Do You Have Difficulty Swallowing?

By Steven A. Meckstroth, MD – Gastroenterology Specialists

If you have difficulty swallowing food or liquids, you may have a medical condition called dysphagia. If it happens occasionally to you, it’s nothing to worry about, but if you find you regularly need more effort to swallow or if you feel pain when swallowing, seek medical attention from a gastroenterologist quickly.

Dysphagia can signal a medical issue with your throat or esophagus. It’s more common in older adults, but can affect anyone. Because of our need to ingest our nutrition, this is a potentially dangerous condition.

Symptoms of Difficulty Swallowing
If an obstruction is blocking your windpipe or preventing you from breathing properly, get medical help immediately. Symptoms of swallowing difficulty can include:
. Coughing or choking when trying to swallow
. Pain while swallowing
. Unable to swallow
. Drooling
. Hoarseness
. Feeling like food is stuck in your throat or chest
. Regurgitation
. Heartburn / GERD
. Acid reflux
. Dehydration
. Unexpected weight loss
. Pneumonia

Causes of Difficulty Swallowing
When you swallow, it seems like a natural act, but it’s actually composed of three actions: moving food or liquid from your mouth to your throat, squeezing it down your throat past your windpipe, and sending it down your esophagus to your stomach. Problems can occur during any of the three actions.

Mouth causes of swallowing difficulty include:
. Dry mouth, not enough saliva to move food out of your mouth, which can be caused by medications or a different health issue

Throat causes of swallowing difficulty
(oropharyngeal dysphagia) include:
. Neurological disorders such as Parkinson’s disease, Alzheimer’s disease, Lou Gehrig’s disease, multiple sclerosis, cerebral palsy, muscular dystrophy or post-polio syndrome
. Neurological damage such as from a spinal cord injury or stroke
.  Cancer and some cancer treatments
. A condition called pharyngeal diverticula that creates a small pouch in your throat, just above your esophagus, that collects food and leads to difficulty swallowing and other problems

Esophagus causes of swallowing difficulty (esophageal dysphagia) include:
. Esophageal muscle weakness (a condition known as achalasia)
. Esophageal stricture, a narrowing of your esophagus
. Food allergies
. Food-created blockages
. Involuntary muscle spasms
. Lymph nodes or bone spurs pressing on your esophagus
. Scar tissue caused by gastroesophageal reflux disease
. Scleroderma, when your esophagus hardens and narrows
. Tumors in your esophagus

Diagnosing Difficulty Swallowing
Because the symptoms can indicate a serious disease like cancer, you should consult a specialist.  A specialist will likely order a number of tests to narrow down the diagnosis. Gastroenterology specialists also offers colon cancer screening, if necessary.

An X-ray of your neck and/or chest with a contrast solution, usually liquid barium, will show where food and liquid are getting stuck; pH monitoring records the level of acid reflux in your esophagus. To see your esophagus, an upper endoscopy, fluoroscopy or laryngoscopy. A manometry allows the doctor to measure the pressure inside your esophagus.

Treating Difficulty Swallowing
For oropharyngeal dysphagia (throat causes), you may be referred to a therapist, who will give you throat and food exercises to do. You may need to alter your normal diet to avoid certain foods. For esophageal dysphagia (esophagus causes), the specialist may try medication or a dilating procedure to widen your esophagus. Surgery is necessary if he found a tumor or other obstruction. If yours is an acute case, you may need to be on a liquid diet or eat through a feeding tube temporarily.

Only a trained, experienced gastroenterologist can determine an accurate diagnosis and proper treatment. Gastroenterology Specialists provide highly personalized and comprehensive care.

For more information about your difficulty swallowing concerns or to schedule an appointment call 239-593-6201 today.