Dysphagia is the medical term for difficulty swallowing, a condition that can be painful and, in severe cases, make swallowing impossible. Occasional difficulty swallowing, such as when eating too fast or not chewing food thoroughly, typically isn't a cause for concern. However, persistent dysphagia can be a serious medical condition that requires treatment.

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

Symptoms of Dysphagia

Common symptoms associated with dysphagia include:

• Pain while swallowing
• Inability to swallow
• Sensation of food being stuck in the throat, chest, or behind the breastbone
• Drooling
• Hoarseness
• Regurgitation of food
• Frequent heartburn
• Food or stomach acid backing up into the throat
• Weight loss
• Coughing or gagging when swallowing

When to See a Doctor

Consult a healthcare professional if you regularly experience difficulty swallowing or if weight loss, regurgitation, or vomiting accompanies dysphagia. If a blockage makes breathing difficult, seek emergency help immediately. If food feels stuck in your throat or chest, go to the nearest emergency department.

Causes of Dysphagia

Swallowing is a complex process involving numerous muscles and nerves. Any condition that weakens or damages these muscles and nerves or causes narrowing of the throat or esophagus can result in dysphagia. Dysphagia generally falls into two main categories:

Esophageal Dysphagia

This type of dysphagia involves the sensation of food sticking or getting caught in the base of the throat or chest after swallowing begins. Common causes include:

• Achalasia: This condition makes it difficult for the esophagus to squeeze food and liquids into the stomach due to damaged nerves or muscles.
• Esophageal Spasm: This involves high-pressure, poorly coordinated contractions of the esophagus, typically after swallowing.
• Narrowed Esophagus (Stricture): Tumors or scar tissue from gastroesophageal reflux disease (GERD) can cause narrowing of the esophagus, trapping large pieces of food.
• Esophageal Tumors: Tumors can progressively narrow the esophagus, making swallowing increasingly difficult.
• Foreign Bodies: Food or other objects can sometimes block the throat or esophagus, especially in older adults with dentures or those who have difficulty chewing.
• Esophageal Ring: A thin area of narrowing in the lower esophagus can cause difficulty swallowing solid foods.
• GERD: Stomach acid backing up into the esophagus can damage tissues, leading to spasm or scarring and narrowing of the esophagus.
• Eosinophilic Esophagitis: This immune system disease involves the buildup of white blood cells in the esophagus.
• Scleroderma: This condition causes scar-like tissue formation, stiffening and hardening tissues, weakening the lower esophageal sphincter, and causing acid reflux.
• Radiation Therapy: Cancer treatments can lead to inflammation and scarring of the esophagus.

Oropharyngeal Dysphagia

Certain conditions can weaken the throat muscles, making it difficult to move food from the mouth into the throat and esophagus. This can lead to choking, gagging, or coughing when swallowing, or the sensation of food or fluids going down the windpipe or up the nose, which can cause pneumonia. Causes include:

• Neurological Disorders: Conditions like multiple sclerosis, muscular dystrophy, and Parkinson's disease can cause dysphagia.
• Neurological Damage: Sudden neurological damage from a stroke or brain or spinal cord injury can affect swallowing ability.
• Pharyngoesophageal Diverticulum (Zenker Diverticulum): A pouch that collects food particles in the throat can cause difficulty swallowing, gurgling sounds, bad breath, and repeated throat clearing or coughing.
• Cancer: Certain cancers and cancer treatments, such as radiation, can cause difficulty swallowing.

Risk Factors

Factors that increase the risk of dysphagia include:

• Aging: Older adults are at higher risk due to natural aging and a greater likelihood of conditions such as stroke or Parkinson's disease. However, dysphagia isn't a typical sign of aging.
• Certain Health Conditions: Neurological or nervous system disorders increase the likelihood of difficulty swallowing.

Complications

Dysphagia can lead to several complications, including:

• Malnutrition, Weight Loss, and Dehydration: Difficulty swallowing can make it challenging to consume enough food and fluids.
• Aspiration Pneonia: Food or liquid entering the airway during swallowing attempts can cause aspiration pneumonia.
• Choking: Food stuck in the throat can cause choking, which can be fatal if the airway is completely blocked.

Prevention

While swallowing difficulties cannot always be prevented, you can reduce the risk of occasional dysphagia by eating slowly and chewing food thoroughly. If you experience symptoms of dysphagia, seek medical advice to address the condition promptly.

Sources

1. Mayo Clinic. (2022). Dysphagia. Retrieved from Mayo Clinic
2. National Institute on Deafness and Other Communication Disorders. (2020). Dysphagia. Retrieved from NIDCD
3. American College of Gastroenterology. (2021). Dysphagia. Retrieved from ACG
4. Cleveland Clinic. (2023). Dysphagia: What You Need to Know. Retrieved from Cleveland Clinic