Dysphagia

What is Dysphagia?
Dysphagia is the medical term for difficulty swallowing. It means it takes more time and effort to move food or liquid from your mouth to your stomach. It can be painful (odynophagia), and in some cases, swallowing may be impossible.

Occasional difficulty caused by eating too fast is normal. However, persistent dysphagia may indicate a serious medical condition affecting the 50 pairs of muscles and nerves used to swallow.

Symptoms

Symptoms vary depending on where the blockage or muscle failure is occurring:

• Pain while swallowing.
• Sensation of food getting stuck in the throat or chest (behind the breastbone).
• Drooling or hoarseness.
• Regurgitation: Bringing food back up.
• Frequent heartburn.
• Coughing or gagging when swallowing.

In Infants and Children

Parents should watch for:

• Tensing of the body during feeding.
• Refusing to eat foods of different textures.
• Lengthy feeding times (30+ minutes).
• Food/liquid leaking from the mouth.
• Recurrent pneumonia (from inhaling food).

⚠️ EMERGENCY WARNING
If an obstruction interferes with breathing, call for emergency help immediately. If you are unable to swallow saliva or are drooling excessively due to a blockage, go to the emergency department.

Causes & Types

Causes usually fall into two categories based on where the problem is located.

1. Esophageal Dysphagia (The Chest)

This is the sensation of food sticking in the base of your throat or chest after you've started to swallow.

• Achalasia: The lower esophageal muscle doesn't relax to let food into the stomach.
• Esophageal Stricture: Narrowing of the esophagus, often due to scar tissue from acid reflux (GERD).
• Esophageal Tumors: Difficulty swallowing gets progressively worse.
• Foreign Bodies: Large pieces of food or objects lodged in the throat.
• Radiation Therapy: Can cause inflammation and scarring.

2. Oropharyngeal Dysphagia (The Throat)

This involves weak throat muscles, making it hard to move food from your mouth to your throat. You may choke or gag when trying to swallow.

• Neurological Damage: Stroke, brain injury, or spinal cord injury.
• Neurological Disorders: Multiple Sclerosis, Muscular Dystrophy, or Parkinson's disease.
• Pharyngeal Diverticula: A small pouch forms in the throat, collecting food particles.
• Cancer: Throat cancer or radiation damage.

Complications

• Malnutrition & Dehydration: Inability to take in enough nourishment.
• Aspiration Pneumonia: Food or liquid entering the airway introduces bacteria to the lungs.

Diagnosis

Doctors use dynamic tests to watch how you swallow:

• Barium X-ray: You drink a chalky solution that coats the esophagus, making it visible on X-rays.
• Dynamic Swallowing Study: You swallow barium-coated foods of different consistencies while an X-ray records the muscle movement.
• Endoscopy: A flexible camera is passed down the throat to visualize the esophagus.
• Manometry: A tube measures the muscle pressure/strength of the esophagus.

Treatment

Treatment is tailored to the type of dysphagia:

For Throat Issues (Oropharyngeal)

• Exercises: Working with a speech therapist to coordinate swallowing muscles.
• Techniques: Learning specific head positions (like the chin tuck) to help swallow safely.

For Esophageal Issues

• Esophageal Dilation: Using a balloon attached to an endoscope to gently stretch a narrow esophagus.
• Surgery: To remove tumors or repair diverticula.
• Medications: Treating acid reflux (GERD) to reduce scarring.

Severe Cases

If you cannot eat enough to maintain weight, a feeding tube may be necessary to bypass the swallowing mechanism while you recover.

Disclaimer: The content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician regarding any medical condition.