Dysphagia, or difficulty swallowing, is a condition characterized by the inability or reduced ability to move food or liquid from the mouth to the stomach. It can be accompanied by pain and may sometimes make swallowing impossible. While occasional difficulty swallowing may not be a cause for concern, persistent dysphagia may indicate a serious underlying medical condition that requires treatment.
Common symptoms of dysphagia include pain while swallowing (odynophagia), the sensation of food getting stuck in the throat or chest, drooling, hoarseness, regurgitation, heartburn, weight loss, coughing or gagging when swallowing, and having to cut food into smaller pieces or avoiding certain foods.
Dysphagia can be caused by various factors and falls into two main categories: esophageal dysphagia and oropharyngeal dysphagia.
Esophageal dysphagia refers to the sensation of food sticking or getting hung up in the base of the throat or chest after swallowing. Some causes of esophageal dysphagia include achalasia (improper relaxation of the lower esophageal muscle), diffuse spasm (poor coordination of esophageal contractions), esophageal stricture (narrowing of the esophagus), esophageal tumors, foreign bodies, esophageal ring (narrowing in the lower esophagus), gastroesophageal reflux disease (GERD), eosinophilic esophagitis (inflammation caused by an overpopulation of certain cells), scleroderma (scar-like tissue development), and radiation therapy.
Oropharyngeal dysphagia, on the other hand, is characterized by weakness in the throat muscles, making it difficult to move food from the mouth to the throat and esophagus. This can be caused by neurological disorders (such as multiple sclerosis or Parkinson’s disease), neurological damage (from a stroke or injury), pharyngoesophageal diverticulum (a pouch that forms in the throat), or certain cancers and cancer treatments.
Risk factors for dysphagia include aging, certain health conditions (such as neurological disorders), and previous radiation therapy.
Complications of dysphagia can include malnutrition, weight loss, dehydration, aspiration pneumonia (food or liquid entering the airway), and choking.
Prevention strategies for occasional difficulty swallowing include eating slowly, chewing food thoroughly, and early detection and treatment of GERD. Diagnosis of dysphagia involves physical examination and various tests such as X-rays, dynamic swallowing studies, endoscopy, esophageal muscle tests, and imaging scans.
Treatment for dysphagia depends on the type and cause of the swallowing disorder. For oropharyngeal dysphagia, speech or swallowing therapy may be recommended, including exercises to coordinate swallowing muscles or swallowing techniques. Esophageal dysphagia may be treated with esophageal dilation (stretching the esophagus), surgery to clear blockages or treat underlying conditions, and medications to reduce stomach acid or relax muscles. Severe dysphagia may require a special liquid diet or a feeding tube. Surgery may also be an option for certain cases.
It’s important to note that age-related changes can also contribute to swallowing difficulties, and strategies such as good oral hygiene, chewing food thoroughly, taking small bites and sips, and working with a speech pathologist to learn proper eating techniques and throat exercises may be beneficial.
If you experience persistent difficulty swallowing, it is recommended to consult with a healthcare professional or an ENT specialist (otolaryngologist) for a proper evaluation and diagnosis.