Dysphagia is the medical term for difficulty swallowing, or the feeling that food is “sticking” in your throat or chest. The feeling is actually in your esophagus, the tube that carries food from your mouth to your stomach. You may experience dysphagia when swallowing solid foods, liquids, or both.
Oropharyngeal dysphagia is when you have trouble moving food from your mouth into your upper esophagus. Esophageal dysphagia is when you have trouble moving food through your esophagus to your stomach. It is the most common kind of dysphagia.
Dysphagia can strike at any age, although the risk increases with age.
Signs and Symptoms:
Symptoms of oropharyngeal dysphagia include the following:
- Difficulty trying to swallow
- Choking or breathing saliva into your lungs while swallowing
- Coughing while swallowing
- Regurgitating liquid through your nose
- Breathing in food while swallowing
- Weak voice
- Weight loss
Symptoms of esophageal dysphagia include the following:
- Pressure sensation in your mid-chest area
- Sensation of food stuck in your throat or chest
- Chest pain
- Pain with swallowing
- Chronic heartburn
- Sore throat
What Causes It?:
Although dysphagia can happen to anyone, it is most common in older adults, premature babies, and people with problems of the brain or nervous system.
Dysphagia in adults may be due to tumors, conditions that cause the esophagus to narrow, neuromuscular conditions, stroke, or Gastroesophageal reflux disease (GERD). It can also be caused when the muscle in your esophagus doesn’t relax enough to let food pass into your stomach. Other risk factors include smoking, excessive alcohol use, certain medications, and teeth or dentures in poor condition.
How is dysphagia diagnosed?
If you are having difficulty swallowing, your doctor will ask questions about your symptoms and past health. He or she will want to know if you have trouble swallowing solids, liquids, or both. He or she will also want to know where you think foods or liquids are getting stuck, whether and for how long you have had heartburn, and how long you have had difficulty swallowing. Your doctor will also do a physical exam. During the exam, your doctor may check your head and neck or ask you to take a small sip of water. He or she may also check your reflexes, muscle strength, and speech. Your doctor may then refer you to a specialist.
Sometimes doctors can find no reason for dysphagia, even though it can have many causes. In some people, dysphagia is just a result of aging. As people get older, all of their muscles can get weaker, including the esophagus.
To help find the cause of your dysphagia, you may need one or more tests, including:
- X-rays. These provide pictures of your neck or chest.
- A barium swallow. This is an X-ray of the throat and esophagus. Before the X-ray, you will drink a chalky liquid called barium. Barium coats the inside of your esophagus so that it shows up better on an X-ray.
- Videoesophagography. This test uses a type of barium swallow that allows your esophagus to be videotaped.
- Laryngoscopy. This test looks at the back of your throat, using either a mirror or a fiber-optic scope.
- Esophagoscopy or upper gastrointestinal endoscopy. During these tests, a thin, flexible instrument called a scope is placed in your mouth and down your throat to look at your esophagus and perhaps your stomach and upper intestines. Sometimes a small piece of tissue is removed for a biopsy. A biopsy is a test that checks for inflammation or cancer cells.
- Manometry. During this test, a small tube is placed down your esophagus. The tube is attached to a computer that measures the pressure in your esophagus as you swallow.
- pH monitoring, which tests how often acid from the stomach gets into the esophagus and how long it stays there.
Health care providers typically treat dysphagia with drugs, exercises, and procedures that open the esophagus, or with surgery. Your treatment will depend on the cause, the seriousness, and any complications you may be experiencing.
Your treatment will depend on what is causing your dysphagia. Treatment for dysphagia includes:
- Exercises for your swallowing muscles – If you have a problem with your brain, nerves, or muscles, you may need to do exercises to train your muscles to work together to help you swallow. You may also need to learn how to position your body or how to put food in your mouth to be able to swallow better.
- Changing the foods you eat – Your doctor may tell you to eat certain foods and liquids to make swallowing easier.
- Dilatation – In this treatment, a device is placed down your esophagus to carefully expand any narrow areas of your esophagus. You may need to have the treatment more than once.
- Endoscopy – In some cases, a long, thin scope can be used to remove an object that is stuck in your esophagus.
- Surgery – If you have something blocking your esophagus, you may need surgery to remove it.
- Medicines – Prescription medicines may help prevent stomach acid from entering your esophagus. Infections in your esophagus are often treated with antibiotic medicines.
There are many different problems that can prevent the throat or esophagus from working properly. Some of these are minor, while others are more serious. If you have a hard time swallowing once or twice, you probably do not have a medical problem. But if you have trouble swallowing on a regular basis, you may have a more serious problem that needs treatment.