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.
The esophagus is a muscular tube that connects your mouth and your stomach. Rings of muscle (sphincters) in the upper and lower portions contract and relax to allow food and liquid to pass.
Signs and symptoms associated with dysphagia may include:
See your doctor if you regularly have difficulty swallowing or if weight loss, regurgitation or vomiting accompanies your dysphagia.
If an obstruction interferes with breathing, call for emergency help immediately. If you're unable to swallow because you feel that the food is stuck in your throat or chest, go to the nearest emergency department.
Swallowing is complex, and a number of conditions can interfere with this process. Sometimes the cause of dysphagia can't be identified. However, dysphagia generally falls into one of the following categories.
Esophageal dysphagia refers to the sensation of food sticking or getting hung up in the base of your throat or in your chest after you've started to swallow. Some of the causes of esophageal dysphagia include:
Certain conditions can weaken your throat muscles, making it difficult to move food from your mouth into your throat and esophagus when you start to swallow. You may choke, gag or cough when you try to swallow or have the sensation of food or fluids going down your windpipe (trachea) or up your nose. This may lead to pneumonia.
Causes of oropharyngeal dysphagia include:
The following are risk factors for dysphagia:
Difficulty swallowing can lead to:
Although swallowing difficulties can't be prevented, you can reduce your risk of occasional difficulty swallowing by eating slowly and chewing your food well. Early detection and effective treatment of GERD can lower your risk of developing dysphagia associated with an esophageal stricture.
Your doctor will likely perform a physical examination and may use a variety of tests to determine the cause of your swallowing problem.
Tests may include:
X-ray with a contrast material (barium X-ray). You drink a barium solution that coats your esophagus, allowing it to show up better on X-rays. Your doctor can then see changes in the shape of your esophagus and can assess the muscular activity.
Your doctor may also have you swallow solid food or a pill coated with barium to watch the muscles in your throat as you swallow or to look for blockages in your esophagus that the liquid barium solution may not identify.
Treatment for dysphagia depends on the type or cause of your swallowing disorder.
For oropharyngeal dysphagia, your doctor may refer you to a speech or swallowing therapist, and therapy may include:
Treatment approaches for esophageal dysphagia may include:
If difficulty swallowing prevents you from eating and drinking adequately, your doctor may recommend:
Surgery may be recommended to relieve swallowing problems caused by throat narrowing or blockages, including bony outgrowths, vocal cord paralysis, pharyngoesophageal diverticulum, GERD and achalasia, or to treat esophageal cancer. Speech and swallowing therapy is usually helpful after surgery.
The type of surgical treatment depends on the cause for dysphagia. Some examples are:
If you have trouble swallowing, be sure to see a doctor and follow his or her advice. Also, some things you can try to help ease your symptoms include:
See your doctor if you're having problems swallowing. Depending on the suspected cause, your doctor may refer you to an ear, nose and throat specialist, a doctor who specializes in treating digestive disorders (gastroenterologist) or a doctor who specializes in diseases of the nervous system (neurologist).
Here's some information to help you prepare for your appointment.
For dysphagia, some basic questions to ask your doctor include:
Your doctor is likely to ask you a number of questions, including:
Until your appointment, it may help to chew your food more slowly and thoroughly than usual. If you have heartburn or GERD, try eating smaller meals, and don't eat right before bedtime. Over-the-counter antacids also may help temporarily.