Overview

What is dysphagia?

Dysphagia (say: “dis-fage-ee-uh”) means difficulty swallowing. People who have dysphagia have pain when they swallow solid foods, liquids or saliva, or may not be able to swallow at all.

Symptoms

What are the symptoms of dysphagia?

If you have dysphagia, you may also have some of the following symptoms:

  • Pain while swallowing
  • Choking
  • Feeling like something is stuck in your throat
  • Coughing up food
  • Gagging when swallowing
  • Bad breath
  • Drooling
  • Weight loss
  • Frequent heartburn
  • Dehydration
  • Inhaling food (aspiration), which can lead to lung infections such as pneumonia

Causes & Risk Factors

What causes dysphagia?

Dysphagia can happen at any age, but it is more common in older people. Many different things can cause dysphagia:Poor eating habits. Eating too fast, taking large bites, eating while lying down or not drinking enough water while eating can all cause dysphagia. You may also experience dysphagia if you can’t chew properly because of painful or missing teeth or dentures.Nerve and muscle disorders. People who have had a stroke, or people who have Parkinson’s disease, multiple sclerosis, muscular dystrophy or myasthenia gravis may have problems swallowing. These disorders can stop the nerves and muscles in your esophagus (the tube that runs from your mouth and throat down to your stomach) from working right. This can cause food to move slowly or even get stuck in the esophagus.Problems with the esophagus itself. For example, conditions like acid reflux can damage the esophagus and cause scar tissue to form. The scar tissue may narrow the opening of the esophagus and may result in dysphagia.Other disorders. Certain cancers, an enlarged thyroid or an enlarged heart may put pressure on the esophagus and cause dysphagia.

Diagnosis & Tests

How can my doctor tell if I have dysphagia?

Your doctor will ask you questions about your symptoms. He or she will probably ask you what foods or liquids you have trouble swallowing, or whether you have pain when swallowing or frequent heartburn. Your doctor may also ask you if you’ve coughed or thrown up any blood. If your doctor decides you may have dysphagia, he or she may order tests to figure out what is causing it.You may have a test called a barium swallow. During this test, you will drink a liquid that contains a small amount of barium, then the doctor can watch it travel through your body on an X-ray machine. This test can show whether something is blocking your esophagus, or if another problem is causing your dysphagia.You may also need an endoscopy. For this test, the doctor uses a flexible tube with a light at the end of it to look inside the esophagus, stomach and the first part of small intestine. The doctor may take a small sample of tissue (called a biopsy) to rule out cancer or other possible causes of your dysphagia. You will probably be given a sedative drug to make you more relaxed and comfortable during the test. Your throat will also be numbed, so you shouldn’t feel pain when the tube is inserted.

Treatment

How is dysphagia treated?

Treatment for your dysphagia will depend on what is causing it. If poor eating habits are the cause, you may be taught how to improve your ability to swallow, such as chewing carefully or drinking more water while eating. Or you may need to change positions while swallowing. This could be as simple as turning your head at a different angle. Your doctor may also work with you to find foods that are easier for you to swallow. You might need to do exercises to strengthen your swallowing muscles, such as your tongue and your esophagus. Sometimes, medicine or other treatments may be used to treat the cause of dysphagia. For example, if your dysphagia is caused by heartburn, your doctor might suggest taking an antacid or acid reducer before every meal. If you have a muscle problem causing dysphasia, a medication called botulinum toxin may be used to relax throat muscles, making swallowing easier. If your dysphagia is caused by a tumor or if something else is blocking the esophagus, you may need surgery to treat these problems.

Questions to Ask Your Doctor

  • Are there lifestyle changes I can make that will help dysphagia?
  • Are there medicines that treat dysphagia, and do they have side effects?
  • Will I need surgery? Are there other options?
  • Is dysphagia sign of another health condition?
  • Can you show me some swallowing techniques or exercises that may improve dysphagia?