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Difficulty swallowing - Dysphagia
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Difficulty swallowing - Dysphagia

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Risk factors 

Due to natural aging and normal wear and tear on the esophagus, older adults are at higher risk of dysphagia. Babies born prematurely are more prone to developmental problems, including gastrointestinal disorders that may cause difficulty swallowing. People with neurologic or nervous system disorders are more likely to experience dysphagia.

When to seek medical advice 

If an obstruction causes an inability to swallow or interferes with breathing, call for emergency help or go to the nearest emergency department immediately.

Slight or occasional difficulty swallowing usually isn't cause for concern. But dysphagia can indicate a serious medical problem, such as esophageal cancer. See your doctor if you regularly have difficulty swallowing. Your doctor will likely perform a physical examination to determine the cause of your swallowing problem. Depending on the cause, your doctor may refer you to an ear, nose and throat specialist (otolaryngologist), a doctor specialized in treating disorders of the esophagus (gastroenterologist), or an expert in diseases of the nervous system (neurologist).

Screening and diagnosis 

Your doctor may use a variety of tests to determine the cause of dysphagia. These may include:

  • Barium X-ray. For this test, you drink a barium solution. The barium coats the inside of 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.

  • Endoscopy. A thin, flexible, lighted instrument (endoscope) is passed down your throat so that your doctor can view your esophagus.

  • Esophageal muscle test. In this test, called manometry, a small tube is inserted into your esophagus and connected to a pressure recorder. This allows measurement of the muscle contractions of your esophagus as you swallow.

Complications

Dysphagia can make it difficult for you to take in enough food and fluids to stay adequately nourished. People with swallowing difficulties are at risk of malnutrition and dehydration. If food or liquid enters your airway (aspiration) as you attempt to swallow, respiratory problems or infections can occur, such as frequent bouts of pneumonia or upper respiratory infections.

Treatment

Treatment for dysphagia is often tailored to the particular type or cause of your swallowing disorder:

  • Oropharyngeal dysphagia. For oropharyngeal dysphagia, your doctor will most likely refer you to a throat specialist or neurologist for further diagnostic testing, and a speech or swallowing specialist for therapy. Certain exercises may help coordinate your swallowing muscles or restimulate the nerves that trigger the swallowing reflex. You may also learn simple ways to place food in your mouth or to position your body and head to help you swallow successfully.

  • Esophageal dysphagia. For a tight esophageal sphincter (achalasia) or an esophageal stricture, your doctor may use an endoscope with a special balloon attached to gently stretch and expand the width of your esophagus (dilatation). For an esophageal tumor or pharyngeal diverticula, you may need surgery to clear your esophageal path. Dysphagia associated with GERD can be treated with prescription oral medications to reduce stomach acid after a stricture is dilated. You may need to take these medications for an extended period of time.

  • Severe dysphagia. If dysphagia prevents you from eating and drinking enough to maintain a healthy weight and avoid dehydration, your doctor may recommend special liquid diets. In severe cases of dysphagia, you may need a feeding tube to bypass the part of your swallowing mechanism that isn't working normally.

Prevention 

Although dysphagia can't be prevented when the cause is neurologic damage or disorders, 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.

Coping skills 

Living with dysphagia can be difficult. Dysphagia may affect your interaction with friends and family, your productivity at work and the overall quality of your life.

 

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Disclaimer

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.
In no event will The DrEddyClinic.com be liable for any decision made or action taken in reliance upon the information provided through this web site.

 


 



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