Dysphagia is difficulty swallowing. Certain conditions can weaken your throat muscles, making it difficult to move food from your mouth into your throat and esophagus when you start to swallow. You may choke, gag or cough when you try to swallow or have the sensation of food or fluids going down your windpipe (trachea) or up your nose. Sometimes the cause can’t be identified. However, dysphagia generally falls into one of the following categories.
This refers to the sensation of food sticking or getting stuck in the base of your throat. Some causes of esophageal dysphagia include:
- Achalasia. When the lower esophageal muscle (sphincter) doesn’t relax properly to allow food to enter your stomach. This may cause you to bring food back up into your throat. The muscles in your esophagus may be weak and can worsen over time.
- Diffuse spasm. This spasm affects the involuntary muscles in the walls of your lower esophagus. The spasm produces multiple high-pressure, poorly coordinated contractions of your esophagus after you swallow.
- Esophageal stricture. A stricture (narrowed section of your esophagus) can trap large pieces of food. Scar tissue, often caused by GERD, gastroesophageal reflux disease can cause the narrowing.
- Foreign bodies. When food or other objects block the esophagus. Dentures or too large of pieces of food becoming lodged in the throat.
- Gastroesophageal reflux disease (GERD). Damage to the esophageal tissues from stomach acid backing up into your throat (esophagus) causing spasms or scarring (tumors) of the narrowing part of the esophagus.
- Eosinophillic esophagitis. A condition which may be related to a food allergy.
- Scleroderma. Scar-like tissue, causing stiffening and hardening of tissues, can weaken your lower esophageal sphincter, allowing acid to back up into your throat causing heartburn.
- Radiation therapy. This cancer treatment can lead to inflammation and scarring of the esophagus.
Tests and Diagnosis of Dysphagia
- X-ray with a contrast. You drink a solution that has a dye to allow better imaging.
- Dynamic swallowing study. You swallow barium coated foods of different consistencies and watching for problems in the coordination of muscles in your mouth and throat and if food travels to your breathing tub.
- Fiber-optic swallowing (FEES). An endoscope with a camera to examine your throat as you swallow.
- Esophageal muscle test (manometry). A small tube is inserted into your nose and down your esophagus and to a pressure recorder to measure the muscle contractions in your esophagus as you swallow.
- Imaging scans.
- CT – combines X-ray view and computer processing to create cross-sectional images of soft tissue.
- MRI – uses a magnetic field and radio waves to create detailed images of organs and tissue.
- ET uses a radioactive drug to show how your tissues and organs are functioning.
Oropharyngeal dysphagia is when you throat muscles weaken.
Causes of Oropharyngeal Dysphagia may include:
- Neurological disorders. Multiple sclerosis, muscular dystrophy and Parkinson’s disease can cause dysphagia.
- Neurological damage. Damage due from a stroke or brain or spinal cord injury can affect your ability to swallow.
- Pharyngeal diverticula. A small pouch that forms and collects food particles in your throat often just above your esophagus, leading to difficulty swallowing, gurgling noises, bad breath, and repeated throat clearing or coughing.
- Cancer. Radiation can cause difficulty swallowing.
Treatment of Esophageal Dysphagia
- Esophageal dilation. Your gastroenterologist may use an endoscope with a special balloon attached to gently stretch and expand the width of your esophagus or pass a flexible tube to stretch the esophagus (dilation).
- Exercises. Certain exercises help coordinate the swallowing muscles or re-stimulate the nerves that trigger the swallowing reflex.
- Learning swallowing techniques. Learning ways to place food in your mouth or position your body and head to help you swallow.
Your doctor may recommend a special liquid diet to maintain a healthy weight and avoid dehydration. In more severe cases of dysphagia, you may need a feeding tube to bypass the part of your swallowing mechanism that isn’t working properly.
Prevention of Dysphagia
Just like your momma told you. “Take smaller bites, chew your food slowly and chew your food well and close your mouth when you chew.” My mom told me to count how many times I chewed. Do you remember what you were told?