Dysphagia

What is a Dysphagia?

​​Dysphagia is difficulty eating because of a problem with the swallowing process. In severe cases, even saliva is difficult to swallow, and you may not be able to take in enough fluids and calories to stay healthy. Complications may include pneumonia from food or liquid in the lungs, food getting stuck in the esophagus, malnutrition, dehydration, and weight loss.

What Causes of Dysphagia?

Some causes of dysphagia include:

• Gastroesophageal reflux (heartburn) and sometimes the scarring that results from this

• Narrowing or swelling of the esophagus from inflammation or infection

• Radiation damage to the esophagus

• Muscle disorders, like dermatomyositis or myotonic dystrophy

• Obstructive lesions in the throat or esophagus, such as tumors

• Neurological disorders

• Scleroderma

• Thyroid disorders

• Medications
• Other less common structural abnormalities (like Zenker’s diverticulum or Cricopharyngeal bar)

Risk Factors

You may develop dysphagia if you have:

• Gastroesophageal reflux disease

• Previous or current treatment for head and neck cancer

• Progressive neurological disorder or muscle disorder

• Head trauma

What are the Symptoms of a Dysphagia?

Symptoms include:

• Trouble swallowing (sensation of food and medications sticking or moving slowly in the chest)

• Constant feeling of a lump in the throat

• Coughing or choking with eating or drinking

• Recurrent pneumonia

• Weight loss

Diagnosing Dysphagia

Your provider will watch you chew and swallow, then perform tests that could include:

• Nasopharyngoscopy — uses a scope to view the throat

• Blood tests — check for infection and thyroid function

• Barium swallow — X-ray test of the esophagus

• Upper endoscopy — uses a scope to examine the esophagus

• Video radiographic studies — X-rays during which swallowing is filmed on video

• Manometry — tests the amount of pressure generated in various parts of the esophagus

• pH studies — tests the degree of acidity in the esophagus

• CT scan — a type of X-ray that uses computers to take pictures of the neck and chest

What is the Treatment for Dysphagia?

Treatment of an underlying condition may help improve your swallowing problems. Some causes of dysphagia can be treated during an endoscopy.  A speech-language pathologist can also teach you:

• Techniques to help you swallow more easily

• Exercises that strengthen the muscles needed for swallowing

Diet Changes

Diet alone will not treat dysphagia, but it can make the symptoms easier to manage. In severe cases, you may need to follow a liquid diet.

Nonsurgical Procedures

Nonsurgical treatments include progressive dilatation —  a process by which your doctor slowly stretches your esophagus.

Surgery

In severe cases, surgery may be needed to:

• Release an overly tight muscle

• Remove a stricture or web blocking the esophagus

• Place a stent (a tiny tube) to hold the esophagus open

• Place a feeding tube through the abdominal wall