Swallowing problems
Food sticking, painful swallowing, or the feeling that swallowing simply isn't working — dysphagia is never a symptom to ignore, and it is one of the most rewarding to diagnose correctly.
What causes difficulty swallowing
The causes range from the mechanical — inflammation, strictures (narrowings), rings, and occasionally tumours — to disorders of movement, where the oesophagus looks normal but fails to propel food properly. Achalasia and oesophageal spasm are the best known motility disorders; eosinophilic oesophagitis is an increasingly common allergic cause, particularly in younger adults whose food sticks intermittently.
How Dr Zeki investigates dysphagia
- Gastroscopy to inspect the oesophagus directly, take biopsies (essential — eosinophilic oesophagitis is invisible without them in a third of cases), and dilate strictures where needed.
- High‑resolution manometry — the definitive test of oesophageal movement, mapping the pressure of every swallow to diagnose achalasia, spasm and ineffective motility against the international Chicago Classification. Dr Zeki performs and interprets these studies personally; oesophageal physiology is his subspecialty.
- Barium studies where the anatomy needs mapping before treatment.
Treatment
Treatment follows the diagnosis: endoscopic dilatation for strictures and rings; dietary or anti‑inflammatory treatment for eosinophilic oesophagitis; and for achalasia, referral for definitive therapy (balloon dilatation, POEM or surgery) with a complete physiological work‑up already done — which is exactly what the treating team needs.
Seeing Dr Zeki
Consultations take place on Tuesdays at HCA UK at The Shard, with testing and endoscopy at London Bridge Hospital — usually within days. Call 020 3301 4916 or email Dr Zeki's secretary to book. Fees and insurers.