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Swallowing difficulty (Dysphagia)

Difficulty while swallowing food or liquids is also called dysphagia. It can be minor or severe. In severe cases, it gives an indication of some throat or esophageal disorder. Dysphagia can happen to anyone at any time but it is generally found in older adults, babies, and people with brain disorders.

Causes

Swallowing is a complex act that involves a fine balance of various nerves to control the working of muscles of the mouth, throat, and esophagus. Following reasons can alter this balance leading to difficulty in swallowing:

  • A brain or nerve disorder or damage due to:
    • Multiple sclerosis
    • Parkinson’s disease
    • Stroke
    • Spinal cord injuries
    • Amyotrophic lateral sclerosis
    • Myasthenia gravis etc.
  • Esophagus problems include:
    • Abnormal spasms of the esophageal muscles
    • Esophageal Cancer
    • Failed relaxing of the muscle ring at the bottom of the esophagus
    • Scarring that narrows the esophagus
    • Some obstruction in the esophagus
    • Esophageal reflux disease
  • Stress or anxiety
  • Scleroderma
  • Chest tumors pressing the esophagus
  • Swollen tongue
  • Dry mouth &throat
  • Allergic reaction
  • Swollen tonsils
What are the symptoms?

Dysphagia is more or less a symptom which can come and go, and be mild or severe. But in some conditions, it may get worse over time and patient complains of:

  • Difficulty getting food or liquids go down the throat
  • Choking or cough while swallowing
  • Food or liquids come back up through throat, mouth, or nose
  • Sour taste in the mouth
  • Feel like foods or liquids are stuck in some part of throat or chest
  • Pain while swallowing
  • Pain or pressure in chest
  • Heaviness or pressure in the neck or chest
  • Trouble breathing when eating
  • Heartburn
  • Nausea
  • Drooling
  • A hoarse voice
  • Weight loss

These sensations may let the person to avoid eating or skipping meals.

How is dysphagia diagnosed?

The diagnosis starts with the doctor taking complete history of the patient followed by physical examination to check for abnormalities or swelling. More specialized tests may be needed to find the exact cause:

  • X-rays
  • A barium swallowX-ray of the throat and esophagus
  • Fluoroscopy
  • Laryngoscopy
  • Esophagoscopy or upper gastrointestinal endoscopy
  • Esophageal pH monitoring (measures acid in the esophagus)
  • Esophageal manometry (measures pressure in the esophagus)
How is it treated?

The treatment specifically depend upon the cause of dysphagia and may include:

  • Exercises to strengthen the swallowing muscles
  • Changing the choice of foods
  • Esophageal dilation
  • Endoscopy to remove an object that is stuck in your esophagus.
  • Surgery
  • Medicines in acid reflux cases

In very rare cases when a person has severe dysphagia, a feeding tube is advised to make the patient get enough food and liquids.

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