What is dysphagia?
Dysphagia is the medical term for difficulty swallowing. If you have this condition, you may swallow more slowly than other people. Some people with dysphagia also experience pain when swallowing — odynophagia.
Signs and symptoms of dysphagia
Food feels stuck
People with dysphagia often have the sensation that food gets stuck in the throat or chest while eating. In some cases, this stuck food can actually come back into the mouth after swallowing. Sometimes, it may come back up through the nose.
If you have difficulty swallowing, you may not swallow as frequently as you used to. This can cause excess saliva that leads to drooling.
Coughing during or after eating
Trouble swallowing can cause you to cough during meals if food is not fully cleared from the throat after swallowing.
Types of dysphagia
Esophageal dysphagia is a disorder of the esophagus, and usually causes the sensation of food getting stuck in the throat. Oropharyngeal dysphagia refers to difficulty getting food from your mouth to your throat.
Causes of dysphagia
Esophageal dysphagia and oropharyngeal dysphagia have different causes.
Causes of esophageal dysphagia include:
Tumors or scar tissue
Tumors and scar tissue can create a narrowing of the esophagus that leads to difficulty swallowing. This is called an esophageal stricture. Scar tissue and inflammation can come from radiation therapy for cancer and other treatments.
Spasms or improper muscle function
- Achalasia — This is when the esophageal sphincter muscle has trouble relaxing, so food doesn't always enter your stomach properly. This may cause regurgitation.
- Diffuse spasm — Normally, your esophagus performs a series of well-timed contractions to get food into your stomach. However, if your esophagus spasms, the movements do not coordinate properly. Food may not reach the stomach properly and can remain in the throat for too long.
Causes of oropharyngeal dysphagia include:
Neurological disorders or damage
This condition occurs when a pouch forms where the esophagus meets the throat due to tense muscles in that area. Food can get stuck in this pouch so people with this condition feel like they need to clear their throat often. Spontaneous emptying of the pouch may also cause coughing. It can also cause difficulty swallowing.
Cancer and cancer treatment
When to see the doctor for dysphagia
See your doctor if you consistently have trouble swallowing, especially if it’s painful or causes weight loss or vomiting. If you have the feeling of something stuck in your throat or chest, seek emergency medical attention.
Diagnosis and tests for dysphagia
Depending on your exact dysphagia symptoms, your doctor may perform any of the following tests:
First, you drink a solution containing barium that coats your esophagus and will show up on an X-ray. They may also have you swallow a barium pill. Then, your doctor takes X-rays of your throat in various stages of swallowing.
An endoscope is a device a doctor can use to look down your throat. It is a thin tube with a lens and a light at the end. Some endoscopes also have a camera on the end that allows doctors to see down your throat even better. If there are any abnormalities, your doctor may do a biopsy.
In this procedure, a doctor inserts a thin tube with a pressure gauge into your esophagus. Then, when you swallow, the device records the strength of your muscles
Treatments for dysphagia
The treatment for dysphagia depends on the cause and the type you have.
The main treatment for oropharyngeal dysphagia uses exercises that strengthen and train your muscles to swallow properly. There are also exercises you can do to help you learn how to place food or how to position your body for swallowing success. People with degenerative disorders can also learn new swallowing techniques to help.
If you have a narrowing of the esophagus caused by achalasia, your doctor may do a procedure called esophageal dilation. They insert an endoscope with a balloon on the end and inflate it to gently reduce the narrowing.
Some cases of dysphagia may require surgery. Esophageal surgeries can remove tumors and fix Zenker's diverticulum. Doctors can also insert permanent or temporary stents to hold the sphincter of the esophagus open. An incision into the sphincter muscle itself can help some cases of achalasia.
Digestive Disorders Resources
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American Society for Gastrointestinal Endoscopy: "Understanding Esophageal Manometry."
Cedars-Sinai: "Diffuse Esophageal Spasm."
Family Doctor: "Dysphagia."
Johns Hopkins Medicine: "Barium Swallow."
Mount Sinai: "Zenker's Diverticulum."
National Health Service: "Achalasia."
National Health Service: "Dysphagia (swallowing problems)."
Saint Luke's Health System: "Esophageal Dilation."
University of Texas MD Anderson Cancer Center: "Dysphagia in cancer patients: What to know."