Difficulty Swallowing (Dysphagia)
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What is dysphagia?
Dysphagia means difficulty swallowing. People who have dysphagia have trouble swallowing solid foods, liquids, or saliva. They may not be able to swallow at all. Dysphagia can make it hard to take in enough calories and fluids to keep your body working properly.
What are the symptoms of dysphagia?
If you have dysphagia, you may also have some of the following symptoms:
- Pain while swallowing
- Feeling like something is stuck in your throat or chest
- Being hoarse
- Coughing up food
- Gagging or coughing when swallowing
- Bad breath
- Weight loss
- Frequent heartburn
- Inhaling food (aspiration), which can lead to lung infections such as pneumonia
If you regularly have trouble swallowing or have these symptoms, contact your healthcare provider. If food has gotten stuck and you’re having trouble breathing, call for emergency help right away.
CAUSES & RISK FACTORS
Dysphagia can happen at any age, but it is more common in older people. Many different things can cause dysphagia:
- Poor eating habits. Eating too fast, taking large bites, eating while lying down or not drinking enough water while eating can all cause dysphagia. You may also experience dysphagia if you can’t chew properly because of painful or missing teeth or dentures.
- Nerve and muscle disorders. People who have had a stroke, or people who have Parkinson’s disease, multiple sclerosis, muscular dystrophy or myasthenia gravis may have problems swallowing. These disorders can stop the nerves and muscles in your esophagus (the tube that runs from your mouth and throat down to your stomach) from working right. This can cause food to move slowly or even get stuck in the esophagus.
- Problems with the esophagus itself. For example, conditions like acid reflux can damage the esophagus and cause scar tissue to form. The scar tissue may narrow the opening of the esophagus and may result in dysphagia.
- Other disorders. Certain cancers, an enlarged thyroid or an enlarged heart may put pressure on the esophagus and cause dysphagia.
DIAGNOSIS & TESTS
How is dysphagia diagnosed?
Your healthcare provider will ask you questions about your symptoms. They will probably ask you what foods or liquids you have trouble swallowing. They will want to know if you have pain when swallowing or frequent heartburn. Your healthcare provider may also ask you if you’ve coughed or thrown up any blood. If your healthcare provider decides you may have dysphagia, they may order tests to figure out what is causing it.
You may have a test called a barium swallow. During this test, you will drink a liquid that contains a small amount of barium, then the healthcare provider can watch it travel through your body on an X-ray machine. This test can show whether something is blocking your esophagus, or if another problem is causing your dysphagia.
You may also need an endoscopy. For this test, the healthcare provider uses a flexible tube with a light at the end of it to look inside the esophagus, stomach and the first part of small intestine.
The healthcare provider may take a small sample of tissue (called a biopsy) to rule out cancer or other possible causes of your dysphagia. You will probably be given a sedative drug to make you more relaxed and comfortable during the test. Your throat will also be numbed, so you shouldn’t feel pain when the tube is inserted.
Can dysphagia be prevented or avoided?
There isn’t anything you can do to prevent having swallowing difficulties. The best way to reduce your risk of occasionally having trouble swallowing is to eat slowly, eat small bites, and chew your food well. In addition, treating acid reflux early can help lower your risk of developing scar tissue in the throat.
Treatment for your dysphagia will depend on what is causing it.
If poor eating habits are the cause, you may be taught how to improve your ability to swallow, such as chewing carefully or drinking more water while eating. Or you may need to change positions while swallowing. This could be as simple as turning your head at a different angle.
Your healthcare provider may also work with you to find foods that are easier for you to swallow. You might need to do exercises to strengthen your swallowing muscles, such as your tongue and your esophagus.
Sometimes, medicine or other treatments may be used to treat the cause of dysphagia. For example, if your dysphagia is caused by heartburn, your healthcare provider might suggest taking an antacid or acid reducer before every meal. If you have a muscle problem causing dysphasia, a medication called botulinum toxin may be used to relax throat muscles, making swallowing easier.
Sometimes dysphagia is caused by a tumor or something else blocking the esophagus. You may need surgery to treat these problems. For some people, surgery won’t help. They would need a feeding tube in the stomach to make sure they are getting the foods and fluids they need.
Living with dysphagia
Dysphagia can lead to complications. These include:
- Malnutrition, weight loss, and dehydration. When you have trouble swallowing, it can be hard to get all of the fluids and nourishment you need.
- When you try to swallow, sometimes food or liquid may accidentally enter your airway. When this food or liquid goes into your lungs, it can introduce bacteria that causes pneumonia. This is called aspiration pneumonia. Pneumonia is a serious illness, especially in older people.
- If food gets stuck in your throat, you may choke. If it completely blocks the airway, you won’t be able to breathe and you could die.