Description

Dysphagia is a medical term for difficulty swallowing. Dysphagia can be a painful condition. In some cases, the swallowing is impossible.

Occasional difficulty in swallowing, such as when you eat too fast or don't chew your food well enough, usually isn't a cause for concern. But the course of dysphagia can be a serious medical condition that needs treatment.

Dysphagia can occur at any age, but is most common in older adults. The causes of swallowing problems vary, and treatment depends on the cause.

Symptoms

The symptoms associated with dysphagia may include:

  • Pain when swallowing.
  • Not be able to swallow.
  • Feeling as if food is stuck in the throat or in your chest or behind the breastbone.
  • Drooling.
  • The hoarseness.
  • Food to return, called regurgitation.
  • Frequent heartburn.
  • The food or acid from the stomach of the backup in the throat.
  • The loss of weight.
  • Coughing or gagging when swallowing.

When to see a doctor

Consult a health care professional if you regularly have difficulty swallowing or if the weight loss, regurgitation or vomiting that occurs with your dysphagia.

If a blockage makes it difficult to breathe, call for emergency help immediately. If you are unable to swallow because you feel that the food is stuck in the throat or chest, go to the nearest emergency department.

Causes

Swallowing is complex, with many muscles and nerves. Any condition that weakens or damages of these muscles and the nerves, or causes narrowing of the back of the throat or the esophagus can cause dysphagia.

Dysphagia generally falls into one of the following categories.

Dysphagia esophageal

Esophageal dysphagia refers to the feeling of food sticking or stuck in the base of the throat or in your chest after swallowing begins. Some of the causes of dysphagia esophageal include:

  • Achalasia. Achalasia is a disorder that leads to difficulty swallowing. Damage to the nerves or muscles make it difficult for the esophagus to push food and liquid in the stomach. Achalasia tends to get worse with time.
  • Esophageal spasm. This condition causes high pressure, with little coordination of the contractions of the esophagus, usually after swallowing. Esophageal spasm affects the involuntary muscles in the walls of the lower part of the esophagus.
  • A narrowing of the esophagus. Known as stenosis, a narrowing of the esophagus can trap large pieces of food. Tumors or scar tissue, often caused by gastroesophageal reflux disease (GERD), can cause narrowing.
  • Esophageal tumors. Difficulty swallowing tends to get progressively worse to the esophagus tumors are present. Tumors of constant growth and narrow the esophagus.
  • The foreign bodies. Sometimes the food or other object can partially block your throat or esophagus. Older adults with dentures and people who have difficulty chewing their food may be more likely to have a piece of food that get stuck in the throat or esophagus.
  • Esophageal ring. A thin area of narrowing in the lower part of the esophagus, on occasion, can cause difficulty swallowing solid foods.
  • The GERD. The acid from the stomach of the backup into the esophagus can damage tissues of the esophagus. This can lead to spasm or scarring and narrowing of the lower esophagus.
  • Esophagitis eosinophilic. Esophagitis eosinophilic disease is a disease of the immune system. Occurs when the white blood cells, called eosinophils, build up in the esophagus.
  • Scleroderma. Scleroderma causes the development of scar-like tissue, which results in stiffness and hardening of the tissues. This can weaken the lower esophageal sphincter. As a result, the acid builds up in the esophagus and cause frequent heartburn.
  • The radiation therapy. This cancer treatment can lead to inflammation and scarring of the esophagus.

Dysphagia oropharyngeal

Certain conditions may weaken the muscles of the throat, making it difficult to move food from the mouth to the throat and the esophagus during swallowing. A person can choke, gag or cough when trying to swallow, or have the sensation of food or liquids going down the trachea, called the trachea, or up the nose. This can lead to pneumonia.

Causes of dysphagia oropharyngeal include:

  • Neurological disorders. Certain disorders such as multiple sclerosis, muscular dystrophy and Parkinson's disease can cause dysphagia.
  • The neurological damage. Sudden neurological damage, such as a stroke or a brain or spinal cord, it can affect the ability to swallow.
  • Pharyngoesophageal diverticulum, also known as the of Zenker diverticulum. A small bag, known as a diverticulum, which forms and collects food particles in the throat, often just above the esophagus, leading to difficulty in swallowing, gurgling sounds, bad breath, and repeated throat clearing or coughing.
  • Cancer. Certain types of cancer and some cancer treatments, such as radiation can cause difficulty swallowing.

Risk factors

The following are risk factors for dysphagia:

  • Aging. Older adults are at greater risk of swallowing difficulties. This is due to the natural process of aging and wear and tear in the esophagus, as well as an increased risk of certain conditions, such as stroke or Parkinson's disease. But dysphagia is not considered a typical sign of aging.
  • Certain health conditions. People with certain neurological or nervous system disorders are more likely to have difficulty swallowing.

