Difficulty swallowing (dysphagia) means it takes more time and effort
to move food or liquid from your mouth to your stomach. Dysphagia may
also be associated with pain. In some cases, swallowing may be
impossible.
Occasional difficulty swallowing, which may occur when you eat too
fast or don’t chew your food well enough, usually isn’t cause for
concern. But persistent dysphagia may indicate a serious medical
condition requiring treatment.
Dysphagia can occur at any age, but it’s more common in older adults.
The causes of swallowing problems vary, and treatment depends on the
cause.
Symptoms
Signs and symptoms associated with dysphagia may include:
Having pain while swallowing (odynophagia), being unable to swallow,
having the sensation of food getting stuck in your throat or chest or
behind your breastbone (sternum), drooling,
being hoarse, bringing food back up (regurgitation), having frequent
heartburn, having food or stomach acid back up into your throat,
unexpectedly losing weight, coughing or gagging when swallowing,
having to cut food into smaller pieces or avoiding certain foods
because of trouble swallowing
Causes
Swallowing is complex, and a number of conditions can interfere with
this process. Sometimes the cause of dysphagia can’t be identified.
However, dysphagia generally falls into one of the following
categories.
Esophageal dysphagia
Esophageal dysphagia refers to the sensation of food sticking or
getting hung up in the base of your throat or in your chest after
you’ve started to swallow. Some of the causes of esophageal dysphagia
include:
Achalasia
When your lower esophageal muscle (sphincter) doesn’t relax properly
to let food enter your stomach, it may cause you to bring food back up
into your throat. Muscles in the wall of your esophagus may be weak as
well, a condition that tends to worsen over time.
Diffuse spasm
This condition produces multiple high-pressure, poorly coordinated
contractions of your esophagus, usually after you swallow. Diffuse
spasm affects the involuntary muscles in the walls of your lower
esophagus.
Esophageal stricture
A narrowed esophagus (stricture) can trap large pieces of food. Tumors
or scar tissue, often caused by gastroesophageal reflux disease
(GERD), can cause narrowing.
Esophageal tumors
Difficulty swallowing tends to get progressively worse when esophageal
tumors are present.
Foreign bodies
Sometimes food or another object can partially block your throat or
esophagus. Older adults with dentures and people who have difficulty
chewing their food may be more likely to have a piece of food become
lodged in the throat or esophagus.
Esophageal ring
A thin area of narrowing in the lower esophagus can intermittently
cause difficulty swallowing solid foods.
GERD
Damage to esophageal tissues from stomach acid backing up into your
esophagus can lead to spasm or scarring and narrowing of your lower
esophagus.
Eosinophilic esophagitis
This condition, which may be related to a food allergy, is caused by
an overpopulation of cells called eosinophils in the esophagus.
Scleroderma
Development of scar-like tissue, causing stiffening and hardening of
tissues, can weaken your lower esophageal sphincter, allowing acid to
back up into your esophagus and cause frequent heartburn.
Radiation therapy
This cancer treatment can lead to inflammation and scarring of the esophagus.
Oropharyngeal dysphagia
Certain conditions can weaken your throat muscles, making it difficult
to move food from your mouth into your throat and esophagus when you
start to swallow. You may choke, gag or cough when you try to swallow
or have the sensation of food or fluids going down your windpipe
(trachea) or up your nose. This may lead to pneumonia.
Risk factors
The following are risk factors for dysphagia:
Aging
Due to natural aging and normal wear and tear on the esophagus and a
greater risk of certain conditions, such as stroke or Parkinson’s
disease, older adults are at higher risk of swallowing difficulties.
But, dysphagia isn’t considered a normal sign of aging.
Certain health conditions
People with certain neurological or nervous system disorders are more
likely to experience difficulty swallowing.
Prevention
Although swallowing difficulties can’t be prevented, you can reduce
your risk of occasional difficulty swallowing by eating slowly and
chewing your food well. Early detection and effective treatment of
GERD can lower your risk of developing dysphagia associated with an
esophageal stricture.
