I’m a 72-year-old man who for the last 11 years has been ‘choking’ regularly. Camera tests in the throat and sleep apnoea tests have been negative. The attacks really panic me, and they leave me with a pain in the centre of my chest. I’ve been taking amitriptyline for the attacks, on the assumption that they have a nervous cause, but they don’t help. What else can I do?

You seem to be suffering from spasm – a form of cramp – either in the larynx or the oesophagus lower down. There is a remote possibility that it could be a form of angina, but having had it for 11 years that’s unlikely. There are drugs that relieve spasm like this, but you would need further tests. As the treatment hasn’t helped so far, why not ask your doctor to review you case and take things further as he or she thinks fit.