Dysphagia is difficulty in swallowing. It is a symptom, not a disease. Dysphagia occurs when food fails to move from the mouth to the stomach because the mouth, throat or esophagus is not working properly or due to a narrowed pathway. Oropharyngeal dysphagia is a swallowing problem involving the mouth or throat, while esophageal dysphagia involves the esophagus.
Signs of oropharyngeal dysphagia include:
- Choking or coughing when swallowing
- Repeatedly having food caught in the throat
- Vomiting liquids through the nose
- Frequent clearing of the throat
- Lengthy chewing or repeated swallowing
- Difficulty or discomfort when swallowing
- Difficulty breathing when eating
- Inability to swallow
- Unusual head or neck movement during swallowing
- Avoiding eating with others
- Loss of appetite, dehydration or weight loss
- The feeling of food slowing or stopping beneath the breast bone
- Chest pain when swallowing
- Vomiting swallowed food
- Waking at night with a cough
- Loss of appetite or weight
Causes and Risk Factors
Approximately five to eight percent of Americans older than 50 suffer from some form of dysphagia, but it may occur at any age. Diseases of the mouth, throat or esophagus can cause the condition. Causes of orophayrngeal dysphagia include:
- Neurologic disorders, including stroke, Parkinson's disease, polio, multiple sclerosis and ALS
- Dementia or Alzheimer's disease
- Muscle diseases
- Tumors of the tongue or throat
- Chronic heartburn or gastroesophageal reflux disease (GERD)
- Collagen vascular diseases. These include scleroderma or lupus.
- Injury to the esophagus. These may include eating caustic materials or radiation treatments.
- Muscle diseases
Dysphagia can be diagnosed with the following techniques:
- Video fluoroscopic swallowing studies let the doctor see how the mouth and throat work during swallowing.
- A barium swallow can show if the esophagus contracts and relaxes correctly or if a blockage is present
- Upper GI endoscopy is done when the patient feels like food sticks in the throat after swallowing
- Laryngoscopy tests for abnormal growths in the throat
- High-resolution esophageal manometry identifies if the esophagus contracts and relaxes properly.
- Twenty-four hour pH testing measures how much acid moves back up from the stomach to the esophagus
- Neurologic tests may include CT or MRI scans
- CT or MRI scans may identify blockages caused by abnormal structures next to the esophagus
Depending on the type of dysphagia, treatment may include:
- Consulting a speech pathologist to learn new ways of swallowing
- Muscle exercises
- Learning new ways to eat
- Using of a feeding tube for patients who cannot take food and liquid by mouth.