Those that suffer from dysphagia, or swallowing disorders, have difficulty or pain moving food or liquids from their mouth to their stomach; some may not be able to swallow at all. Many people have experienced an occurrence of dysphagia if they eat too quickly or don’t chew their food well enough; this is not cause for concern. Frequent episodes of dysphagia on the other hand may indicate a serious medical condition and should be addressed immediately.
The common symptoms of dysphagia are pain when swallowing, having a sensation of food being stuck in your throat, throwing up food, frequent heartburn and drooling. Not being able to eat or drink enough may also lead to weight loss and dehydration.
The complicated process of swallowing contains three phases: oral, pharyngeal and esophageal. The oral phase involves chewing and moving food or liquid around into the throat. The pharyngeal phase is the beginning of the swallowing process; food is squeezed down the throat while the airway is closed off to prevent food or liquid from entering. The final phase is esophageal; this involves a series of relaxing and tightening movements of the esophagus in order to push the food through to the stomach.
Much like the process of swallowing, the various swallowing disorders are also broken up into separate categories: esophageal and oropharyngeal.
Oropharyngeal swallowing disorders involve an issue with moving food from your mouth into your throat, to start the swallowing process. Choking, gagging and coughing are all common symptoms of this type of disorder. Neurological disorders such as multiple sclerosis and Parkinson’s disease, neurological damage and some cancers and cancer treatments can weaken the throat muscles, leading to this type of swallowing disorder.
Esophageal dysphagia involves food sticking within the throat or chest after the swallowing process has begun. There are multiple causes for this type of swallowing disorder. Achalasia prevents the lower esophageal muscle from relaxing properly, causing food to back up into the throat. Esophageal stricture occurs when the esophagus has been narrowed, usually by gastroesophageal reflux disease (GERD), and food becomes stuck. Scleroderma is the development of scar-like tissue within the esophagus causing the tissue to harden. This leads to an acid backup within the esophagus.
After reviewing your medical history, there are a variety of tests your doctor may need to perform in order to make a diagnosis. An X-ray with contrast (such as a barium solution) is used to show the shape of your esophagus. A dynamic swallowing study involves swallowing barium-coated foods. Your doctor is able to watch the food travel through your mouth to your stomach to see where the problem is located.
Once your doctor is able to diagnose the specific cause of your dysphagia the next step is treatment. If you are suffering from an oropharyngeal dysphagia your doctor may recommend exercises to retrain your swallowing muscles and new swallowing techniques to practice. Treating an esophageal dysphagia is more complicated. If the dysphagia is caused by a tight or narrowed esophagus an esophageal dilation may be performed. This involves your doctor inserting a balloon to gently expand the width of your esophagus. If the dysphagia is caused by an obstruction in the throat, such as a tumor, surgery may be needed to remove the blockage. Medication can be useful if the cause is related to an increase in stomach acid, such as GERD.
If dysphagia is severe enough to not respond to treatment, a liquid diet or a feeding tube may be necessary. This would ensure you were still getting adequate nutrition and hydration.