Difficulty Swallowing

Food usually is a source of joy for many people. But difficulty swallowing can make meal-time stressful and diminish your quality of life.

Difficulty swallowing is the description for dysphagia. Dysphagia results in the abnormal movement of food from your mouth to your stomach.

This page will first discuss when you should see a gastroenterologist for dysphagia. We’ll then outline how we diagnose this symptom. We’ll also explore potential causes of dysphagia, including neuromuscular and structural changes. Lastly, we’ll discuss the treatment of dysphagia so that you know your options.

We’ve all dealt with the rare occurrence of food going down the wrong pipe. And the coughing fit that followed. But swallowing difficulty that occurs regularly is not normal.

Contact your doctor if you experience any of the following symptoms:

• Choking or coughing
• Husky or hoarse voice
• Food stuck in the neck or chest
• Regurgitation
• Heartburn
• Chest pain
• Food or drink that comes out through the nose
• Weight loss
• Inability to swallow
• Aspiration of food

It’s essential to seek treatment for dysphagia to prevent the development of serious medical complications. Consequences of dysphagia may include:

• Malnutrition
• Dehydration
• Aspiration pneumonia
• Chronic lung disease

A gastroenterologist can diagnose the cause of your symptoms and develop a treatment plan to improve your quality of life. Gastroenterologists receive specialized training in the workings of the digestive tract. We are the most qualified doctors to address your digestive issues.

If you want to find the answers to your swallowing problems, you can schedule an appointment online or call our office at (806) 696-4440.

The diagnosis of dysphagia begins by first determining if you have oropharyngeal or esophageal dysphagia. We’ll then complete testing to identify the root cause of your symptoms.

Oropharyngeal dysphagia results in swallowing difficulty in the mouth and pharynx, the upper part of your throat. This can cause trouble chewing food and moving it from your mouth to your throat.

Tests for oropharyngeal dysphagia may include:

• Neurological exam
• Swallowing function test
  • Videofluoroscopy
  • Modified barium swallow
• Nasal endoscopy
• CT scan
• MRI

Esophageal dysphagia results in swallowing problems that occur in the esophagus, the tube that runs from your mouth to your stomach. Issues in the esophagus can cause food to move slowly or get stuck in your chest.

Tests for esophageal dysphagia may include:

• Upper endoscopy
• Barium swallow test
• Esophageal manometry
• Blood tests

There are many potential causes of dysphagia. But they generally fall into two main categories — neuromuscular and structural causes. Neuromuscular causes are due to a change in the muscles or nerves that affect your ability to swallow. And structural causes are a result of changes in the anatomy of the esophagus.

Neuromuscular causes of dysphagia may include:

• Polymyositis
• Myasthenia gravis
• Scleroderma
• Stroke
• Achalasia
• Spasm of the esophagus

Neuromuscular changes most often cause oropharyngeal dysphagia because the nerves that control the mouth’s muscles and top of the throat connect directly to your brain.

On the other hand, structural changes in the esophagus most often cause esophageal dysphagia. Structural changes may include:

• Narrowing of the esophagus (stricture)
• Inflammation of the esophagus
• Scar tissue
• Tumors
• Compression of the esophagus

Conditions that can cause structural changes in the esophagus include:

• Chronic acid reflux
• Infection
• Esophageal cancer
• Enlarged heart
• Eosinophilic esophagitis

Treatment of dysphagia depends on your diagnosis and the severity of your symptoms. We’ll discuss potential treatment options below, including:

• Dietary changes
• Medication
• Medical intervention
• Surgery

Dietary Changes

If you have difficulty swallowing, you may need to change the foods that you consume. Thickened liquids can prevent the aspiration of fluid in the lungs. Soft or pureed food can also prevent aspiration and make swallowing easier.

Your doctor may prescribe the following dietary changes:

• Nectar thick liquids
• Honey thick liquids
• Pureed diet
• Mechanical soft diet

Medication

Medication may reduce inflammation in the esophagus, prevent muscle spasms, or heal infections.

Treatment with medication may include:

• Antacids
• Steroids
• Muscle relaxants
• Antibiotics

Endoscopic Intervention

Many endoscopic interventions can improve your ability to swallow. We’ll highlight some of the more common treatments below.

• Esophageal stent placement is the insertion of a metal or plastic tube in the esophagus so that food has a pathway to the stomach.
• Esophageal dilation stretches the narrowed areas of the esophagus with a dilator or balloon. This widens the passageway to improve the movement of food from the mouth to the stomach.
• Botox can reduce muscle spasms in the esophagus and relieve symptoms of dysphagia.
• Endoscopy procedures can treat dysphagia by removing food that gets stuck in the esophagus. An inability to swallow is a sign of food impaction. And this needs immediate endoscopic intervention.
• Speech therapy can teach you strategies to improve your ability to swallow. This treatment focuses on swallowing safety and increasing food and fluid intake.

Surgery

In more severe cases of dysphagia, you may need surgery.

Your doctor may recommend a percutaneous endoscopic gastrostomy (PEG) tube to prevent malnutrition, dehydration, and weight loss. This procedure inserts a feeding tube into the stomach. A PEG tube allows you to consume nutrition, fluids, and medication by bypassing the mouth and esophagus.

An esophagectomy is a surgical procedure that is used to remove part of the esophagus. This treatment may occur after the diagnosis of esophageal cancer.

Dr. Sameer Islam is a gastroenterologist and West Texas native. He specializes in the diagnosis and treatment of digestive conditions such as dysphagia.

If you or a loved one experiences difficulty swallowing, you can schedule an appointment online or call our office at (806) 696-4440.