Dysphagia

Swallowing problems (dysphagia) occur when solids and liquids seem to stick in your throat on the way down to your stomach, or the food takes longer to get to the stomach. Other symptoms (problems) include regurgitating (burping) up food, noises coming from the throat, chest discomfort with swallowing, and a feeling of fullness in the throat when swallowing. When blockage in the throat is complete it may be associated with drooling.

CAUSES

There are many causes of swallowing difficulties and the following is generalized information regarding a number of reasons for this problem. Problems with swallowing may occur because of problems with the muscles. The food cannot be propelled in the usual manner into the stomach. There may be ulcers, scar tissueor inflammation (soreness) in the esophagus (the food tube from the mouth to the stomach) which blocks food from passing normally into the stomach. Causes of inflammation include acid reflux from the stomach into the esophagus. Inflammation can also be caused by the herpes simplex virus, Candida (yeast), radiation (as with treatment of cancer), or inflammation from medications not taken with adequate fluids to wash them down into the stomach. There may be nerve problems so signals cannot be sent adequately telling the muscles of the esophagus to contract and move the food along. Achalasia is a rare disorder of the esophagus in which muscular contractions of the esophagus are uncoordinated. Globus hystericus is a relatively common problem in young females in which there is a sense of an obstruction or difficulty in swallowing, but in which no abnormalities can be found. This problem usually improves over time with reassurance and testing to rule out other causes.

DIAGNOSIS

A number of tests will help your caregiver know what is the cause of your swallowing problems. These tests may include a barium swallow in which x-rays are taken while you are drinking a liquid that outlines the lining of the esophagus on x-ray. If the stomach and small bowel are also studied in this manner it is called an upper gastrointestinal exam (UGI). Endoscopy may be done in which your caregiver examines your throat, esophagus, stomach and small bowel with an instrument like a small flexible telescope. Motility studies which measure the effectiveness and coordination of the muscular contractions of the esophagus may also be done.

TREATMENT

The treatment of swallowing problems are many, varying from medications to surgical treatment. The treatment varies with the type of problem found. Your caregiver will discuss your results and treatment with you. If swallowing problems are severe the long term problems which may occur include: malnutrition, pneumonia (from food going into the breathing tubes called trachea and bronchi), and an increase in tumors (lumps) of the esophagus.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Food or other object becomes lodged in your throat or esophagus and won't move.