Difficulty Swallowing

Also known as dysphagia, “difficulty swallowing” is generally a sign of problems with either your esophagus or your throat. Dysphagia is more common in babies, the elderly, and individuals with brain or nervous system disorders, but anyone can have difficulty swallowing at any time.

Causes and Concerns

There are several reasons why the throat or the esophagus might not function correctly. Some are minor while others are more serious health conditions. If you or a member of your family only experience difficulty swallowing a few times,  you don’t need to worry, as this is likely not a major medical problem. However, if this happens frequently it may be a warning sign of a serious issue that needs to be addressed by your health care provider.

There are two kinds of conditions that could possibly be causing difficulty swallowing. One involves the nerves and muscles that move food from the throat and esophagus. If these structures are not functioning properly, your swallowing problem could be the result of:

  • Brain trauma, a spinal cord injury, or stroke – These injuries result in difficulty swallowing.
  • A nervous system disorder – This could include diseases such as muscular dystrophy or multiple sclerosis.
  • An immune system condition – These cause inflammation, swelling, and weakness of the esophagus and throat.
  • Esophageal spasm – This involves sudden squeezing of the muscles of the esophagus.
  • Scleroderma – This is a condition where esophageal tissues become narrowed and hardened. This condition can also cause the lower esophageal muscles to weaken so stomach acids and food will back up into your mouth and throat.

The second cause involves something blocking your esophagus or throat due to:

  • GERD (gastroesophageal reflux disease) – This is where stomach acid frequently backs up into your esophagus. GERD can result in esophageal ulcers and scarring that forms can cause narrowing of your esophagus.
  • Esophagitis – With this condition, there is inflammation of the esophagus, which may be caused by things like GERD, infections, allergic reactions, or the presence of a foreign body in your esophagus.
  • Diverticula – The presence of small sacs (diverticula) in the walls of your esophagus and/or throat can lead to difficulty swallowing.
  • Esophageal tumors – These growths may be either benign or cancerous.
  • Pressure – Constant pressure on your esophagus caused by external mass can lead to dysphagia.

Symptoms and Signs

Difficulty swallowing can be transitory, mild, severe, and it often worsens over time (called a progressive disorder). If you experience accompanying symptoms and signs, you should see one of our throat specialists as soon as possible. The symptoms and signs include:

  • Problems with food or liquids not going down the first time you swallow
  • Gagging, choking and/or coughing when swallowing
  • Food or fluids back up into your mouth, throat and/or nose after swallowing
  • A sensation that liquids or food are stuck in your throat or chest
  • Painful swallowing
  • Pain and/or pressure in your chest or heartburn
  • Loss of weight as a result of inadequate intake of food/liquids

Solutions and Options

A throat specialist can evaluate and treat you for difficulty swallowing. Depending on the severity of your individual health condition, he or she may refer you to a GI specialist or neurologist. Some of the procedures and test the doctor may perform include:

  • X-rays of your neck and/or chest are done for evaluation.
  •  Barium swallow:  This is an X-ray of your esophagus and throat.
  • Fluoroscopy:  This is a type of barium swallow where your dysphagia is videotaped.
  • Laryngoscopy:  This is an examination of the back of the throat using a fiber-optic scope.
  • Upper GI endoscopy or Esophagoscopy:  This involves a thin, flexible scope placed in your mouth and down your throat so the doctor can view your esophagus, stomach and/or upper intestines. Also, a biopsy to check for cancer cells may be done.

Naturally, treatment for your condition will depend on the cause. Some of the solutions and options we offer for dysphagia include:

  • Swallowing exercises – If a neurological disorder is causing your swallowing problems, exercises will train your muscles to work together again to aid in swallowing.
  • Changing your diet – If the foods and fluids you consume are the problem, the doctor will help you adjust your diet to make swallowing easier.
  • Dilation – This involves a device put down your esophagus to expand the narrow areas of your esophagus. Repeat procedures may be necessary.
  • Endoscopy – With this procedure, the doctor uses a long, thin scope to remove a foreign body stuck in your esophagus.
  • Surgery – When the doctor finds a problem, removal of a tumor or diverticula is done with surgical intervention.
  • Medications – Some problems swallowing can be treated with medications, such as underlying conditions like GERD, esophagitis or heartburn. These medicines prevent the backup of stomach acids. Also, esophageal infections are treated with certain antibiotics.

Summary

Difficulty swallowing is seldom caused by a cancerous tumor or serious neurological disorder. However, if the problem does not resolve itself within a short time, you should consult one of our competent, specially trained throat specialists. The doctor can offer you a solution to your symptom.