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Difficulty swallowing - Dysphagia

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Are you having difficulty swallowing but no pain when swallowing?Dysphagia is difficulty in moving food or liquid from mouth to the stomach. Dysphagia may be associated with pain while swallowing, or not being able to swallow at all.

Occasional difficulty in swallowing usually isn't cause for concern, and may simply occur when you eat too fast or don't chew your food well enough. But persistent swallowing problems may indicate a serious medical problem requiring treatment.

Dysphagia can occur at any age, but is most common in older adults. The causes of dysphagia vary, and treatments depend upon the cause. In many cases, dysphagia can be partially or completely corrected.

Signs and symptoms 

Signs and symptoms sometimes associated with dysphagia may include:

  • Pain while swallowing (odynophagia)

  • Not being able to swallow at all

  • Choking or coughing while eating

  • Sensation of food getting stuck in your throat or chest, or behind your breastbone (sternum)

  • Pressure or pain in your chest

  • Bringing food back up (regurgitation)

  • Frequent heartburn

  • Food or stomach acid backing up into your throat

  • Gurgling sound in your throat

  • Unexpected weight loss

In infants and children, signs and symptoms of dysphagia may include:

  •  Lack of attention during feeding or meals

  • Tensing of the body during feeding

  • Refusing to eat foods of different textures

  • Lengthy feeding or eating times (30 minutes or longer)

  • Food or liquid leaking from the mouth

  • Coughing or gagging during feeding or meals

  • Spitting up or vomiting during feeding or meals

  • Inability to coordinate breathing with eating and drinking

  • Poor weight gain or growth


When you swallow, your tongue pushes food to the back of your throat. Muscle contractions quickly move food through your pharynx, the area that extends from the back of your throat to the top of your esophagus. Next, the food moves past your windpipe (trachea) and into your esophagus, the tube that connects your throat to your stomach.

Circular bands of muscles (sphincters) at the top and bottom of your esophagus open every time you swallow to let food pass, then quickly close. The lower sphincter allows food to enter your stomach and keeps stomach acid from coming up into your esophagus. Muscles in the wall of your esophagus help push food toward your stomach in a coordinated process (peristalsis). Dysphagia occurs when there's a problem with any part of the swallowing process.

A number of conditions can interfere with swallowing, and they generally fall into one of several main categories:

Esophageal dysphagia
This is the most common type of dysphagia, and refers to the sensation of food sticking or getting hung up in the base of your throat or chest. Common causes of esophageal dysphagia include:

  • Achalasia. This occurs when your lower esophageal muscle (sphincter) doesn't relax properly to let food enter your stomach. Muscles in the wall of your esophagus are often weak as well. This can cause regurgitation of food not yet mixed with stomach contents, sometimes causing a sweet taste in your mouth.

  • Aging. With age, your esophagus tends to lose some of the muscle strength and coordination needed to push food into your stomach.

  • Diffuse spasm. This condition produces multiple, high-pressure, poorly coordinated contractions of your esophagus usually after you swallow. Diffuse spasm is a rare disorder that affects the smooth (involuntary) muscles in the walls of your lower esophagus. The contractions often occur intermittently, becoming more severe over a period of years.

  • Esophageal stricture. Narrowing of your esophagus (stricture) causes large chunks of food to get caught. Narrowing may result from the formation of scar tissue, often caused by gastroesophageal reflux disease (GERD), or tumors.

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

  • Foreign bodies. Sometimes, food, such as a large piece of meat or bone, or another object can become lodged in your throat or esophagus. Older adults with dentures and people who have difficulty chewing their food properly are at risk of obstruction of the throat or esophagus. Children are prone to swallowing pins, coins, pieces of toys, or other small objects that can become stuck. If an obstruction causes an inability to swallow or interferes with breathing, call for emergency help or go to the nearest emergency department immediately.

  • Gastroesophageal reflux disease (GERD). Damage to esophageal tissues from stomach acid backing up (refluxing) into your esophagus can lead to scarring and narrowing of your lower esophagus, making swallowing difficult. Long-term GERD can sometimes lead to Barrett's esophagus, a condition in which the color and composition of the cells lining your lower esophagus change because of repeated exposure to stomach acid. Having Barrett's esophagus increases your risk of esophageal cancer.

  • Pharyngeal diverticula. A small pouch forms and collects food particles in your throat, often just above your esophagus, leading to difficulty swallowing, gurgling sounds, bad breath and repeated throat-clearing or coughing. This disorder is more common as you age.

  • Scleroderma. This disease is characterized by an overgrowth of scar-like tissue, causing stiffening and hardening of tissues. It can weaken your lower esophageal sphincter, allowing acid to reflux into your esophagus and causing symptoms and complications similar to those of GERD.

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This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.
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