Dysphagia

Dysphagia can occur at any age, but is more prevalent in older adults.  If you regularly have difficulty swallowing or if weight loss, regurgitation or vomiting accompany your dysphagia it is important to schedule an appointment with us to determine the cause.  An upper endoscopy is needed to diagnose and treat causes of esophageal dysphagia.  Barium swallow x-rays may initially be used.  Oropharyngeal dysphagia may require other studies to better define motility such as a dysphagia swallowing study or esophageal manometry study.

Signs of Dysphagia

Dysphagia can show itself in different forms. Some of the signs and symptoms that are associated with dysphagia are:

  • having pain while swallowing (odynophagia)
  • drooling
  • unexpectedly losing weight
  • being hoarse
  • having the sensation of food getting stuck in your throat or chest or behind your breastbone (sternum)
  • having to cut food into smaller pieces or avoiding certain foods due to trouble swallowing
  • having frequent heartburn
  • being unable to swallow
  • having food or stomach acid back up into your throat, bringing food back up (regurgitation)
  • coughing or gagging when swallowing

With swallowing being such a complex action and there being many things that can interfere with swallowing, the exact cause of dysphagia can be a challenge to pinpoint. Dysphagia usually falls into 2 categories, esophageal dysphagia and oropharyngeal dysphagia.

Esophageal dysphagia is when there is the sensation that food is sticking or getting hung in the base of the throat or in the chest after you have begun to swallow. There are many different causes of esophageal dysphagia.  Causes can include:

  • Achalasia
  • Diffuse Spasm
  • Esophageal stricture
  • Esophageal Tumors
  • Foreign bodies
  • Esophageal ring
  • Gastroesophageal reflux disease (GERD)
  • Eosinophilic esophagitis
  • Scleroderma
  • Radiation therapy

Oropharyngeal dysphagia is where the throat muscles can weaken and make it difficult to move food from the mouth, to the throat, and then to the esophagus when swallowing begins.  One may cough, choke, or even gag when they begin to swallow.  The individual may also feel as if the food or liquid is going into the windpipe or in the nose.  Oropharyngeal dysphagia could potentially lead to pneumonia.  Causes of oropharyngeal dysphagia consist of neurological disorders, neurological damage, pharyngeal diverticula, and cancer.  The neurological disorders that can cause dysphagia are multiple sclerosis, muscular dystrophy, and Parkinson’s disease.  A stroke, brain, or spinal cord injury that is associated with neurological damage can affect the ability to swallow. The small pouch, pharyngeal diverticula, that can form and collect food in the throat right about the esophagus can cause gurgling sounds, repeated coughing and throat clearing, difficulty swallowing, and bad breath. Some cancers and cancer treatment methods, such as radiation can cause difficulty swallowing.