. You'll find that your symptoms match up far better with that than they do ALS.

And the next time you get medical test results back, ask the doctor who ordered the test for the interpretation of the results. Trying to puzzle out the meaning of the results of a medical test using the Internet is like trying to work a jigsaw puzzle with pieces missing and the pieces you do have flipped upside down. You might force things to fit together, but it will only be by random chance that you get the picture right.
 
I believe decreased epiglottic tilt is seen in some neuromuscular conditions such as Guillane-Barre syndrome.

However, to answer your question, I know of absolutely no one on this forum, who has presented with this as a first symptom to bulbar onset of motor neuron disease. Between this, and your age, its just not something that you should be concerned about.


IMO keep going to your ENT, they are well trained in the area of cranial nerves, and if the ENT finds reason to send you to a neurologist, then, of course get in to see one.

You also might want to consider seeing a gastrologist. Between the two specialties (ENT and gastro) they should have you covered as far as area of expertise goes.

good luck to you :)
 
Thank you all so much for responding.

I had my follow up with the ENT and he recommended that I see a neurologist from the standpoint that my epiglottis is not functioning normally. I guess it's not sealing properly and providing enough pressure for food to move down which is leading to my esophagus being slow to clear. I can feel the fluid in the back of my throat building up and have to clear often but still no slurred speech or drooling so I'm hoping for the best. I've only woken up once coughing. I'll update after my appointment on Tuesday.

Hope everyone has a safe weekend.

Thank you all again.
 
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