Overview 

Difficulty swallowing may sometimes happen due to different reasons, such as eating too fast or not chewing the food well enough. This isn’t much of a concern. But if dysphagia persistently happens, it can be a clear sign of a serious medical condition, and treatment is required. 

Dysphagia can happen to any age, but it commonly happens to older adults. There are various causes of dysphagia, and treatment will depend on its cause. 

Symptoms of Dysphagia 

Difficulty swallowing has many symptoms which include: 

• Cannot swallow properly 
• Feeling pain while swallowing or also referred to as odynophagia 
• Drooling 
• Regurgitation 
• Hoarse 
• Having regular heartburn 
• Losing weight unexpectedly 
• Having stomach acid or food back up into the throat 
• Feeling the sensation of food staying in your throat, chest, or behind your breastbone 
• Gagging or coughing while swallowing 
• Needing to avoid fast foods or cut them into smaller pieces 

Causes of Dysphagia 

Since swallowing is a complex process, several factors can interfere with it. In some cases, the cause of dysphagia cannot be identified. But dysphagia has the following categories which are: 

Esophageal dysphagia 

This happens when you get the food sticking sensation in the base of the throat or chest after swallowing. Esophageal dysphagia has many causes which are: 

• Achalasia – your lower esophageal muscle or sphincter should relax properly so foods can enter your stomach without any problems. When this is not possible, this condition may bring every food that you eat goes back into your throat. 
• Diffuse spasm – this influences the involuntary muscles found in the walls of the lower esophagus. 
• Esophageal stricture – this condition is often caused by gastroesophageal reflux disease or GERD. If you have a narrowed esophagus, large pieces of food can be trapped, resulting in tumors or scar tissue. 
• Foreign bodies – aside from foods, other objects could block your throat or esophagus. For example, an adult who has dentures may accidentally swallow her dentures. This can cause difficulty swallowing. 
• GERD or gastroesophageal reflux disease – lower esophagus can get narrowed due to the damage of esophageal tissues caused by stomach acid. 

Diagnosis and Treatment of Dysphagia 

To diagnose and determine the cause of dysphagia, your doctor will perform a physical examination and do some tests which may include the following: 

• Study of dynamic swallowing. During this test, you will be asked to swallow foods that are barium-coated with various consistencies. Dynamic swallowing study will provide an image that will show how the food is traveling from your mouth down to your throat. A problem with coordination between throat muscles and mouth will be determined with this test. 
• Endoscopy. This is a visual examination of the esophagus. During this test, a thin and flexible lighted instrument, also called an endoscope, will be inserted to your mouth and passed down to your throat so your doctor can determine the real condition of your esophagus. Biopsies of your esophagus may also be requested by your doctor to check eosinophilic esophagitis, inflammation, narrowing, or tumor. 
• Fiber-optic endoscopic evaluation of swallowing or also referred to as FEES. Your doctor will use a specific camera and endoscope to examine your throat and see any problem inside. 
• Esophageal muscle test or manometry. The muscle contractions of your esophagus, while you swallow, will be measured using a tiny tube. This tube will be inserted into the esophagus, and it will be attached to a pressure recorder. 
• Imaging scans. This test may be a combination of a CT scan, X-ray, MRI scan to see if there is something wrong with your esophagus. 

Treatment for Dysphagia 

The best treatment for your dysphagia will depend on its type or its cause. 

Oropharyngeal dysphagia 

If you have a case of oropharyngeal dysphagia, your doctor will recommend you to a swallowing or speech therapist, and your therapy may include: 

• Learning exercises – there are exercises that you can do to improve the coordination of your swallowing muscles or restimulating your nerve that triggers your swallowing reflex. 
• Learning swallowing techniques – you will need to practice another way to place the food inside your mouth or determine the right position of your head and body to help you with swallowing. To treat dysphagia, which was caused by neurological diseases such as Alzheimer’s disease and Parkinson’s disease, you will need to learn specific exercises and new techniques for swallowing. 

