A medical term for swallowing problems is dysphagia. However, it may be a painful condition, and sometimes, people cannot swallow at all. Commonly, difficulty swallowing that happens sometimes is not a cause for concern. It usually occurs when you eat too fast or do not chew the food well. In any case, dysphagia is a serious health condition that requires treatment.
While this disease may happen at any age, it often occurs in older people mostly.
Symptoms
People with dysphagia usually experience the following symptoms. These include:
- Drooling
- Hoarseness
- Weight loss
- Cough when swallowing
- Stomach acid or food that goes backward in the throat
- Recurrent heartburn
- Regurgitation
- Inability to swallow
- Painful swallowing
- A feeling that food is stuck in the chest, throat, or behind the breastbone
If you experience regularly the following symptoms, you should visit a doctor. For example, difficulty swallowing, weight loss, regurgitation, or vomiting.
Seek emergency care if a blockage occurs, and causes breathing problems.
Causes
The swallowing process involves multiple nerves and muscles. Therefore, any health problem that makes these muscles weak or causes damage to the nerves may lead to dysphagia. In most cases, this condition falls into one of the following categories. Check below some dysphagia causes:
Esophageal Dysphagia
Generally, this type refers to a feeling that the food is caught or sticks in the base of the throat or the chest. Check below some causes:
- Achalasia – This is a health condition that causes swallowing problems due to damaged nerves or muscles. Usually, this condition worsens over time without treatment.
- Esophageal spasm – A condition in which poorly coordinated contractions and high pressure of the esophagus make it difficult to swallow. It negatively affects the involuntary muscles in the esophagus walls.
- A narrowed esophagus – This condition is also called a stricture. Narrowing of the tube that carries the food from the mouth to the stomach (esophagus) occurs due to gastroesophageal reflux disease (GERD), tumors, or scar tissue.
- Esophageal tumors – Tumors that appear in the esophagus also may lead to dysphagia.
- Foreign bodies – In some cases, people get their esophagus or throat partially blocked with food or another object. It usually occurs in older people who have difficulty chewing their food.
- Esophageal ring – Occasionally, this ring may cause difficulty swallowing solid foods.
- GERD – This is a condition in which the stomach acid goes backward in the esophagus. Thus, it may cause damage to the esophagus lining that may lead to spasms, narrowing, or scarring of the lower esophagus.
- Eosinophilic esophagitis – This is an immune system disease that happens due to white blood cells (eosinophils) that begin to build up in the esophagus.
- Scleroderma – This condition causes scar tissue to develop in the lower esophagus. Thus, people begin to experience heartburn frequently.
- Radiation therapy – This is a treatment used to destroy cancer cells. Hence, it also may cause inflammation and scarring of the esophagus.
Oropharyngeal Dysphagia
There are some diseases that may weaken the throat muscles and cause dysphagia. Moreover, a person may choke, gag, or cough when swallowing food. Check below some causes of oropharyngeal dysphagia:
- Neurological diseases – These include multiple sclerosis, muscular dystrophy, Parkinson’s disease, and others.
- Neurological damage – The ability to swallow may be affected by sudden neurological damage that is often caused by stroke, a brain or spinal cord injury, and others.
- Pharyngoesophageal diverticulum (also called Zenker diverticulum) – This is a condition in which a small pouch (diverticulum) forms and collects food in the throat. As a result, it may lead to swallowing problems.
- Cancer – There are some cancer and cancer treatments that also may lead to this condition. One of them is radiation therapy (a treatment used to kill cancer cells).
Risk Factors
Physicians identified some factors that may elevate your risk of developing dysphagia. For example:
- Age – Older people are at increased risk of swallowing problems caused by natural aging and wear and tear of the esophagus. Generally, dysphagia is considered an aging sign.
- Some diseases – People with neurological disorders and nervous system conditions are at higher risk of developing dysphagia.
What Are The Possible Complications of Dysphagia?
People with dysphagia may experience some complications, especially if they do not get treatment. Check below some dysphagia complications:
- Aspiration pneumonia – It occurs when food or liquid enters the airway during swallowing tries. However, pneumonia occurs due to bacteria that enter the lungs from the food.
- Choking – Sometimes, the food may get stuck in the throat and cause choking. Unfortunately, if the food completely blocks the airway and if no one intervenes, death may happen.
- Malnutrition, weight loss, and dehydration – Difficulty swallowing may lead to not eating enough food and liquids.
How to Prevent Dysphagia?
