- douglakemd
Liquid Before Solid
What’s your sport or physical activity? Golfing, skiing, running, walking, swimming, weightlifting? Whatever your favorite, I bet it comes with a warm-up strategy. Few golfers walk on the course, skip the practice range, skip the warm-up, and skip the practice swings. I’’m not a golfer, but I’ve never heard of someone walking onto the course and ripping off a 300-yard drive without a warm-up. No runner walks out the door for a max effort 5K or timed mile without jogging or active stretching.
Your esophagus is a muscle like other muscles in your body. My 3-step strategy outlined in Esophagus Attack relies on warming up the esophagus before we challenge it. Eating steak or other difficult solids is challenging for our esophagus. Our first step to warm-up is…(say it with me) Liquid Before Solid.
Olivia's story:
Olivia was serving her cat some deli sliced turkey for breakfast—lucky cat!—and decided to share the meal. But as soon as she swallowed, she felt a painful squeezing sensation in her chest. She was caught so off-guard she knocked the cat’'s dish right off the counter.
She grabbed the closest thing she thought would wash it down: milk. A little sip, and, hallelujah, the pain released. It felt like the turkey had passed along its journey, as originally planned. Relief! Another sip of milk went down fine on its own, then a gulp. Olivia felt her body, which had been on high-alert a moment ago, relax. She felt completely better, though she was a little wary of eating again. The whole episode was too alarming, and Olivia immediately made an appointment to see her doctor.
Olivia’’s doctor heard her story and sent her on to me for an esophagram. Olivia relayed the whole tale to me, still trying to make sense of it for herself. How had a slice of turkey—thin-sliced turkey—gotten stuck when chunks of steak went down fine at dinner the night before?
While I explained my 3-step process, Olivia released frustration and fear. As Olivia learned how the esophagus works, what happens when it doesn’t, and how to help it keep working 100 percent, she visibly relaxed in her face and body. She released concerns and confusion and gained confidence over the problem with a natural system.
Where she’d already begun to worry about not knowing when food would get stuck, and fear of eating at family gatherings, or out with friends, or at favorite restaurants, she traded those worries for the sense of control that comes with knowledge and understanding.
Olivia had instinctively tried my Step 1—Liquid Before Solid—without even knowing any doctor might recommend it. And if she remembered nothing else from our conversation, that would have been a good lesson to take with her: her instinct to take small sips of liquid were spot-on.
There are two reasons Liquid Before Solid works.
Liquid and saliva coat your esophagus and make it slicker. Food passes easier.
Swallowing tells your spinal cord and brain you’’re eating. Nerves send signals to your esophagus muscles, “Open and close! Contract and relax!”
Swallowing liquid “wakes up the esophagus,” as I explain it to patients. When you sit down for a meal, your brain knows you’’re about to eat. But, your esophagus is a muscle. It doesn’t know you’’re about to eat until it gets a message from your brain.
Sipping alerts your esophagus that liquid, and later food, is coming. A complex neural network jumps into action when you swallow. Swallowing liquid signals your spinal cord. Your spinal cord relays signals further down your esophagus. These signals tell your esophagus to open. Gulping or consecutive swallows cascades more alerts to your esophagus muscles to prepare for more.
Photo by Lennart Schneider on Unsplash