Dysphagia (Difficulty Swallowing)

Overview

Dysphagia is a medical term that refers to the inability to properly swallow food. Most of the time, it indicates a problem with your throat or esophagus, a muscular tube that connects the back of your mouth to your stomach.

Swallowing issues can express themselves in a number of different sites, including the mouth, throat, and esophagus.When you have begun to swallow and have the sensation of food sticking or being lodged up at the base of your throat or in your chest, this is referred to as esophageal dysphagia. Oropharyngeal dysphagia refers to swallowing difficulties that manifest in the mouth or throat.

Muscle weakness, sensory anomalies, or growths and obstructions in the mouth or throat are all typical causes of swallowing problems.

Swallowing problems can range in severity from minor to severe. Dysphagia is sometimes accompanied by a sense of discomfort. Swallowing can be difficult in some situations.When it is present in small concentrations, it is characterized by the sense that food is passing through the esophagus more slowly. It is generally considered to be harmless. Liquids may or may not be a source of contention.It is possible that solids and liquids will be unable to move down the esophagus at all when the condition is severe, causing you to vomit the food and drinks you have consumed.In severe case, there may be difficulty swallowing saliva.

Swallowing problems, which can occur when you eat too quickly or do not fully chew your food, are not a major source of concern for the vast majority of people. Persistent dysphagia, on the other hand, may be a sign of a more serious medical problem that necessitates medical intervention and therapy.Difficulty swallowing is also a symptom of Covid infection.

Difficulty swallowing can affect anyone at any age, but it is more common in older people than in children.

There are numerous causes of swallowing difficulties, and the treatment is influenced by the etiology of the difficulty swallowing.

Depending on the underlying cause of the problem, there are a variety of treatment options available. Doctors in some instances sometimes prescribe medicine to aid with the swallowing process. If you are unable to swallow, a feeding tube may be required to ensure that you receive appropriate nutrition.

Dysphagia diet reduces the chance of food or liquid entering the windpipe or trachea, which leads to the lungs.Including a range of textures in meals and beverages can help patients swallow more easily and safely.

Causes

There are a multitude of disorders, diseases, and conditions that can result in difficulty swallowing food.

Swallowing difficulties can be divided into three groups:

When there is a problem in the mouth, this condition is known as dysphagia of the oral cavity. A number of factors contribute to this, the most prevalent being post-stroke tongue paralysis, chewing difficulty, and neuromuscular abnormalities.

Oropharyngeal dysphagia is a condition that affects the throat. This could be the outcome of a neurological or muscular problem.

Esophageal dysphagia is a disorder that affects the esophageal tube. Any obstruction or compression of the esophagus, as well as a muscle dysfunction, or the presence of pouches in the esophagus, might result in this condition occurring.

Other medical conditions dysphagia causes are:

Brain disorders: Certain medical problems have an effect on your brain and neurological system (the network of nerves that controls muscles and organs). Swallowing difficulties can occur as a result of conditions such as multiple sclerosis, Parkinson’s disease, amyotrophic lateral sclerosis (ALS), and stroke.

Blockage: The esophagus may become restricted because of esophageal cancer, a tumor, or a big thyroid gland. The act of swallowing becomes more difficult when you have a restricted esophagus. Due to the constriction of this tissue, swallowing big amounts of food becomes more difficult. Swallowing difficulties can be caused by cricopharyngeal hypertrophy or other anomalies at the esophageal entrance as well as other factors. If you have something stuck in your throat, swallowing may be difficult or impossible to accomplish.

Anxiety: Difficulty swallowing is linked with anxiety as it causes the neck muscles to contract, giving some people the impression of having a lump in their throat.

Symptoms

Dysphagia is defined as difficulty swallowing and can present with various symptoms. Common dysphagia symptoms include food or liquids becoming caught in the throat or chest, choking or coughing when eating or drinking, frequent heartburn or regurgitation, accidental weight loss, and chronic pain or discomfort when swallowing. Dysphagia can substantially influence a person’s ability to eat and drink comfortably, resulting in nutritional deficits and a lower quality of life.

