If you frequently experience the feeling of taking more time and effort to move food or liquid from your mouth to your stomach, you may have a swallowing disorder called dysphagia. Dysphagia may also be accompanied by pain when swallowing. Show Occasional difficulty swallowing, which may occur when you eat or drink too quickly or when you don’t chew your food well enough, is not cause for concern. However, persistent dysphagia may indicate a serious medical condition requiring treatment. Dysphagia can occur at any age but is more common in older adults. The causes of swallowing disorders vary, and treatments vary depending on the cause. What are the symptoms of a swallowing disorder?
If you have been experiencing difficulty swallowing liquids or solids daily for more than 2-4 weeks, you should make an appointment with a specialist. What causes a swallowing disorder?Swallowing is complex, and a number of conditions can interfere with this process. Sometimes the cause of dysphagia cannot be identified. Most of the time, dysphagia can be identified as esophageal dysphagia or oropharyngeal dysphagia. Causes of Esophageal DysphagiaEsophageal dysphagia refers to the sensation of food sticking in the base of your throat or in your chest after you’ve started to swallow. Some (but not all) of the causes of esophageal dysphagia are:
Causes of Oropharyngeal DysphagiaOropharyngeal dysphagia is characterized by difficulty with timing the movement of food and liquids from your mouth to your throat and esophagus when you start to swallow. If you have oropharyngeal dysphagia, you may experience choking, gagging, or coughing when swallowing. You may have the sensation of liquids and/or solids “going down the wrong pipe” (going into the airway) or going up into the nose. Frequent episodes of liquids/solids going into the airway may lead to pneumonia. Some (but not all) of the causes of oropharyngeal dysphagia are:
How is a swallowing disorder diagnosed?If you are having difficulty swallowing solids or liquids, your doctor will ask you about your symptoms. He or she will probably perform or refer you for two or more of the following tests: Flexible laryngoscopy: This test is used to view the structures of the larynx (throat). A small flexible camera is passed through the nasal passage, through the nasopharynx (the connection between the nose and throat), and down into the throat. A topical anesthetic (numbing medication) is used for maximum comfort during the examination. The examination takes around 1 - 2 minutes and is not painful. Modified barium swallow study (MBS): This test is used to view your swallowing process. You will be asked to swallow a variety of barium-coated substances, such as liquid, applesauce, and a graham cracker. Barium is a whitish paste that allows the substances to light up under an X-ray so the examiner can determine how these substances are moving through your mouth, pharynx, and esophagus. Flexible endoscopic evaluation of swallowing (FEES): FEES is an instrumental examination of swallowing that allows the examiner to view food and liquid as it passes through the throat. In order to view the swallow, a small flexible laryngoscopy is performed (as described above). While visualizing the throat through the laryngoscope, a variety of foods and liquids are eaten and drank. During this examination, no radiation exposure is necessary. In contrast to the MBS, which does involve a small amount of radiation exposure, this test cannot be used to evaluate the oral and esophageal phases and cannot view the precise moment of aspiration. Therefore, this test is not appropriate for all dysphagia complaints. Esophageal manometry: This test is used to show whether your esophagus is working properly. The esophagus is a long, muscular tube that connects the throat to the stomach. An esophageal manometry measures the rhythmic muscle contractions that occur in your esophagus when you swallow. It also measures the coordination and force exerted by the muscles of your esophagus. During this test, a thin, flexible tube (catheter) that contains sensors is passed through your nose, down your esophagus, and into your stomach. Your throat and nose will be numbed for this test. During the test, you will be asked to take small sips of water, and swallow on command. How do you treat a swallowing disorder?Depending on the type and severity of dysphagia that you are experiencing, treatments can vary greatly. The most important things your doctor will consider when determining treatment are nourishment and risk of pneumonia or other pulmonary infections. Treatments for dysphagia may include (but are not limited to):
Complications of a swallowing disorderDysphagia can be frustrating because it takes the joy out of eating and drinking. It can also lead to more severe complications such as malnutrition, weight-loss, and dehydration. In addition, if you are aspirating (having liquids or solids enter the airway while swallowing), respiratory problems can occur such as pneumonia, bronchitis, or other upper respiratory infections. Conditions we treat |