What is dysphagia?
If you have difficulty swallowing, you have the condition known as dysphagia. Dysphagia may be painful and frightening, make you need extra effort to ingest food or liquids, and cause you to lose your appetite or even avoid eating. Dysphagia – if it is recurrent – usually reflects an underlying issue with the mouth, pharynx, or esophagus. Sometimes the issue can be serious. So if you experience recurrent dysphagia you should It consult a gastroenterologist.
What are the symptoms of dysphagia?
In addition to difficulty swallowing, dysphagia symptoms often include:
- Pain, coughing or gagging while you swallow
- Feeling like something’s stuck in your throat or chest
- Excessive saliva production and drooling
- Feeling hoarse
- Heartburn
- Regurgitation (food or stomach acid coming back up your throat)
- Unexplained weight loss
What causes dysphagia?
Swallowing may seem to be a simple reflex, however, it’s actually a complicated process with multiple steps involving your brain, throat, and esophagus. The underlying problem may be structure (e.g. a mechanical blockage) or functional (e.g. a neuromuscular inability to propel the food downward).
Two locations of dysphagia
Depending on the part of the swallowing process that’s affected, you may experience oropharyngeal or esophageal dysphagia. These different types of dysphagia also have distinct causes.
Oropharyngeal dysphagia is difficulty starting the act of swallowing. It usually results from an issue affecting your brain’s ability to communicate with the nerves in your mouth or throat. Causes can include neurological disorders such as Parkinson’s disease and multiple sclerosis, as well as physical conditions such as a stroke.
If you have oropharyngeal dysphagia, the act of swallowing can cause you to gag, cough, or feel as if food or liquids are going down your windpipe or up your nose.
Esophageal dysphagia reflects a structural or neuromuscular problem in the esophagus (your food pipe). This version of dysphagia can feel like food sticks in your throat or chest after you swallow, and “won’t go down.
Mouth causes of swallowing difficulty include:
- Dry mouth, not enough saliva to move food out of your mouth, which medications or a different health issue can cause.
Throat causes of swallowing difficulty (oropharyngeal dysphagia) include:
- Neurological disorders such as Parkinson’s disease, Alzheimer’s disease, Lou Gehrig’s disease, multiple sclerosis, cerebral palsy, muscular dystrophy, or post-polio syndrome
- Neurological damage such as from a spinal cord injury or stroke
- Cancer and some cancer treatments
- A condition called pharyngeal diverticula creates a small pouch in your throat, just above your esophagus, that collects food and leads to difficulty swallowing and other problems.
Esophagus causes of swallowing difficulty (esophageal dysphagia) include:
- esophageal cancer
- Esophageal muscle weakness (a condition known as achalasia) or other motility disorders
- Esophageal stricture, a narrowing of your esophagus
- Eosinophilic Esophagitis
- Esophageal Cancer
- Food allergies
- Food-created blockages
- Involuntary muscle spasms or other motility disorders
- Lymph nodes or bone spurs pressing on your esophagus
- Scar tissue caused by gastroesophageal reflux disease
- Scleroderma, when your esophagus hardens and narrows
How do we make the diagnosis?
We obtain a careful history, and then may recommend a variety of tests, such as x-rays, endoscopy, esophageal acid measurement, or measurement of esophageal contraction. We can usually establish the diagnosis.
Difficulty Swallowing: The Treatments Vary
It’s important to get a physical exam to determine if you have dysphagia; which type of condition you have; and the underlying cause.
Once your doctor makes a diagnosis, he or she can tailor your treatment accordingly.
Treatment may include:
- Adjusting your eating habits
- Medication, possibly including medication to control stomach acid if you have GERD
- Assessment with an endoscopy or another swallowing study
- Gently dilating your esophagus with an endoscope if there is a narrow or tight section
- Endoscopy to remove an object obstructing your esophagus
How do we manage dysphagia?
Depending on the diagnosis, we may stretch the esophagus during endoscopy, prescribe prescription medications, recommend an altered diet, or seek input from an expert affiliated specialist, such as a throat specialist. Sometimes (e.g. when we stretch a esophageal narrowing) the relief is immediate, and usually we can provide significant relief.
Important Reminder:
The information provided above is meant to be used as an informative guide for patients. For precise and individualized recommendations, please consult with one of our board certified gastroenterologists to discuss your symptoms.
For additional information or to book an appointment at the Aayushman clinic Gastroenterology Center, please feel free to reach out to our dedicated team by calling us at 8860291508. You can also schedule online or reach out to us via the Contact Us form.