In dysphagia, eating and drinking are impaired due to difficulties swallowing food or liquid. Dysphagia can cause complications such as aspiration pneumonia, malnutrition, and choking. This blog post discusses the causes, symptoms, diagnosis, treatment, and prevention of dysphagia, which can be caused by a variety of factors, including neurological disorders, esophageal problems, and cancer.
The two types of dysphagia are oropharyngeal and esophageal. An oropharyngeal dysphagia occurs when swallowing cannot be initiated or coordinated due to problems in the mouth or throat. An esophageal dysphagia is a condition in which food or liquid cannot pass through the esophagus (the tube connecting the throat to the stomach).
Some of the possible causes of oropharyngeal dysphagia are:
Stroke
Brain injury
Parkinson’s disease
Multiple sclerosis
Amyotrophic lateral sclerosis (ALS)
Alzheimer’s disease
Head and neck cancer
Radiation therapy
Surgery
Medications
Dry mouth
Some of the possible causes of esophageal dysphagia are:
Esophageal stricture (narrowing of the esophagus due to scar tissue, inflammation, or tumors)
Esophageal cancer
Eosinophilic esophagitis (an allergic condition that causes inflammation and swelling of the esophagus)
Achalasia (a disorder that affects the muscle contractions and relaxation of the lower esophageal sphincter)
Scleroderma (a connective tissue disorder that causes hardening and thickening of the skin and internal organs)
Esophageal diverticulum (a pouch that forms in the wall of the esophagus and traps food or liquid)
Esophageal ring (a thin band of tissue that forms at the lower end of the esophagus and narrows its opening)
The symptoms of dysphagia may vary depending on the type and severity of the condition. Some of the common symptoms are:
Difficulty initiating swallowing
Feeling of food or liquid getting stuck in the throat or chest
Coughing, choking, or gagging when swallowing
Drooling or regurgitation of food or liquid
Frequent heartburn or acid reflux
Unexplained weight loss
Recurrent chest infections or pneumonia
Change in voice quality or hoarseness
Reduced appetite or avoidance of certain foods or textures
For a proper diagnosis and treatment of dysphagia, you should consult a health care provider. In order to determine the cause and extent of your swallowing problem, your health care provider will ask about your medical history, perform a physical examination, and order tests. Some tests may include:
You drink a liquid containing barium, which makes your esophagus visible on X-rays. This test can reveal changes in the shape and function of your esophagus.
Test to determine how your mouth and throat muscles work when you swallow foods of different consistencies coated with barium.
An endoscope (a thin, flexible tube with a light and camera) is inserted through your mouth or nose into your esophagus to determine if there are any abnormalities or blockages. A biopsy (a small sample of tissue) may also be taken.
In manometry, a small tube with sensors is inserted into your esophagus and connected to a device that measures the pressure and movement of your esophageal muscles.
The use of a CT scan or an MRI scan can provide detailed images of your head, neck, chest, and abdomen. These scans can help detect tumors, infections, or structural problems that may affect your swallowing ability.
Dysphagia is treated to improve swallowing function, prevent complications, and maintain nutrition and hydration. Treatment options include:
A speech-language pathologist or swallowing therapist can help you strengthen your swallowing muscles, stimulate your swallowing reflex, and coordinate your breathing and swallowing by teaching you exercises and techniques. To facilitate swallowing, you may also learn how to position your head and body.
In order to accommodate your swallowing abilities, you may need to change the texture, consistency, temperature, or flavor of your food and liquids. A dietitian or nutritionist can advise you on how to modify your diet. Also, you may need to eat smaller, more frequent meals, chew your food well, and drink plenty of fluids.
There are medications available that can help treat the underlying cause of dysphagia or reduce its symptoms. For example, botulinum toxin (Botox) can be injected into the lower esophageal sphincter to relax it and allow food to pass through. It is possible to treat acid reflux or heartburn with antacids, proton pump inhibitors, or H2 blockers. Infections or inflammation can be treated with antibiotics.
Your dysphagia may need to be corrected or removed through surgery in some cases. As an example, surgery can be used to widen a narrowed esophagus, remove a tumor or diverticulum, repair a hiatal hernia, or implant a device that stimulates swallowing nerves.
To deliver nutrition and hydration directly into your stomach or intestine if you suffer from severe dysphagia, you may need a feeding tube. A feeding tube can be inserted through your nose (nasogastric tube) or through your abdomen (gastrostomy tube or jejunostomy tube).
Dysphagia cannot always be prevented, but you can take some steps to reduce your risk or minimize its impact. Some of the preventive measures are:
Maintain good oral hygiene and dental care
Avoid smoking, drinking alcohol, and caffeine
Eat slowly and chew your food well
Drink enough fluids and stay hydrated
Avoid foods that are too hot, cold, spicy, acidic, or hard
Follow your health care provider’s instructions on medication use and dosage
Seek medical attention if you have symptoms of dysphagia or any other health problems that may affect your swallowing
Follow your treatment plan and attend regular follow-up appointments
If you have any concerns or questions about dysphagia, you should speak to your health care provider or a specialist who can assist you in managing your condition.