Generally, it is not possible to prevent his condition, but you may reduce the risk of difficult swallowing that happens occasionally by eating slowly and chewing your food completely. Anyway, if you experience dysphagia symptoms that occur frequently, immediately contact your healthcare professional.
Diagnosis
First, physicians will perform a physical examination to check for abnormalities linked with dysphagia and ask some questions about your symptoms and medical history. However, to confirm the condition, they will perform the following tests. For example:
- A barium X-ray – This test is performed with a contrast material because it helps doctors easily see abnormalities on X-rays.
- Dynamic swallowing study – It involves swallowing barium-coated foods to get detailed images of these foods when they travel down the throat. It may help determine problems in the throat muscles and mouth coordination during swallowing.
- Endoscopy – This test involves a small and flexible lighted tool that is inserted down the throat to check for irregularities linked with dysphagia. These include inflammation or narrowing of the esophagus.
- FEES (fiber-optic endoscopic evaluation of swallowing)
- Esophageal muscle test (also known as manometry) – This test involves the measurement of the muscle contractions of the esophagus during swallowing.
- Other imaging tests – These include a CT (computerized tomography) scan or an MRI (magnetic resonance imaging) scan.
Treatment
The treatments prescribed by doctors are usually different among patients because they depend on several factors. For example, existing health problems, your age, the severity and type of the dysphagia, and others.
Oropharyngeal Dysphagia
In most cases, people with this type are referred to a swallowing or speech therapist.
- Learning exercises – This treatment helps coordinate swallowing muscles.
- Swallowing techniques – These involve ways to place the food in the mouth and body and head positions that help to swallow. These techniques are effective if dysphagia is caused by neurological disorders (such as Parkinson’s disease or Alzheimer’s disease).
Esophageal Dysphagia
Check below some treatment options usually recommended by doctors:
- Esophageal dilation – This treatment involves an endoscope and an inflating balloon. It is usually used in people with achalasia, esophageal stricture, motility disorders, and an irregular ring of tissue that occurs at the junction of the stomach and esophagus (also known as the Schatzki ring).
- Surgery – This surgery is used to clear the tube that carries the food and drinks from the mouth to the stomach. In most cases, physicians recommend this treatment for people with pharyngoesophageal diverticulum, esophageal tumor, and achalasia.
- Medications – Doctors usually prescribe medicines for people with GERD to reduce stomach acid production.
- Dietary changes – A special diet is required for people with dysphagia. Sometimes, this diet may be used as a treatment, especially for people with eosinophilic esophagitis.
In severe dysphagia cases, people may need a feeding tube that helps them get nutrients without swallowing.
Surgery
Commonly, surgery is needed to relieve difficulty swallowing caused by the narrowing of blockages. Usually, blockages include bony outgrowths, vocal cord paralysis, pharyngoesophageal diverticular, achalasia, and gastroesophageal reflux disease (GERD). Esophageal cancer also is treated with surgery. Check below some surgery types usually used in people with dysphagia:
- Laparoscopic Heller myotomy – This procedure involves the cutting of the muscle located at the esophagus end (also called esophageal sphincter).
- POEM (peroral endoscopic myotomy) – This surgery involves an opening in the esophagus lining. It helps treat achalasia.
- Stent placement – A plastic or metal tube (also called a stent) is used to treat a narrowed or blocked esophagus. Sometimes, these stents are permanent.
- OnabotulinumtoxinA (Botox) – This is an injection administered often at the esophagus end to relax the muscle and improve swallowing.
Home Remedies
There are some tips that may help lessen the symptoms. For example:
- Eating habit changes – You can try to eat more and smaller meals instead of one but large. Chew food well and cut it into small pieces.
- Try different foods – Avoid foods that may cause swallowing problems. For example, sticky foods (including peanut butter or caramel), coffee and juice, and others.
- Limit or avoid alcohol and caffeine because these beverages may lead to dry mouth and throat causing difficulty swallowing.
Frequently Asked Questions
What is the primary cause of dysphagia?
In most cases, dysphagia is caused by another condition. These include nervous system diseases (such as dementia, stroke, or head injury), mouth or esophageal cancer, gastroesophageal reflux disease (GERD), and others.
Is it possible to cure dysphagia?
Unfortunately, a cure is not always possible because it depends on the underlying cause and the severity of the disease.
What are dysphagia complications?
Those who suffer from dysphagia may experience some complications, especially if they ignore the symptoms and do not treat the condition. For example:
- Malnutrition
- Aspiration-induced pneumonia
- Morbidity
- Death
- Dehydration
This document does not contain all possible complications of this condition. If you have additional questions, ask your doctor.
