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Difficulty SwallowingConditions
Overview

If you find it hard to swallow, you might be experiencing dysphagia (difficulty swallowing). Dysphagia can make swallowing uncomfortable and difficult, requiring extra effort to eat or drink. This condition might lead to loss of appetite or avoiding meals. If you frequently have trouble swallowing, it could indicate an issue with your mouth, throat, or esophagus. Sometimes, this underlying issue might be serious. It's a good idea to consult a gastroenterologist if you experience recurring swallowing difficulty.

Symptoms

Apart from the challenge of swallowing, dysphagia symptoms can include:

  • Pain, coughing, or gagging while swallowing
  • Sensation of something stuck in your throat or chest
  • Increased saliva and drooling
  • Hoarseness
  • Heartburn
  • Food or stomach acid coming back up (regurgitation)
  • Unexplained weight loss
Testing

Swallowing might seem simple, but it's a complex process involving your brain, throat, and esophagus (swallowing tube). The issue could be structural (like a physical blockage) or functional (difficulty in moving food downward due to neuromuscular problems).

To diagnose the cause of dysphagia, we gather your medical history and might recommend various tests. These could include X-rays to observe swallowing, endoscopy, measuring esophageal acid, or assessing esophageal contractions with esophageal manometry. Sometimes, an ENT doctor who specializes in swallowing disorders might be consulted.

Types of Dysphagia and their Causes:

Dysphagia can be categorized into oropharyngeal (mouth/throat origin) or esophageal (swallowing tube origin) depending on which part of the swallowing mechanism is affected.

Oropharyngeal Dysphagia: Trouble starting or completing swallowing due to issues with communication between your brain and mouth/throat nerves. Causes might include Parkinson’s disease, multiple sclerosis, stroke, or throat cancer. This type can make attempts to swallow lead to gagging, coughing, or the feeling of food going the wrong way.

Esophageal Dysphagia: This arises from structural or neuromuscular problems in the esophagus (food pipe). It can feel like food gets stuck in your throat or chest after swallowing. Causes include GERD with scarring, inflammation, abnormal esophageal tissue (webs/rings), allergic conditions such as eosinophilic esophagitis, or stomach/esophagus cancer. Neuromuscular issues might include spasms or uncoordinated contractions.

Treatment

After a proper diagnosis is established, treatment is tailored to your specific condition and its cause. Approaches might involve:

  • Adjusting eating habits
  • Medication to control stomach acid for GERD or enhance esophageal contractions
  • Gentle dilation of the esophagus during endoscopy for narrow/tight sections
  • Endoscopy to remove objects blocking the esophagus
  • Speech and swallowing rehabilitation