HIV: PROBLEMS OF THE DIGESTIVE SYSTEM-PAINFUL SWALLOWING

Some people find eating unpleasant and good nutrition difficult because they have pain when they swallow. Sometimes the pain is in the back of the mouth; usually it is in the chest and is a result of esophagitis, an inflammation of the esophagus. The most common cause by far is infection with Candida albicans, the fungus responsible for thrush. Other causes are infections with viruses; some have no known cause but appear similar to aphthous ulcers of the mouth.
The treatment of esophagitis depends on the cause. The probability of Candida albicans is so great that physicians often treat for Candida without testing for it. If the person with esophagitis does not respond to treatment or if the cause is obscure, an endoscopy—a special procedure in which a specialist (gastroenterologist) puts a tube into the esophagus and takes a sample of tissue—is often advised. If the cause is a viral infection, esophagitis can be treated with antiviral drugs. If the cause is aphthous ulcers, the ulcers in the esophagus, like those in the mouth, often respond to corticosteroids.
Anyone with painful swallowing should see a physician. Despite painful swallowing, it is important to maintain nutrition. Eat foods that are soft or liquid: milkshakes, milk, oatmeal, puddings made with milk or cream, custard, jello, ice cream, cottage cheese, cooked and pureed bland vegetables, popsicles, ground meats, baked fish, melons, bananas, scrambled eggs, omelets, French toast, cream soups, noodles, mashed potatoes. Try drinking through a straw. Such a diet, though easy on your throat, can cause loose stools; liquid supplements, like Enrich, Sustacal with fiber, or Metamucil, are sources of soluble fiber that can help prevent loose stools.
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