Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group TROUBLE SWALLOWING

Your right it is very scary when you get food caught. I was eating licorice when a piece about and inch and half got stuck sideways. Can no longer eat steak unless i take very little bites. I try to stay away from any hard food. I take Nexium right now but have still have had regurgitation while sleeping once in awhile. Thanks for info Wendy.

if the swallowing problem is from the AS, then others will be able to help you more. my husband has gone through bouts of trouble swallowing from having scar tissue in his esophagus from having very bad reflux / GERD. the gastroenterologists have removed the scar tissue several times over the years. a combination of taking prilosec once a day, mylanta at night when needed, and not eating for a few hours preceding bedtime, and avoiding certain foods (which i think depends from person to person) have helped him immensely. the last time he was scoped, things looked very good down there. when it is bad, food gets stuck.

Just an update, have had colon and stomach scoped and the Specialist says problem is for sure AS related. See my Doc on Tuesday to see whats next, though i think it will be changing to a softer diet as i will not let them operate on my neck or spine..so we will see.

I had some swallowing problems. Learned to chew my food very carefully. Doc did a scope and my esophagus was scarred form years of Gerd. He stretched it out and it was like a new throat. I had to have had this done twice now with 7 years in between. Very similar to Sue's post


If I get too much heartburn I know it is slowly closing again.

Just a thought - in the UK Speech therapists are the ones who understand and can help you with strategies for dealing with swallowing problems. Not sure if it is the same in other countries? I've heard a number of people with quite different disorders get really excellent help and advise from speech therapists on this.

I attended speech therapists before leaving for Fr. Did help a 'little' with thhe dysphonia but not the dysphragia.

Food still gets stuck - perrenial problem, as mentioned before, even with liquids, then have to spt everything out! Horrible.

But, Bosunsmate: AS related. Yes. Last Sept, 2010 had a whole raft of MRIs done in the UK and there it was, DISH (Forestiere's Disease). And bony outcrops (syndesmophytes) sticking into the esophagus...DISH and AS 'can' be bedfellows though rare, it does happen. If you 'do' have DISH then will need an X-Ray or MRI to pick it up. Mention DISH to yr doctor: Diffuse idiopathic skeletal hyperostosis. To google up put in a relationship searcvh, AS & DISH or DISH as it relates to AS. Quite interesting. I printed off the info for my doctor here. My rheumy in the UK said that in y case it was related.

Such a relief to get the DX - no one else had spotted the relationship - or knew of it?

Tell you, there is soooo much info here on KA, needs collating, that's for sure! <VBG>

(OK typoes an all - can't see properly to pick em all up. Roll on ophtho appt.)

Good for yr specialist to spot it - the fellow I saw over here a year ago didn't!

DISH and Ankylosing Spondylitis Link - DISH Linked to A.... S.....

DISH (Diffuse Idiopathic Skeletal Hyperostosis) - Spine ...
Dec 28, 2010 ... Like ankylosing spondylitis, with DISH there may be a delay in diagnosis of ... 2001 Jul-Aug;9(4):258-67 PMID:11476536 (Link to Abstract) ...
www.orthobullets.com/spine/2045/dish-diffuse-idiopath...

Ankylosing
(DISH, Forestier's disease). Florid new bone formation at entheses results in spinal stiffness. May be confused with ankylosing spondylitis. ...
www.healthdictionary.info/Ankylosing.htm -

Seronegative Spondyloarthropathies: Joint Disorders: Merck ...
Ankylosing spondylitis (AS) is 3 times more frequent in men than in women ... Diffuse idiopathic skeletal hyperostosis (DISH) occurs primarily in men > 50 ...
www.merckmanuals.com/professional/sec04/ch034/ch034d....

There's not a lot to actually 'link' the two diseases, but they 'can' be linked. The (my) MRIs (Saggital STIR) are very clear on DX both conditions. Lubly-jubly...

Bit more info that may be of general interest re the swallowing problems:-

http://www.brighthub.com/health/arthritis/articles/102130.aspx

Diffuse idiopathic skeletal hyperostosis, or DISH, is considered a type of osteoarthritis that doesn't show any wear and tear, and may be present with no symptoms. According to Spine University, DISH occurs most often between ages 50 and 60, with more cases reported in men than women. The most common ligament affected is the anterior longitudinal ligament on the front of the spine.