Diagnosis

Dysphagia diagnosis is by using a multidisciplinary approach. A healthcare provider will perform a complete medical history and physical examination. In a barium swallow study, a patient drinks a contrast dye to visualize the swallowing process using X-rays or endoscopy, and the esophagus and throat are examined using a thin, flexible tube with a camera. Furthermore, studies such as manometry can evaluate esophageal muscle function and quantify pressure while swallowing, which can help determine the origin and severity of dysphagia.

Treatment

Dysphagia treatment is determined by the underlying cause and severity. In many situations, management entails dietary changes, such as changing food texture or thickness, as well as practicing specific swallowing methods under the supervision of a speech therapist. Medications may be provided to treat acid reflux or esophageal irritation. 

Severe cases may necessitate surgical procedures, such as dilating restricted esophageal regions or fixing structural problems. Individuals with dysphagia must collaborate closely with a healthcare team to find the best treatment plan for their specific requirements and diagnosis.

When To See A Doctor

See your doctor if you are experiencing regular trouble swallowing and are losing weight, regurgitating, or vomiting because of the problem of difficulty swallowing.

If you are having trouble breathing because of an obstruction, seek medical attention right away.

You should seek medical assistance at your nearest emergency hospital if you are unable to swallow owing to suspected food caught in your throat or chest cavity.

Summary 

Dysphagia is a medical term for difficulty swallowing, often due to problems in the throat or esophagus. It can manifest in the mouth, throat (oropharyngeal dysphagia), or esophagus (esophageal dysphagia), with causes ranging from muscle weakness and sensory issues to growths or obstructions. According to the National Institutes of Health (NIH), dysphagia affects approximately 13% of the general population and up to 22% of adults over the age of 50. Symptoms include the sensation of food sticking in the throat or chest, choking, coughing, heartburn, regurgitation, weight loss, and pain while swallowing. Swallowing issues vary in severity and can sometimes lead to vomiting or difficulty swallowing saliva.

Dysphagia can result from numerous conditions, including neurological disorders like multiple sclerosis, Parkinson’s disease, ALS, stroke, and esophageal blockages caused by cancer or tumors. Nearly 80% of individuals with Parkinson’s disease and up to 68% of stroke survivors experience some form of dysphagia. Anxiety can also trigger swallowing difficulties due to muscle contraction in the neck, creating a feeling of a lump in the throat. While occasional swallowing problems may be harmless, persistent dysphagia could indicate serious medical conditions requiring intervention. Dysphagia is also a symptom in about 12.8% of patients with COVID-19, particularly those with prolonged intubation.

Diagnosis typically involves a medical history review, physical examination, and tests such as a barium swallow study, endoscopy, or manometry to assess muscle function and identify obstructions. Treatment depends on the cause and severity of dysphagia and may include dietary adjustments, swallowing exercises, medications, or surgical procedures to address structural issues. Approximately 50-75% of patients with oropharyngeal dysphagia benefit from rehabilitation and specific swallowing techniques.

Dysphagia can significantly affect a person’s ability to eat and drink, leading to nutritional deficiencies and reduced quality of life. Studies have shown that dysphagia can increase the risk of malnutrition and aspiration pneumonia, a leading cause of death in patients with neurodegenerative diseases. Individuals should seek medical advice if they experience frequent swallowing difficulties, unexplained weight loss, or severe symptoms like obstruction or difficulty breathing. Immediate medical attention is necessary for cases of suspected food blockage in the throat or chest. Close collaboration with healthcare providers is essential to determine the best management plan tailored to the patient’s specific needs and diagnosis.

-Disclaimer-

This information is intended for educational purposes only and should not be considered a substitute for professional medical advice. If you have concerns about dysphagia or any other medical condition, please see a doctor for an accurate diagnosis and personalized treatment suggestions.