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Dysphagia

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OVERVIEW

What is dysphagia?

Dysphagia (say: “dis-fage-ee-uh”) means difficulty swallowing. People who have dysphagia have pain when they swallow solid foods, liquids or saliva, or may not be able to swallow at all.

SYMPTOMS

What are the symptoms of dysphagia?

If you have dysphagia, you may also have some of the following symptoms:

  • Pain while swallowing
  • Choking
  • Feeling like something is stuck in your throat
  • Coughing up food
  • Gagging when swallowing
  • Bad breath
  • Drooling
  • Weight loss
  • Frequent heartburn
  • Dehydration
  • Inhaling food (aspiration), which can lead to lung infections such as pneumonia

CAUSES & RISK FACTORS

What causes dysphagia?

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 can my healthcare provider tell if I have dysphagia?

Your healthcare provider will ask you questions about your symptoms. They will probably ask you what foods or liquids you have trouble swallowing, or whether 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.

TREATMENT

How is dysphagia treated?

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.

If your dysphagia is caused by a tumor or if something else is blocking the esophagus, you may need surgery to treat these problems.

QUESTIONS TO ASK YOUR HEALTHCARE PROVIDER

  • Are there lifestyle changes I can make that will help dysphagia?
  • Are there medicines that treat dysphagia, and do they have side effects?
  • Will I need surgery? Are there other options?
  • Is dysphagia sign of another health condition?
  • Can you show me some swallowing techniques or exercises that may improve dysphagia?

Written by familydoctor.org editorial staff.

Revised/Updated: 04-01-2014

Created: 09-01-2009

This handout provides a general overview on this topic and may not apply to everyone. To find out if this handout applies to you and to get more information on this subject, contact your family healthcare provider.

Copyright (c) by the American Academy of Family Physicians

Permission is granted to print and photocopy this material for non-profit educational uses.

Written permission is required for all other uses, including electronic uses.

Nova Scotia Telecare, Reviewed by Clinical Services Working Group, July 2019.

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