Conditions

Dysphagia

Dysphagia is used to describe difficulty swallowing. Those who have dysphagia experience lack of appetite, and often avoid eating or drinking in general, as it can take extra effort to get down food or liquids. Difficulty swallowing can be a sign of a more serious issue, so patients should be sure to contact a physician immediately if it becomes a recurring problem. Dysphagia can often cause the following symptoms:

• Discomfort, coughing or gagging upon swallowing
• The sensation that something is lodged in the chest or throat
• Excessive saliva production and drooling
• Feeling hoarse
• Food or stomach acid coming back up the throat
• Heartburn
• Unexplained weight loss

Although swallowing seems like a natural reflex, it is actually a complex process of brain, throat, and esophagus muscle systems acting in coordination. Due to the intricacy of the internal process, it can be difficult to pinpoint which part of the body is having an issue, and at what point in the process.

There are two types of dysphagia: oropharyngeal and esophageal. The kind of dysphagia that a patient is suffering from depends on what part of the swallowing process is affected. Oropharyngeal dysphagia occurs when the patient has trouble beginning the act of swallowing. Usually, this is caused by a failure from the brain to communicate with the nerves in the mouth or throat. Some common neurological disorders that can cause this lack of communication are Parkinson’s disease and multiple sclerosis (MS), as well as medical trauma such as stroke. Oropharyngeal dysphagia may cause the patient to gag, cough, or feel as though food or drink is going down the windpipe or up the nose when they swallow. Esophageal dysphagia is caused by an esophagus that is narrowed, scarred, blocked, inflamed or otherwise compromised structurally. Some common conditions that may cause this type of dysphagia include gastroesophageal reflux disease (GERD), and Barrett’s esophagus. This condition may cause the patient to feel as though food is caught in the throat or chest when they swallow.

Treatment begins by first identifying which type of the above dysphagia the patient is suffering from. Physicians can then tailor the level of medical attention needed accordingly. In minor cases, a modification of the diet can suffice. In more severe or chronic cases, medication may be necessary to control stomach acid if the patient has GERD, or an endoscopy may be performed to gently dilate the esophagus if it has become narrowed. Less commonly, there may be an object obstructing the esophagus, in which case an endoscopy will be performed to remove the blockage.