Dysphagia refers to difficulties during the swallowing process. There are two main types:
- Oropharyngeal dysphagia — swallowing problems happen in the mouth and pharynx (the part of the throat behind the mouth)
- Esophageal dysphagia—swallowing problems happen in the esophagus (tube that transports food from the throat to the stomach)
This article focuses on esophageal dysphagia.
A number of conditions can cause esophageal dysphagia, such as:
Many conditions and factors may increase your risk of esophageal dysphagia, like:
- Advanced age
- Gastroesophageal reflux disease (GERD)
- Radiation therapy
- Respiratory or cardiovascular disorder (eg, stroke )
- Surgery (eg, fundoplication )
- Being born prematurely
- Taking certain medicines that may affect how the esophagus works (eg, tetracycline , anticholinergics, corticosteroids)
- Difficulty swallowing solids, liquids, or both
- A sensation of food being stuck in the esophagus
- Pain when swallowing
- Heartburn, regurgitation
- Coughing or choking when eating or drinking
- Wheezing, hoarse voice
- Weight loss, malnutrition, and dehydration (due to problems with eating and drinking)
The doctor will:
Ask about your symptoms, such as:
- Where do you feel the pain when you swallow?
- What foods or liquids lead to symptoms?
- Do the symptoms happen every time you eat or drink? Is the problem getting worse?
- Do you have heartburn?
- Take your medical history.
- Do a physical exam.
Tests may include:
- Swallow test (to observe what happens when you swallow)
- Videofluorographic swallowing study (VFSS)—an imaging test that involves swallowing food mixed with barium solution (This allows the doctor to watch the swallowing process on a monitor.)
- Barium swallow —an imaging test that involves swallowing a barium solution and having x-rays taken of the esophagus
- Endoscopy —a thin, lighted tube is inserted down the throat to examine the esophagus
- Esophageal manometry—a test to measure the functioning of the esophageal muscles
Treatment may include:
- Procedures, such as:
- Surgery (eg, to remove an esophageal tumor)
- Dietary changes—You may need to avoid eating foods that cause problems, like meat. Or you may need to eat only pureed food. In severe cases, a feeding tube may be needed to provide nutrition.
- Therapy to improve swallowing—such as learning ways to prevent choking while eating.
- Medicine (eg, to treat GERD or to relax the esophagus)
You can reduce your risk by getting early treatment for any related condition, like GERD.
- Reviewer: Daus Mahnke, MD
- Review Date: 10/2011 -