Complications

Difficulty swallowing may lead to:

  • Malnutrition, weight loss, and dehydration. Dysphagia can make it difficult to take in enough food and liquids.
  • Aspiration pneumonia. The food or liquid entering the airway during attempts to swallow can cause aspiration pneumonia as a result of the food introduction of bacteria into the lungs.
  • Suffocation. Food stuck in the throat can cause suffocation. If the food has completely blocks the airway and will not be involved with a successful Heimlich maneuver, death can occur.

Prevention

Despite difficulties in swallowing can't be prevented, you can reduce your risk once in a while, difficulty swallowing by eat slowly and chew food well. However, if you have symptoms of dysphagia, consult a health care professional.

If you have GERD , please consult a health professional for treatment.

Diagnosis

A member of your health care team will probably ask you for a description and history of his difficulties in swallowing, performing a physical examination, and the use of several tests to find the cause of your swallowing problem.

Tests may include:

  • X-ray with a contrast material called X-ray bario.De drink a barium solution that covers the esophagus, making it easier to see on x-rays. A health care team can see the changes in the shape of the esophagus, and you can check the activity of the muscles. You can also ask to swallow solid foods, or a pill coated with barium. This allows the health care team to see the muscles of the throat during swallowing or to look for blockages in the esophagus barium liquid solution may not display.
  • Dynamic swallowing study. This study involves the swallowing of barium-coated with food of different consistencies. Provides a picture of these foods as you travel through the throat. Images may show problems in the coordination of the mouth and the muscles of the throat during swallowing. The images can also show if the food is going in the breathing tube.
  • Endoscopy. Endoscopy involves passing a thin, flexible, lighted instrument called an endoscope, through the throat. This allows your health care team to see to your esophagus. The samples of tissue, called biopsies, may be collected. The samples are studied to see if there is inflammation, esophagitis eosinophilic, narrowing, or a tumor.
  • Fiber-optic endoscopic evaluation of swallowing (fees apply). For the FEES of the study, a health care professional examines the throat with an endoscope during swallowing.
  • Esophageal muscle test, called manometry. In the manometry (muh-NOM-uh-tree), a small tube that is inserted into the esophagus and connected to a pressure recorder to measure the contractions of the muscles of the esophagus during swallowing.
  • Imaging tests. These may include a ct scan or an mri. A ct scan combines a series of X-ray points of view, and computer processing to create cross-sectional images of the body, the bones and the soft tissues. An mri uses a magnetic field and radio waves to create detailed images of organs and tissues.

X-ray with a contrast material called barium X-ray. Drinking a barium solution that covers the esophagus, making it easier to see on x-rays. A health care team can see the changes in the shape of the esophagus, and you can check the activity of the muscles.

You can also ask to swallow solid foods, or a pill coated with barium. This allows the health care team to see the muscles of the throat during swallowing or to look for blockages in the esophagus barium liquid solution may not display.

Treatment

Treatment of dysphagia depends on the type or the cause of your disorder of swallowing.

Dysphagia oropharyngeal

For dysphagia oropharyngeal, you may be referred to a speech or swallowing therapist. The therapy may include:

  • Learning exercises. Certain exercises can help coordinate the muscles of swallowing or restimulate the nerves that trigger the reflex of swallowing.
  • Learning swallowing techniques. You can also learn ways to place the food in the mouth or the position of his body and head to help swallowing. Exercises new and swallowing techniques may help if the dysphagia is caused by neurological problems such as Alzheimer's disease or Parkinson's disease.

Dysphagia esophageal

Treatment approaches for esophageal dysphagia may include:

  • Dilation of the esophagus. Dilation involves the introduction of an endoscope in the esophagus and inflate, you attach a balloon to stretch. This treatment is used for achalasia, esophageal stenosis, motility disorders, or an irregular ring of tissue at the junction of the esophagus and the stomach, known as the ring of Schatzki. Long, flexible tubes of variable diameter can also be inserted through the mouth into the esophagus for the treatment of strictures and rings.
  • Surgery. For a tumor of the esophagus, achalasia, or pharyngoesophageal diverticulum, you may need surgery to clean up his esophagus way.
  • Drugs.Difficulty swallowing caused byGERDcan be treated with medications prescribed to reduce stomach acid. You might need to take these medicines for a long time. Corticosteroids may be recommended for esophagitis eosinophilic. For esophageal spasm, smooth muscle relaxants may help.
  • Of the diet. You may be prescribed a special diet to help with symptoms depending on the cause of the dysphagia. If you have esophagitis eosinophilic, the diet may be used as a treatment.

