Swallowing problems
Dysphagia: Understanding Swallowing Difficulties
Dysphagia means that you can’t swallow well. Dysphagia is not a diagnosis; it is the symptom. Many factors may cause dysphagia, and most are temporary and non-life-threatening.
In uncommon situations, swallowing difficulties can be related to a tumor or a nerve system disorder. It happens to people of all ages, but more often in the elderly. If swallowing is difficult on a regular basis, you should see an ENT (ear, nose, and throat) specialist, or otolaryngologist.
People normally swallow hundreds of times a day to eat solids, drink liquids, and swallow the normal saliva and mucus that the body produces. The process of swallowing has four related stages:
The first stage is the oral preparation stage, where food or liquid is made ready in the mouth, chewed, and gathered together in preparation for swallowing.
The second stage is the oral stage, where the tongue pushes the food or liquid to the back of the mouth, starting the swallowing response.
The third stage is the pharyngeal stage, when what is processed in the mouth is passed through the pharynx, your throat, and into the esophagus, your food pipe.
In the fourth and final stage, the esophageal stage, food or liquid passes through the esophagus and into your stomach.
The third and fourth parts of the swallowing process happen automatically, without you even thinking about it.
What Are the Symptoms of Dysphagia?
Symptoms of swallowing disorders may include:
- Drooling
- A feeling that food, liquid, or pills are sticking in the throat
- Hearing loss
- Coughing or choking on bits of food or liquid, or saliva not moving easily, which may lead to aspiration (when these materials fall or get sucked into the lungs)
- Sensing of a “lump” in the throat
- Losing weight
- Developing lung infections like pneumonia
- Changing voice
- Coughing up blood
Diagnosis of Dysphagia
Dysphagia is diagnosed using a variety of tests. The following are examples of typical tests:
Flexible endoscopy: The first test required to look for the cause of dysphagia.
Esophageal manometry: If endoscopy is normal, then manometry is useful to diagnose the cause of dysphagia. A small tube is inserted into the food pipe to check the pressure of the esophageal muscles. Achalasia requires manometry to confirm.
Barium swallow: A speech therapist will offer you several meals and drinks to chew and swallow during this examination. Barium, a minty liquid or pasty substance, will be used to coat the meal. On X-ray scans, barium permits images of the patient's mouth, throat, and esophagus. While the person is swallowing, they will take X-ray pictures.
Esophagram: In this, the patient is given barium to consume, and the radiologist snaps photographs of the esophagus during this exam.
Dysphagia Treatment
Most swallowing issues are manageable. The type of dysphagia will determine treatment. When deciding on therapy, the source of dysphagia is also considered.
Oropharyngeal Dysphagia
Dysphagia affects the mouth and throat. Altered muscular function, sensory alterations, or growths & blockages in the throat or mouth are the most prevalent causes of swallowing issues.
There are three main treatments for high dysphagia:
- Swallowing therapy: Speech and language therapists (SLTs) employ various strategies, such as training patients in swallowing movements, that can be adapted to unique situations.
- Dietary changes
- Feeding tubes
