What is difficulty swallowing (dysphagia)?

Individuals with difficulty swallowing (dysphagia) experience discomfort or pain when passing food and liquid from the mouth to the stomach. In some cases, swallowing can become impossible.

What causes difficulty swallowing (dysphagia)?

Difficulty swallowing may occur when you eat too fast or do not chew your food enough and isn’t cause for concern. However, persistent difficulty swallowing may indicate a more serious medical condition that requires a consultation with a gastroenterologist and a treatment plan.

Dysphagia is typically caused by nerve or muscle problems and is more common in older individuals and babies.

There are three types of dysphagia that occur during the swallowing process:

  • Oral dysphagia (high dysphagia) occurs in the mouth, often caused by tongue weakness following a stroke, difficulty chewing food, or problems transporting food from the mouth.
  • Pharyngeal dysphagia occurs in the throat and stems from neurological problems impacting the nerves.
  • Esophageal dysphagia (low dysphagia) occurs in the esophagus, typically caused by a blockage or irritation. Patients experiencing esophageal dysphagia often require dilation of the esophagus.

What are the symptoms of difficulty swallowing (dysphagia)?

There are several symptoms of dysphagia, which include:

  • Difficulty swallowing, extra effort or time needed to chew and swallow
  • Pain while swallowing
  • Gagging, choking, or coughing while eating or drinking
  • Sensation of food being stuck in the throat or chest
  • Food or liquid leaking from the mouth or getting stuck in the mouth
  • Acid reflux
  • Heartburn
  • Regurgitation (bringing food back up)
  • Recurring pneumonia or chest congestion after eating
  • Weight loss or dehydration from not being able to eat enough

When should I see a doctor?

If you have difficulty swallowing on a regular basis – it’s time to consult a gastroenterologist, especially if you are experiencing weight loss or vomiting as a result of your inability to consume food and drink.

Please note: If you have an obstruction in your throat that is interfering with your breathing, go to an emergency room immediately, as this is a very serious condition.

How is dysphagia diagnosed?

Your gastroenterologist will ask you a series of questions regarding your symptoms during your first examination to understand how long you’ve been experiencing difficulty swallowing and the factors causing discomfort. There are a variety of test that can be performed to identify the cause of your dysphagia, including:

  • Endoscopy – A minimally invasive procedure where a thin, flexible scope is placed directly down the throat and esophagus to observe, diagnose and treat conditions affecting the esophagus, stomach, and beginning of the small intestine
  • Barium Swallow Test – A special imaging test using barium and X-rays to create images of the upper gastrointestinal tract. Barium allows physicians to see the size and shape of the pharynx and esophagus and how the patient swallows that might not be seen in a standard chest X-ray.

How is dysphagia treated?

Treatment of difficulty swallowing depends on the type and cause of the disorder. There are three major types of swallowing disorders.

  • Oropharyngeal dysphagia – Patients are often referred to a speech or swallowing therapist, and treatments include exercises and swallowing techniques to help coordinate swallowing muscles or stimulate the nerves that trigger the swallowing reflex.
  • Esophageal dysphagia – Treatments include:
    • For patients with a tight esophageal sphincter (achalasia) or an esophageal stricture, esophageal dilation is performed using a special balloon to gently stretch and expand the width of the esophagus.
    • Surgery may be recommended to help relieve swallowing problems for patients with esophageal tumors, refractory GERD, achalasia, large or complicated hiatal hernias, pharyngoesophageal diverticulum, or esophageal cancer.
    • Medication is prescribed for patients who suffer from difficulty swallowing associated with GERD, eosinophilic esophagitis, or esophageal spasms.

Disclaimer: The information presented on this website is not intended to take the place of your personal physician’s advice and is not intended to diagnose, treat, cure or prevent any disease. Discuss this information with your healthcare provider to determine what is right for you. All information is intended for your general knowledge only and is not a substitute for medical advice or treatment for specific medical conditions.

This website is owned and managed by Brian Cooley, MD. Any information, offers, or instruction as written, inferred, or implied is the sole responsibility of Brian Cooley, MD, and does not warrant claim or representation, inherent, or implied of DHAT, its subsidiaries, or employees.