Esophageal dysphagia 

For esophageal dysphagia, the treatment may include: 

• Esophageal dilation – if you have an esophageal stricture or tight esophageal sphincter (achalasia), your doctor will need to stretch and expand your esophagus’ width using an endoscope with a special balloon or a flexible tube/s. 
• Surgery – For some cases like an esophageal tumor, pharyngoesophageal diverticulum, or achalasia, surgery may be needed to clear the path of your esophagus. 
• Medications – if your difficulty swallowing is associated with GERD, this can be treated with medication to lessen your stomach acid. This medication may need to be taken in an extended period, depending on your doctor’s diagnosis. 

Severe Dysphagia 

When your dysphagia is preventing you from eating and drinking normally, your treatment may include: 

• Liquid diet – to maintain your healthy weight and to avoid dehydration, your doctor will recommend a special liquid diet. 
• Feeding tube – a feeding tube will be needed if you have severe dysphagia. This will be the substitute for your normal swallowing process. 

Surgery 

Dysphagia has cases where surgery is needed to relieve the problems due to throat narrowing or blockages. These problems may include bony outgrowths, pharyngoesophageal diverticulum, vocal cord paralysis, GERD, and achalasia. This is done to treat esophageal cancer. After the surgery, the patient commonly undergoes a speech and swallowing therapy since it can be more helpful along with the surgery. 

Your doctor may recommend any of these surgical treatments after diagnosing the type and cause of your dysphagia: 

• Laparoscopic Heller myotomy 
• Peroral endoscopic myotomy (POEM). 
• Esophageal dilation 
• Stent placement 

What are the normal conditions of dysphagia? 

Experiencing difficulties with swallowing is the primary symptom of dysphagia. But aside from this, there are certain symptoms that you need to observe before you schedule an appointment with your doctor. Those symptoms may include: 

• hoarse voice 
• drooling 
• you will that something is blocking in the throat 
• unexpected weight loss 
• regurgitation 
• chocking or coughing when swallowing 
• heartburn 
• pain when swallowing 
• difficulty with chewing foods 
• you want to avoid eating or skip meals because of these sensations 

For those children who are experiencing difficulty swallowing, they may feel: 

• refusing to eat some foods 
• food or liquid is leaking from their mouth 
• experience trouble with breathing while eating 
• regurgitate during meals 
• unintentional lose weight 

Risks of Having Dysphagia 

You are at high risk of developing dysphagia due to the following factors: 

• Age – adults are at high risk of dysphagia. Due to the natural process of aging, wear and tear happen on the esophagus. Adults may also subject to aging diseases such as stroke and Parkinson’s disease. But you shouldn’t associate dysphagia with getting old because this is not a normal sign of aging. 
• Certain health conditions – if a patient has an existing medical condition such as a neurological or nervous system, she is at high risk of dysphagia or experience difficulty swallowing. 

Complications of dysphagia 

Your difficulty swallowing has various complications which may include: 

• Weight loss, malnutrition, and dehydration. Since you cannot swallow properly, your body will not have enough fluids and nourishments which you can get from your daily meals. It is normal for a person who has dysphagia to lose weight without even trying. 
• Aspiration pneumonia. When the food or liquid enters your airways may bring bacteria to your lungs, which can lead to aspiration pneumonia. 
• Choking. Since every food that you eat is stuck in your throat, choking may frequently happen. In cases where food is completely blocking the airways, and there is no successful Heimlich maneuver, death may occur. 

When to Seek Medical Attention 

During the early stage, difficulty swallowing may feel normal to you. This happens to anyone. But if you get to experience the following conditions, this is a sign that you will need to seek medical attention: 

• Frequent difficulty swallowing – when your difficulty swallowing frequently happens in a day, you need to call your doctor and discuss your condition. This can be serious, and you will need proper treatment. 
• Weight loss, vomiting, or regurgitation – when you keep on experiencing these conditions, they may be a sign of dysphagia, and you will need some medications to ease your symptoms. 
• Obstruction interferes with breathing – when you cannot breathe while eating due to obstruction inside your throat or airways, you need to call an emergency assistant and visit the nearest emergency department. 

Difficulty swallowing or dysphagia may sound simple to you since it can happen anytime. But you should feel the need to see your doctor if you continue to experience this condition. Get the right treatment for your dysphagia before everything is too late.