What is dysphagia?
Dysphagia is the clinical term for difficulty swallowing. Dysphagia means it takes more time and effort to get food or liquids safely and effectively at any level from your mouth down to your stomach. You are always encouraged to seek medical attention if you experience dysphagia.
How is dysphagia diagnosed?
Dysphagia can be categorized into abnormalities arising from the mouth, pharynx and/or the esophagus. A careful medical history, barium swallow X-rays, upper endoscopy, and esophageal manometry are the tools used to help identify the causes of dysphagia and determine the appropriate treatment options.
What are the symptoms of dysphagia?
Oral (mouth) and pharyngeal dysphagia may result from weaknesses in the muscles of the mouth and throat. You may report symptoms of impaired chewing ability, coughing, choking, gagging, throat clearing, chronic hoarseness, history of pneumonia, or a sensation of airway obstruction when swallowing food or liquids. Certain conditions such as a history of stroke, Parkinson’s disease, Zenker’s diverticulum, head/neck cancer and radiation therapy to the head or neck can increase your risk for oral and pharyngeal dysphagia.
Natural aging can also increase your risk for oral and pharyngeal dysphagia. If oral and pharyngeal dysphagia is identified, swallowing exercises can be helpful to strengthen and compensate for weakened oral and pharyngeal muscles.
Esophageal dysphagia refers to the sensation of food and/or liquids hanging up in the esophagus. This delay can be a brief retention of material for a few seconds, or it may cause a complete obstruction that needs emergent endoscopy to remove food safely from the esophagus.
Esophageal dysphagia may be caused by either a structural narrowing in the esophageal lumen or from esophageal dysmotility (abnormal muscle function of the esophagus). Narrowing of the esophageal lumen can be caused from esophagitis related to acid reflux injury or an allergic condition, esophageal rings and strictures, and/or esophageal cancer. Diet and lifestyle changes, medications to reduce acid reflux or allergic injury and upper endoscopy with dilation (“stretching”) can be helpful to increase the esophageal lumen to a more normal diameter.
Esophageal dysmotility is a broad term that describes abnormalities of the peristaltic motion of the muscles of the esophagus. Esophageal dysmotility can present with symptoms of difficulty swallowing solid foods and/or liquids, regurgitation, excessive and foamy saliva, chest pain, and/or esophageal spasms. An esophageal manometry is a useful examination to measure the muscle function of the esophagus when dysmotility is suspected.
How is dysphagia treated?
Endoscopic treatments are very helpful and effective. These are typically directed at dilation of esophageal strictures (or narrowing) of the esophagus, either using rigid inflatable balloons, or flexible rubber dilators placed over a guidewire. Occasionally, esophageal stenting is used when the dysphagia is due to malignancy. Treatment options for esophageal dysmotility can include medications, upper endoscopy with dilation or Botox injection, or surgery.
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