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Dysphagia

Dysphagia is the medical terminology for difficulty in swallowing.

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In severe conditions, you may not be able to swallow at all. The problem lies in the esophagus or the throat which prevents propulsion of food smoothly from the mouth to the esophagus.

The term dysphagia is usually classified as a ‘symptom and sign’ for other conditions. In some cases, dysphagia is a condition in itself. It makes it difficult to pass solids or liquids from the mouth to the stomach.

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What are the symptoms of dysphagia?

Although dysphagia can occur in an individual, it’s more common in babies and old people.

You can understand that your baby is having trouble swallowing from the following symptoms:

  • Getting cranky, tensing the body and denying to eat
  • Vomiting the food, regurgitation or gurgling out liquid food
  • Choking while feeding, gasping for breath, coughing
  • Infants would also have a problem with breastfeeding

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Old people with dysphagia will experience the following difficulties:

  • Frequent gag reflex and coughing while swallowing
  • Pain while food passes down in the stomach
  • Chest pain due to chocking of food
  • Heartburn, acidity as stomach acids move up to the throat

What causes dysphagia?

There are two types of Dysphagia: Esophageal dysphagia and Oropharyngeal dysphasia

Esophageal dysphagia can make you feel as if food has gotten stuck in the food pipe, throat or your chest. This could happen due to narrowing (stricture) of the esophagus and improper relaxation (achalasia) of esophageal muscles or due to esophageal spasms.

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The problem is more evident in people with esophagitis like GERD or food allergy disease. The condition is worse in those diagnosed with esophagealtumors, scleroderma or dry mouth syndrome.

Oropharyngeal dysphasia is a serious condition occurring from improper functioning of nerves and muscles which hinders movement of food from mouth to stomach. It’s more evident in people with neurological disorders like Parkinson’s disease and multiple sclerosis.

Injury in spinal cord, stroke, cerebral damage and pharyngeal diverticula are some other reasons behind oropharyngeal dysphasia

Complications of oropharyngeal dysphasia

  • Oropharyngeal dysphasia can cause pneumonia
  • Weight loss and lack of nutrition due to reduced intake of food

Diagnosis of dysphagia

Your doctor will evaluate the symptoms and ask you several questions regarding incidence of swallowing, heartburn, vomiting, etc. Let your doctor know if you have a medical history of any disease or trauma.

After this initial evaluation, you need to undergo a series of diagnostic tests that would detect the underlying problem.

The tests are:

  • X ray which includes fluoroscopic swallowing study and barium swallow studies and barium x ray
  • Endoscopy of the pharynx, esophagus and stomach
  • Evaluate the function of pharyngeal and esophageal muscles called manometry
  • Esophageal acid testing to check acid reflux

Treatment for dysphagia

There are several lines of treatment for dysphagia, which depends completely on the underlying condition and the severity of the disease.

Dilation and surgery in the esophagus may be opted in to cure strictures, muscles complexities and congenital abnormalities. If your swallowing mechanism is completely impaired, the feeding tubes may be bypassed to restore normal swallowing.

If the complication has been diagnosed in the nervous system, then the treatment would be directed towards it.

Chemotherapy and radiation therapy would be suggested to cure tumors.

Botulinum toxin could also be used for treating achalasia while corticosteroids may be prescribed to treat eosinophilic esophagitis. GERD symptoms would be managed with antacids, calcium channel blockers, cholinergic medications, etc.

Coping and support for dysphagia patients

Your doctor would also explain you certain swallowing techniques and body postures while eating that would make swallowing easy.

Exercises to improve swallowing and esophageal function would also be taught. You need to practice them at home to manage the conditions.

You will be suggested special diet which could be liquid foods or solid of certain texture and consistency. You also need to be careful about your diet. Avoid eating foods that trigger acidity.

Dysphagia can occur any age and lead to problems swallowing. Seek immediate medical attention to avoid choking and further complications.

Written by: Saptakee sengupta
Date last updated: April 28, 2015