Dysphagia is difficulty eating because of disruption in the swallowing process. If dysphagia is severe, you may not be able to take in enough fluids and calories to stay healthy. In severe cases, even saliva is difficult to swallow. Complications may include aspiration
pneumonia
(food or liquids are pulled into your lungs), malnutrition, dehydration, weight loss, and airway blockage.
Some causes of dysphagia include:
- Muscle disorders (dermatomyositis, myotonic dystrophy)
- Nervous system problems
- Obstructive lesions in the throat or esophagus, such as tumors
- Central nervous system infections
- Vitamin B12 deficiency
- Stroke
- Head injury
- Cerebral palsy
- Parkinson's disease
- Huntington's disease
- Myasthenia gravis
- Amyotrophic lateral sclerosis
- Multiple sclerosis
- Scleroderma
-
Infection with
herpes
simplex virus or yeast
- Narrowing of the esophagus after infection or irritation
- Injury to the swallowing muscles from chemotherapy and radiation for cancer
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-
Birth defects (such as
cleft palate
)
-
Head and neck cancers
-
Scarring after
radiation treatment
for cancer
-
Gastroesophageal reflux disorder
-
Diabetes
-
Alcoholism
-
Alzheimer's disease
-
Postpolio syndrome
- Thyroid disorders
-
Medications, including:
- Antibiotics
- Theophylline
- Potassium tablets
- Iron supplements
- Blood pressure medications
- Antipsychotics
- Narcotic pain relievers
- Steroids
- Lipid-lowering medications
- Colchicine
- Vitamins
- Nonsteroidal anti-inflammatory medications (NSAIDs)
A risk factor is something that increases your chance of getting a disease or condition.
Risk factors include:
- Diabetes
-
History of
polio
- Previous treatment for head and neck cancer
- Progressive neurological disorder or muscle disorder
- Gastroesophageal reflux disease
- Head trauma
The doctor will ask about your symptoms and medical history, and perform a physical exam. The exam will focus on the nervous system. The doctor will also watch you chewing and swallowing.
Tests may include:
- Nasopharyngoscopy—using a scope to view the throat
- Blood tests—to check for infection and thyroid function
-
Esophagram with
Barium Swallow
—x-ray test of the esophagus
- Endoscopy—a thin, lighted tube inserted down the throat to examine the esophagus
- Videoradiographic studies—x-rays during which swallowing is filmed on video
- Ultrasound
—a test that uses sound waves to examine structures inside the body
- Manometry—tests the amount of pressure generated in various parts of the esophagus
- pH studies—tests the degree of acidity in the esophagus
- CT scan
—a type of x-ray that uses computers to make pictures of the neck and chest
- Chest x-ray
—to check for pneumonia
Treatment may include:
Treating the underlying condition may help improve your swallowing problems.
A speech-language pathologist can teach you:
- Techniques to help you swallow more easily
- Exercises that strengthen the muscles needed for swallowing
In severe cases, you may need to use high-nutrition liquid drinks. If you have trouble swallowing thin liquids, you may need powders to thicken liquids so they are easier to swallow.
If the esophagus is too narrow, instruments may be used to slowly stretch the esophagus.
- Biofeedback
- Nasogastric feeding tube
In severe cases, surgery may be needed to:
- Release an overly tight muscle
- Remove a stricture or web that is blocking the esophagus
- Place a stent (a tiny tube) to hold the esophagus open
- Place a feeding tube through the abdominal wall
Most causes of dysphagia cannot be prevented. If you have a medical condition, get treatment so that you don't suffer complications, such as dysphagia.