Drugs. Difficulty swallowing caused by GERD can be treated with medications prescribed to reduce stomach acid. You might need to take these medicines for a long time.

Corticosteroids may be recommended for esophagitis eosinophilic. For esophageal spasm, smooth muscle relaxants may help.

Dysphagia severe

If you have difficulty swallowing prevents him from eating and drinking enough, and the treatment does not allow to swallow safely, a feeding tube may be recommended. A feeding tube provides the nutrients without the need to swallow.

Surgery

Surgery may be needed to alleviate the problems of swallowing caused by a narrowing of the throat or blockages. The locks, which include bone tumors, vocal cord paralysis, pharyngoesophageal diverticula, GERD and achalasia. The surgery can also treat cancer of the esophagus. Speech and swallowing therapy is usually helpful after the surgery.

The type of surgical treatment depends on the cause of the dysphagia. Some examples are:

  • Laparoscopic Heller myotomy. This involves cutting the muscle at the lower end of the esophagus, called the esophageal sphincter. In people with achalasia, the esophageal sphincter does not open, and the release of food into the stomach. The Heller myotomy helps to correct this problem.
  • Peroral endoscopic myotomy (POEM). The POEM procedure involves creating an incision in the inner lining of the esophagus for the treatment of achalasia. Then, as in a Heller myotomy, the surgeon or gastroenterologist cuts the muscle at the lower end of the esophageal sphincter.
  • The placement of a Stent. A metal or plastic tube called a stent can be used to hold open a narrowing or blockage of the esophagus. Some stents are permanent, such as those for people with cancer of the esophagus, while others are removed later.
  • OnabotulinumtoxinA (Botox). This can be injected into the muscle at the bottom of the esophagus, called the esophageal sphincter. This makes you relax, the improvement of swallowing in achalasia. Less invasive than surgery, this technique may require repeat injections. More studies are needed.

Lifestyle and home remedies

If you have difficulty swallowing, be sure to consult a health professional. You can also try these approaches to help relieve the symptoms:

  • Change your eating habits. Try eating smaller, more frequent meals. Cut the food into smaller pieces, chew food well, and eat more slowly. If you have difficulty swallowing liquids, there are products that you can buy to thicken the liquid.
  • Trying foods with different textures to see if there is some cause more problems. Thin liquids, such as coffee and juice, are a problem for some people, and sticky foods, such as peanut butter or caramel, you can make it hard to swallow. Avoid foods that cause problems.
  • Limit the consumption of alcohol and caffeine. These can dry out the mouth and throat, making swallowing more difficult.

Preparing for your appointment

Consult a health care professional if you are having trouble swallowing. Depending on the suspected cause, you may be referred to an ear, nose, and throat specialist, a doctor who specializes in the treatment of digestive disorders, called a gastroenterologist, or a doctor who specializes in diseases of the nervous system, called a neurologist.

Here's some information to help you prepare for your appointment.

What you can do

When you make the appointment, ask if there is something that you need to do in advance, such as restrict your diet.

Make a list of:

  • Your symptoms, including any that seem unrelated to the reason for which you scheduled the appointment, and when they began.
  • Key personal information, including major stresses or recent life changes.
  • All the drugs, vitamins, and supplements you are taking, including dosage.
  • Questions to ask your health care team.

For dysphagia, questions include:

  • What is the most likely cause of my symptoms?
  • What are other possible causes?
  • What tests do I need?
  • Is this condition temporary or long-term?
  • I have other health conditions. How can I best manage them together?
  • I need to restrict my diet?
  • Are there brochures or other printed material I can have? What sites do you recommend?

What to expect from your doctor

Your health care team is likely to ask a series of questions, including:

  • The symptoms been continuous or occasional?
  • Nothing seems to improve the symptoms?
  • What, if anything, appears to worsen your symptoms? For example, there are certain foods harder to digest than others?
  • Do you have difficulty swallowing solids, liquids, or both?
  • Does your cough or gag when you try to swallow?
  • It was the first one has difficulty swallowing solids, and then develop difficulty in swallowing liquids?
  • Do you bring food after you swallow it?
  • Have you ever vomit or appears, blood or black material?
  • Have you lost weight?

What you can do in the meantime

Until his appointment, it may help to chew food slowly and thoroughly than usual. If you have heartburn or gastroesophageal reflux , try to eat smaller meals and not eating right before bedtime. Antacids you can buy without a prescription also may help temporarily.

Symptoms and treatment of Dysphagia