Dysphagia is the medical term for difficulty swallowing, or the feeling that food is “sticking” in your throat or chest. The feeling is actually in your esophagus, the tube that carries food from your mouth to your stomach.
You may experience dysphagia when swallowing solid foods, liquids, or both.
Oropharyngeal dysphagia is when you have trouble moving food from your mouth into your upper esophagus. Esophageal dysphagia is when you have trouble moving food through your esophagus to your stomach. It is the most common kind of dysphagia.
Dysphagia can strike at any age, although the risk increases with age.
What causes dysphagia?
Normally, the muscles in your throat and esophagus squeeze, or contract, to move food and liquids from your mouth to your stomach without problems.
Sometimes, though, food and liquids have trouble getting to your stomach. There are two types of problems that can make it hard for food and liquids to travel down your esophagus:
The muscles and nerves that help move food through the throat and esophagus are not working right. This can happen if you have:
- Had a stroke or a brain or spinal cord injury.
- Certain problems with your nervous system, such as post-polio syndrome, multiple sclerosis, muscular dystrophy, or Parkinson’s disease.
- An immune system problem that causes swelling (or inflammation) and weakness, such as polymyositis or dermatomyositis.
- Esophageal spasm. This means that the muscles of the esophagus suddenly squeeze. Sometimes this can prevent food from reaching the stomach.
- Scleroderma. In this condition, tissues of the esophagus become hard and narrow. Scleroderma can also make the lower esophageal muscle weak, which may cause food and stomach acid to come back up into your throat and mouth.
What are the symptoms?
Dysphagia can come and go, be mild or severe, or get worse over time. If you have dysphagia, you may:
- Have problems getting food or liquids to go down on the first try.
- Gag, choke, or cough when you swallow.
- Have food or liquids come back up through your throat, mouth, or nose after you swallow.
- Feel like foods or liquids are stuck in some part of your throat or chest.
- Have pain when you swallow.
- Have pain or pressure in your chest or have heartburn.
- Lose weight because you are not getting enough food or liquid.
How is dysphagia diagnosed?
If you are having difficulty swallowing, your doctor will ask questions about your symptoms and examine you. He or she will want to know if you have trouble swallowing solids, liquids, or both.
He or she will also want to know where you think foods or liquids are getting stuck, whether and for how long you have had heartburn, and how long you have had difficulty swallowing. He or she may also check your reflexes, muscle strength, and speech.
Your doctor may then refer you to one of the following specialists:
- An otolaryngologist, who treats ear, nose, and throat problems
- A gastroenterologist, who treats problems of the digestive system
- A neurologist, who treats problems of the brain, spinal cord, and nervous system
- A speech-language pathologist, who evaluates and treats swallowing problems
Health care providers typically treat dysphagia with drugs, exercises, and procedures that open the esophagus, or with surgery. Your treatment will depend on the cause, the seriousness, and any complications you may be experiencing.
You usually do not need to go to the hospital, as long as you are able to eat enough and have a low risk of complications.
If your esophagus is severely blocked, however, you may be hospitalized. Infants and children with dysphagia are often hospitalized.
To treat oropharyngeal dysphagia, you may learn special exercises that stimulate the nerves involved in swallowing. You may also learn to position your head in ways that help you swallow.
For esophageal dysphagia involving an esophageal muscle that doesn’t relax, your doctor may dilate your esophagus with a balloon attached to an endoscope.
If the problem is GERD, you will be given antacids or proton pump inhibitors. Your doctor may also prescribe medications that relax your esophagus and prevent spasms. If dysphagia is due to a tumor or other obstruction, you may need surgery.