Difficulty swallowing

If this is largely presenting when backpacking but not in his day-to-day life I'd wonder if he's not allowing himself to get dehydrated when backpacking and therefore isn't producing enough saliva for when he's eating.

The soup suggestion earlier could help in two ways then- one to add fluids to his diet and also to help him swallow. But he may just need to up his drinking, because dehydration can cause a host of other problems too.

We were probably both slightly dehydrated. I drank two pints of beer at the restaurant and never needed to pee afterwards!

He spoke to a doctor and the doctor thinks it's because he sleeps with his mouth open and hikes with his mouth open and that makes his mouth too dry. This advice didn't convince him to go back to the trail, which is too bad because I was looking forward to having the house to myself.

Hi Piper

> because he sleeps with his mouth open and hikes with his mouth open and that makes
> his mouth too dry.
Oh, I can certainly believe that! It happens!
Which brings us back to thick soups…

Cheers

I had a similar problem starting in my late 40s, gradually getting worse with age. It wasn't associated with hiking. It felt like my throat was shutting down and I couldn't swallow, especially with dry foods like chicken. At its worst, it felt like it could be a heart attack. I suspect that dehydration and altitude would have made it worse.

It turned out to be GERD/reflux. The tests that were done were swallowing a barium solution while xray movies were taken. Since reflux can cause precancerous cell changes, I had endoscopy and a biopsy taken. The solution was an acid blocker (prevacid, now over the counter as Lansaprozole). With prevacid it almost never happens. If it's mild GERD, an antireflux diet might help.

Find a better primary care doc. Mine is great, diagnosed all this but still sent me to specialists for tests and confirmation. A referral to a gastroenterologist might be good.

I can't buy that reasoning.

Did he suddenly learn how to breath on the way to the bar, his mouth hydrated, and everything was a okay ?

Unlikely.

"Find a better primary care doc. Mine is great, diagnosed all this but still sent me to specialists for tests and confirmation. A referral to a gastroenterologist might be good."

+100!!! Of all the possible causes mentioned on this thread, GERD and its follow on complications present the most serious threat to health. For gosh sake, Piper, get your friend to a decent doc, preferably one that doesn't show up wearing a wolf's head while shaking rattles, and eliminate the possibility of GERD, or it that is the cause, have it treated. GERD, left untreated, very often progresses to Barrett's esophagus and then esophageal cancer, which does not have a good prognosis.

I realize I’m a bit late to the party here, but I’ve had very similar experiences, and I’m not close to 60 yet. I would chew and chew, and couldn’t get myself to swallow, except for straight sugars (read: M&M’s, Skittles, that sort of thing).

This is NOT a medical answer as I’m not a doctor, but I think it’s overexertion. In essence, he’s overdoing it, and needs to do things like slowing down his hiking pace, going less miles, staying hydrated but NOT over-saturating himself with water. Also being in shape.

For me, I was 20 lbs overweight and trying to tackle routes I could handle 20 years ago when I was younger and in shape. I’d tackle too many miles and too much elevation gain (no problem with altitude, but it can sure take a lot of energy). Then I’d have a hard time swallowing/eating, and my body didn’t want to ingest it. But I’d drink water—too much—and then I’d want to throw up. So I’m not really sure if dehydration is even part of it; for me, it was squarely overexertion and being out of shape.

For your friend who is 64, age may be catching up a little bit (I say that with no offense intended). He may just need to throttle back. Less days on the trail, less miles, less exertion might just do the trick.

Oh, and I’d get down off the mountain and could down a 20-piece chicken nugget box and large fries without a problem or hesitation. So it wasn’t a problem with my throat, reflux, etc. I was just pushing myself too hard, and my body said no bueno.

That’s probably it. He pushes himself way too hard.

I hope so, but I’d say test it out a bit. Maybe this spring, go with your friend on a 1 or 2 night trip, purposely scaling back the miles and strain. Take some more “normal” food (since it’s only a night or two) that he’d usually eat. I did some trial and error testing (once I lost 20 pounds, which was a HUGE part of it) to test the waters, so-to-speak. For me, I try to take a couple apples, bananas (not dried) for the first day or two, things that I’d normally eat, and even some sugars that I know I like (Skittles, Fig Newtons). They help me transition from my “normal” food to backpacking fare over the first couple days. Kind of like acclimating my stomach, the same way I have to let my body (back, legs, hips, etc.) acclimate to the motions of hiking, etc.

I also changed up how I drank water. At home I drink water best from a glass or bottled water, and I’ll usually chug a full glass or bottle all at one time. but backpacking I used a 3 liter Camelbak reservoir with hose attached to my shoulder straps, and sipped at it continuously. I found that I was actually drinking water in a way that my body wasn’t used to, and it didn’t work well. I changed things up and added a molle water bottle holder to my waste belt (I hike with a Granite Gear Blaze AC 60). What that did was make me stop at various points, enjoy the view while I guzzled a bit. For me, it worked a LOT better because it’s what my body was used to doing.

Hope that helps! I think it’s awesome that you’re trying to figure this out for your friend, my hat’s off to you! (But not for too long, because I cover my head to avoid sunburn…) :)

PS… I went for a week solo trip to the Wind River Range this past summer (2015) after making all the changes. The difference was literally life and death; meaning, a year previous (2014) had I tried the trip, I wouldn’t have made it without getting into serious physical trouble. I actually had to cut a similar Wind River trip that year (in 2014) three nights short because of what I was experiencing with the inability to eat.

If it comes and goes, I’d be worried about a TIA (transient ischemic attack), aka “mini stroke.” You can have one, some, or all of the classic signs of a stroke (including dysphagia) and they only last a short amount of time then resolve. Think of it as the body’s warning sign that there’s a high risk for a stroke in the future. But that’s just another differential diagnosis among the long list of things it could be. I’d get a second opinion from another doctor before deciding it’s psychosomatic.