@cindyilges I’m so sorry you’re dealing with this. I had an aortic dissection 11 years ago, and I have had trouble swallowing ever since. I’ve also been involved with UT Texas aortic research, and I can tell you that compression of the esophagus from an enlarged or dissected aorta is a very real phenomenon.

Over the years I’ve learned to make some pretty deliberate adjustments in how and what I eat. I avoid heavy, dry starches like potatoes and fibrous foods such as shredded chicken or tuna unless they have a lot of mayonnaise or dressing. I try to chew everything until the pieces are extremely small—ideally no bigger than a grain of rice. Ground hamburger generally gives me very little trouble, while steak can be much more difficult. Water helps but it has to me pretty continuous as I eat. If food gets stuck it's too late and I just struggle till it finally passes down. I eat a lot of yogurt and softer foods, and when I eat grains I tend toward smaller, softer ones such as couscous or oatmeal. You gradually learn which foods work and which ones simply aren’t worth the trouble. Despite having difficulty swallowing for all these years, I can assure you that I have NOT managed to lose any weight in the 11 years since my dissection! Funny how that works.

One frustrating part of this is that many heart doctors simply don’t encounter esophageal compression from an aortic aneurysm or dissection very often. In my own case, the first time I saw it clearly on one of my high-definition scans, I immediately understood what was happening, and so did my thoracic surgeon. Some of the cardiologists I have seen, however, have been surprisingly unfamiliar with the phenomenon. I get tired of trying to explain it to them because unless they themselves have had an aortic dissection they just are never going to understand it. So if you're finding yourself unheard, get used to it because it is just something that gets missed in medical school for these folks and it's not their fault. That said, it's a real thing and most of them just do not internalize the fact that if you're aorta is enlarged it compresses the other structures within your thoracic region, and because your esophagus lies next to your aorta in between your spine and your sternum, there's no place for it to go except to get squished. You're not imagining it. When doctors give you a dumb look on this point, shoot it right back. So please know that what you are experiencing can have an anatomical explanation and deserves to be taken seriously, particularly since your CT has actually documented compression. I’m very glad you are seeing a thoracic surgeon.

I really feel for you. You can make adjustments to what you eat and how you eat that may help greatly while your doctors sort out the underlying problem. I’m sorry you’re going through this, and I hope your appointment goes well and that you continue to do well. Peace.