When symptoms do appear, stiffness and a reduced range of motion are the most common, particularly when bending sideways. With DISH, extra bone growth or bone spurs can develop. Possible symptoms of bone spurs include: difficulty swallowing, if the bone spur occurs near the esophagus; or numbness, if the spur puts pressure on the spinal cord.

Diagnostic Testing
Whether testing for ankylosing spondylitis or diffuse idiopathic skeletal hyperostosis, your doctor will begin with a complete physical examination. This includes locating any painful areas, especially related to your spine and joints. Blood tests to define or rule out other disease processes may be done.

In evaluating for DISH, the Mayo Clinic recommends X-rays, computerized tomography (CT) and magnetic resonance imaging (MRI) be used as diagnostic tools. An X-ray may show the characteristic distinction of calcification along the spine, and an MRI or CT is particularly helpful in determining if a condition is AS or DISH.

(or both...!)

Read more: http://www.brighthub.com/health/arthritis/articles/102130.aspx#ixzz1DBF4o8oc

Looks to be quite complicated to define the 'two together' - got to have up-to-date equipment and a really good radiologist to read the results. Not always easy to find the two together! (Top hospitals, like the Mayo Clinic - who are creme de la creme - or the big hospital in Houston, TX (*Excellent reports of Houston) is where you need to be looking.) Just a couple of cents worth. 'Smile'.

Oops, you're in Canada Bosun, well Toronto has a very good hospital. They should have all the goodies.

I've been busy guys - put in a different worded search, bingo!

Coexistance of ankylosing sponylitis and DISH

Simultaneous Occurance of DISH with ankylosing spondylitis

Now, the silultaneous relationship of the two together is *rare, but does exist. Rhe paers that I have skimmed through, and printed, say very few cases, c10 known (!) but possibly/probably more than that as DISH is diff to DX with AS - needs specific radiology/radiography - radiology dept...(get there!!).

ALso of great interest is the facts that DISH, when it effects the cervicals, can cause dyphragia - difficulty in swallowing. Which is where wwe came in.

Bosumsmate, thank you for the thread. Knew of the connection, but ONLY since I was DX back in Sept last, and now I know more of the disease. And, with the histories as presented here, well..... are there MORE cases of DISH that are NOT reported as they have not been DX? There's a thought now. With soooo much dysphragia reported by KAers then would not surprise me if it were not more common.

Thinnk this could well be a case for rheumies to go check into - more grist to the AS mil as 'twere?

I truly think this is important. DISH is difficult to DX, so many cases will prob be undiagnosed?

Not that one can do owt about DISH ( ) but feel that the facts of the matter needs to be addressed - if for nowt else thaan for the comfort and allaying fears of the patient.

(typoes an all friends - eyes are really 'horrible' - gritty, vile, horrible anad 'streaming'...!)

Thank you for the info on Dish, does sound interesting. I have been scoped and everything looks fine. Now i do have Sjogren's and have problems swallowing dry food or uncoated pills, so of course i drink alot of water. But the difficulty swallowing thats different. Anyway i see my Rheumy on Tuesday and will mention Dish to him. Thank you for pointing me in that direction....

I contacted one of the imaging clinics to fnd out about equipment avaiability and costs - here's what their response, but did not disclose any info on Saggital STIR...:-

We have a 1.5 Tesla machine. Regarding slices, we do as many as are required to cover the area.

The scan would take around 60 minutes to complete and the cost of the scan would be £1,709 including the thoracic spine and £1,459 without the thoracic spine being scanned.

We can give the patient a CD to take away with them, we would then need two radiologists to report the different areas of the scan.

We will require a referral form before we can scan the patient.

I hope this information helps.

Kind Regards,

Hannah Bailey

Administrator

Queen Square Imaging Centre
8-11 Queen Square, London, WC1N 3AR

T : 0207 833 2513
F : 0207 837 8074

----------------------------##

Really *expensive. Heck, I got more than that done for the same price in Bath! And they were Saggital STIR...

As for Sjogren's - yes. Right horrible to deal with, as eyes, nose, mouth, ears, lungs are affected. Keeping a bowl of water in C/H rooms helps a tad and bathing eyes in warm water also helps - and of course sipping warm water. All so tedious. But press onwards -

Take care Bosun (will ask that there clinic IF Saggit STIR imaging... )