Difficulty Swallowing

General Gastroenterology
Written By Sydney Nagahiro

Difficulty swallowing (dysphagia) means it takes more time and effort to move food or liquid from your mouth to your stomach. Dysphagia may also be associated with pain. In some cases, swallowing may be impossible.  Occasional difficulty swallowing, which may occur when you eat too fast or don't chew your food well enough, usually isn't cause for concern. But persistent dysphagia may indicate a serious medical condition requiring treatment.

Dysphagia can occur at any age, but it's more common in older adults. The causes of swallowing problems vary, and treatment depends on the cause.  Fortunately, we have all the diagnostic and treatment tools necessary for the diagnosis and treatment of almost all diseases causing dysphagia at Integrated Gastroenterology Consultants.

Symptoms
Signs and symptoms associated with dysphagia may include:

  • Having pain while swallowing (odynophagia)

  • Being unable to swallow

  • Having the sensation of food getting stuck in your throat or chest or behind your breastbone (sternum)

  • Drooling

  • Being hoarse

  • Bringing food back up (regurgitation)

  • Having frequent heartburn

  • Having food or stomach acid back up into your throat

  • Unexpectedly losing weight

  • Coughing or gagging when swallowing

  • Having to cut food into smaller pieces or avoiding certain foods because of trouble swallowing

Some of the causes of esophageal dysphagia include:

  • Achalasia. When your lower esophageal muscle (sphincter) doesn't relax properly to let food enter your stomach, it may cause you to bring food back up into your throat. Muscles in the wall of your esophagus may be weak as well, a condition that tends to worsen over time.

  • Diffuse spasm. This condition produces multiple high-pressure, poorly coordinated contractions of your esophagus, usually after you swallow. Diffuse spasm affects the involuntary muscles in the walls of your lower esophagus.

  • Esophageal stricture. A narrowed esophagus (stricture) can trap large pieces of food. Tumors or scar tissue, often caused by gastroesophageal reflux disease (GERD), can cause narrowing.

  • Esophageal tumors. Difficulty swallowing tends to get progressively worse when esophageal tumors are present.

  • Foreign bodies. Sometimes food or another object can partially block your throat or esophagus. Older adults with dentures and people who have difficulty chewing their food may be more likely to have a piece of food become lodged in the throat or esophagus.

  • Esophageal ring. A thin area of narrowing in the lower esophagus can intermittently cause difficulty swallowing solid foods.

  • GERD. Damage to esophageal tissues from stomach acid backing up into your esophagus can lead to spasm or scarring and narrowing of your lower esophagus.

  • Eosinophilic esophagitis. This condition, which may be related to a food allergy, is caused by an overpopulation of cells called eosinophils in the esophagus.

  • Scleroderma. Development of scar-like tissue, causing stiffening and hardening of tissues, can weaken your lower esophageal sphincter, allowing acid to back up into your esophagus and cause frequent heartburn.

  • Radiation therapy. This cancer treatment can lead to inflammation and scarring of the esophagus.

Diagnosis
Your doctor will likely perform a physical examination and may use a variety of tests to determine the cause of your swallowing.
Tests may include:

  • Dynamic swallowing study. You swallow barium-coated foods of different consistencies. This test provides an image of these foods as they travel through your mouth and down your throat. The images may show problems in the coordination of your mouth and throat muscles when you swallow and determine whether food is going into your breathing tube.

  • A visual examination of your esophagus (endoscopy). A thin, flexible lighted instrument (endoscope) is passed down your throat so that your doctor can see your esophagus. Your doctor may also take biopsies of the esophagus to look for inflammation, eosinophilic esophagitis, narrowing or a tumor.

  • Esophageal muscle test (manometry). In manometry (muh-NOM-uh-tree), a small tube is inserted into your esophagus and connected to a pressure recorder to measure the muscle contractions of your esophagus as you swallow.

If you suffer from dysphagia, contact your doctor.  You can also call us at 978-459-6737  to schedule a consultation.

Sydney Nagahiro
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