Dysphagia – Symptoms and Causes
What Is Dysphagia?
Dysphagia refers to difficulty swallowing. This condition can range from mildly uncomfortable to extremely painful. In severe cases, a person might find swallowing impossible altogether.
Most people experience trouble swallowing occasionally, like when eating too quickly or not chewing food properly. These isolated incidents typically don’t require medical attention. However, persistent swallowing problems may indicate a serious condition that needs treatment.
While dysphagia can affect people of all ages, older adults face a higher risk. The causes vary widely among patients, and treatment options depend directly on what’s causing the swallowing difficulty in each case.
Signs of Swallowing Problems
People with swallowing difficulties (dysphagia) may notice several signs. These can include feeling pain when trying to swallow or being completely unable to swallow food or liquids.
Many feel like food is stuck somewhere in their throat or chest area. Other common signs include drooling, speaking with a hoarse voice, and food coming back up after eating.
Some people experience frequent heartburn or notice stomach acid backing up into their throat. Weight loss often happens because eating becomes difficult. Coughing or gagging while swallowing is also common.
When You Should Get Medical Help
Contact your doctor if you regularly have trouble swallowing or if you’re losing weight, bringing food back up, or vomiting. These signs shouldn’t be ignored.
For serious situations, get emergency help right away if swallowing problems make it hard to breathe. If you feel food is stuck in your throat or chest and you can’t swallow at all, go to the nearest emergency room immediately.
Causes of Swallowing Difficulty
Swallowing is a complex process that involves many muscles and nerves working together.
When these muscles or nerves become weak or damaged, or when there’s narrowing in the throat or food pipe, swallowing problems can happen. These problems generally fall into two main types.
Problems in the Food Pipe
When food feels stuck at the base of your throat or in your chest after you start to swallow, this is called esophageal dysphagia. Several conditions can cause this:
Muscle Control Issues: In a condition called achalasia, damaged nerves or muscles make it hard for the food pipe to push food down to the stomach. This problem usually gets worse over time.
Muscle Spasms: Sometimes the muscles in the lower food pipe contract with too much pressure or in the wrong pattern after swallowing. These involuntary spasms can make swallowing difficult.
Narrowed Passages: The food pipe can become narrowed (called a stricture), trapping larger food pieces. This narrowing might come from scar tissue or tumors, often related to acid reflux disease.
Growths: Tumors in the food pipe make swallowing harder as they grow and narrow the passage for food.
Stuck Objects: Food or other items can get caught in the throat or food pipe. People with dentures or chewing problems face higher risks of this happening.
Thin Rings: Some people have a naturally narrow ring in the lower food pipe that makes it hard to swallow solid foods.
Acid Damage: When stomach acid flows back into the food pipe, it can harm the tissues. This may lead to spasms or scarring that narrows the passage.
Immune Response: In eosinophilic esophagitis, white blood cells build up in the food pipe, causing inflammation and swallowing problems.
Tissue Hardening: Conditions like scleroderma can create scar-like tissue that stiffens the food pipe and weakens the valve that keeps stomach acid down.
Cancer Treatment: Radiation therapy can inflame and scar the food pipe, making swallowing difficult.
Problems in the Mouth and Throat
Some conditions weaken throat muscles, making it hard to move food from the mouth into the throat and food pipe. People might choke, gag, or feel like food is going down the windpipe or up the nose.
This type is called oropharyngeal dysphagia and can lead to pneumonia if food enters the lungs.
Causes include:
1. Nerve and Muscle Disorders
- Multiple sclerosis
- Muscular dystrophy
- Parkinson’s disease
2. Sudden Nerve Damage
- Strokes
- Brain injuries
- Spinal cord injuries
3. Structural Problems
- Small pouches (Zenker diverticulum) that form in the throat and collect food, causing difficulty swallowing, gurgling sounds, bad breath, and coughing
4. Cancer and Treatment Effects
- Certain cancers affecting the throat or mouth
- Side effects from radiation therapy
Risk Factors
Several factors can increase your chance of having swallowing problems:
Age-Related Changes
- Older people face higher risks due to natural wear of the esophagus
- Not a normal part of aging, but more common in seniors
Health Conditions
- Neurological disorders often affect swallowing ability
- Conditions like stroke and Parkinson’s disease can impair normal swallowing function
Complications
Swallowing problems can create serious health risks.
Nutrition Issues and Dehydration
When eating becomes difficult, people may consume less food and liquid. This can lead to weight loss, malnutrition, and not getting enough fluids.
Lung Infections
Food or drinks that accidentally enter the airways can introduce harmful bacteria to the lungs. This may cause aspiration pneumonia, a serious infection.
Airway Blockage
Perhaps most dangerous is the risk of choking. Food stuck in the throat can block breathing. Complete airway blockage requires immediate help through the Heimlich maneuver to prevent death.
Preventing Swallowing Problems
You can’t completely prevent swallowing difficulties, but you can lower your risk by following some simple steps.
Try eating more slowly and chewing food thoroughly before swallowing. This gives your body more time to process each bite properly.
People with acid reflux (GERD) should seek medical treatment to help manage their condition and prevent swallowing complications.
