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Steakhouse Syndrome

Definition

Steakhouse syndrome is a condition in which a mass of food (called a bolus) becomes stuck in the lower part of the esophagus. The esophagus is the muscular tube that carries food and liquids from the mouth to the stomach.

The Esophagus
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Causes

This condition happens when a mass of food, usually meat, blocks the passageway of the esophagus.

Risk Factors

Risk factors include:

  • Not chewing your food completely
  • Drinking too much alcohol
  • Wearing dentures
  • Having a physical problem that affects how food moves down the esophagus
    • Esophageal motility disorder (achalasia)
    • Gastroesophageal reflux disease
  • Having a condition that affects the esophagus, such as:
    • Schatzkis ring—ring of tissue that forms in the lower part of the esophagus
    • Esophageal stenosis—narrowing of the esophagus caused by scar tissue
    • Hiatal hernia—upper part of the stomach moves up through a small opening into the chest
    • Eosinophilic esophagitis—chronic inflammation in the esophagus
    • Esophageal cancer or other tumors

Symptoms

Symptoms may include:

  • Chest pain
  • Difficulty swallowing
  • Drooling
  • Coughing, gagging, choking

These symptoms may be due to other conditions. If you have any of these symptoms, talk to your doctor.

Diagnosis

Your doctor will:

  • Ask about your symptoms and medical history
  • Do a physical exam
  • Order tests, such as:
    • X-ray with or without barium (a chalky liquid used to coat the organs so they can be easily seen on x-ray)
    • Endoscopy—to examine the esophagus

Treatment

If the bolus does not pass into the stomach on its own, your doctor may consider treatment, such as:

  • Drinking a carbonated beverage to help move the bolus into your stomach
  • Giving a substance called glucagon by an injection—This will decrease the pressure in your esophagus, allowing the bolus to pass into your stomach.

If the bolus still does not pass or you are not able to swallow your saliva, the doctor may need to remove it from your esophagus. They will use an endoscope to locate the bolus. Once the bolus has been found, tools (such as snares, forceps, and net) are passed down the endoscope to remove the bolus. In some case, the bolus may move into the stomach during the procedure.

Often, the doctor will also look for underlying conditions that may have put you at risk for this problem.

Prevention

To help reduce your chance of getting steakhouse syndrome, take the following steps:

  • Chew slowly and until the food is small enough to safely swallow.
  • If you have been diagnosed with a condition that affects your esophagus, get proper care for it.

Revision Information

  • American Academy of Otolaryngology—Head and Neck Surgery

    http://www.entnet.org

  • The American College of Gastroenterology

    http://www.acg.gi.org

  • The Canadian Association of Gastroenterology

    http://www.cag-acg.org

  • Canadian Society of Otolaryngology

    http://www.entcanada.org

  • Belafsky PC, Postma GN, et al. Steakhouse syndrome in a man with a lower esophageal ring and a hiatal hernia. Ear Nose Throat J. 2003;82(2):102.

  • Chae HS, Lee TK, et al. Two cases of steakhouse syndrome associated with nutcracker esophagus. Dis Esophagus. 2002;15(4):330-333.

  • DiPalma JA, Brady CE III. Steakhouse spasm. J Clin Gastroenterol. 1987;9(3):274-278.

  • Esophageal food bolus obstruction (steakhouse syndrome). National Center for Emergency Medicine Informatics. Available at: http://www.ncemi.org/cse0602.htm. Accessed November 22, 2010.

  • Stadler J, Hölscher AH, et al. The "steakhouse syndrome." Primary and definitive diagnosis and therapy. Surg Endosc. 1989;3(4):195-198.