What is dysphagia?
Dysphagia, or difficulty swallowing, is a type of swallowing disorder that makes it hard for you to eat, drink or swallow saliva. Some people with dysphagia can’t swallow at all.
Occasional swallowing problems affect everyone. You may have a hard time swallowing food if you don’t chew it well enough or feel like something “went down the wrong way” if you eat or drink too quickly. Dysphagia, however, causes regular, ongoing swallowing difficulties that, untreated, can lead to malnutrition (not getting the nutrients your body needs), dehydration, weight loss and other concerns.
Dysphagia can develop as you get older and the muscles that help you swallow become weak. But it’s not a condition on its own. Dysphagia can be a symptom of many conditions that affect your nerves, muscles or esophagus. Your doctor can help you find what’s causing your dysphagia and treat the cause or offer ways to improve your ability to swallow.
Types of dysphagia
Doctors might categorize dysphagia based on how it affects your ability to swallow.
Swallowing happens in four phases. First, chewing or gathering food or drinks in your mouth gets them ready for you to swallow (oral preparation phase). Second, your tongue moves foods and drinks toward your throat (oral phase). Third, food moves from your throat into your esophagus (pharyngeal phase). Finally, food travels down your esophagus into your stomach (esophageal stage).
Dysphagia can cause problems at each stage.
- Oropharyngeal dysphagia: Foods and liquids don’t travel from your throat into your esophagus as they should.
- Esophageal dysphagia: Swallowing difficulty occurs because of problems with the structure of your esophagus or its ability to move foods and drinks to your stomach.
Dysphagia symptoms
Dysphagia makes swallowing difficult, but what “difficult” looks like can vary. Some people may have problems swallowing only solids or liquids, while others may have difficulties swallowing both. Some symptoms affect the act of swallowing, and others show up a few seconds later.
Symptoms of dysphagia can include:
- Aspirating (inhaling) food
- Choking on foods or drinks or gagging when trying to swallow
- Coughing up food or blood
- Difficulty breathing while eating
- Drooling
- Feeling like something you’re trying to swallow is stuck in your throat or chest
- Foods and drinks coming out through the nose
- Having foods, drinks or stomach acids come back up into your throat (regurgitation)
- Heartburn that occurs frequently
- Hoarseness or other changes to your voice, such as gurgling
- Pain when you’re trying to swallow
- Taking longer than usual or using more effort to chew or swallow
When to see a doctor
See your doctor if you or someone you’re caring for has the symptoms of dysphagia listed above. Symptoms, such as drooling, choking, pain or problems swallowing, usually need attention as soon as you can see your doctor. Dysphagia can lead to aspiration pneumonia.
If someone is choking and cannot breathe, call 911.
Dysphagia causes
Many different conditions can cause dysphagia. These conditions may affect the brain, nervous system and muscles; how well the esophagus works (esophageal motility); or the esophagus itself. Oropharyngeal dysphagia can be caused by neurological or structural problems, and esophageal dysphagia can be caused by motility disorders or structural issues.
Dysphagia risk factors
Having a condition or taking a medication associated with dysphagia could increase your risk of developing it. Still, having one of those conditions does not mean you will develop dysphagia.
The other primary risk factor for dysphagia is age. It generally affects people aged 50 and older. Although dysphagia is not a natural part of aging, it occurs with many conditions that commonly occur as people get older. The esophagus also experiences age-related wear and tear, and swallowing muscles may get weak with age, increasing the chances of developing dysphagia.
Complications
Dysphagia can be isolating. You may not want to eat in social settings if you have trouble swallowing or symptoms that might feel embarrassing. You may also enjoy meals less than you used to.
Physically, dysphagia can cause long-term and potentially serious complications, including:
- Aspiration: When you inhale food into your lungs, harmful bacteria can enter your airways and cause pneumonia. Long-term aspiration can lead to chronic lung disease.
- Choking: Choking on food that you cannot swallow can be fatal.
- Dehydration, malnutrition and weight loss: Dysphagia can prevent your body from getting the liquid and nutrients you need. Over time, you can lose too much weight.
How is dysphagia diagnosed?
Dysphagia is often a symptom of another condition, so when you see your doctor, they will want to find out what could be causing your swallowing difficulties. They will start with a medical exam and then order tests to learn the underlying cause.
Dysphagia treatment
To treat your dysphagia, your doctor will focus on the underlying cause. There are many medications, therapies and procedures available to treat or manage conditions that cause dysphagia. You may need to work with one or more specialists, such as a gastroenterologist, neurologist, otolaryngologist (ear, nose and throat doctor), oncologist or surgeon, to find the right treatment for you.
Lifestyle changes and working with a speech-language pathologist (a specially trained therapist with expertise in swallowing disorders) may help you manage swallowing difficulties while receiving treatment for a related condition. Dysphagia therapy can also help people with dementia, cerebral palsy and similar conditions avoid complications.
When medical treatments or therapy no longer work, a feeding tube may be necessary.
Find care close to home if you have difficulty swallowing
At Baylor Scott & White, we offer several locations for the treatment of diseases of the digestive system, including dysphagia, at gastroenterology centers across North and Central Texas. Our experienced team is ready to provide personalized care to help improve your quality of life. Whether you're seeking diagnostic testing, treatment options or ongoing support, we are here to help you.
Loading locations...
Loading locations...