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Difficulty in Swallowing

difficulty-in-swallowing
By Medicover Hospitals / 10 Mar 2021
Home | symptoms | difficulty-in-swallowing
  • The scientific term used to explain difficulty swallowing is dysphagia. A muscular tube that binds the throat to the stomach is the esophagus. The esophageal muscle contracts with each swallow and drives food into the stomach. A valve (a special sphincter muscle) stays closed at the lower end of the esophagus, unless you swallow food or fluids or when you burp or vomit.
  • Article Context:

    1. What is Difficulty Swallowing?
    2. Causes
    3. Risk factors
    4. Diagnosis
    5. Treatment
    6. When to visit a Doctor?
    7. FAQ's

    What is Difficulty Swallowing?

  • Difficulty swallowing scientific term is dysphagia. It takes more effort than normal to move food from mouth to stomach. Usually caused by nerve or muscle problems, dysphagia can be painful and is more common in older people and infants. Although the medical term dysphagia is often considered a symptom, it is sometimes used to describe a condition in its own right. There is a wide range of possible causes of dysphagia. If it only occurs once or twice, there is probably no serious underlying problem, but if it occurs regularly, a doctor should see it. As there are several explanations why dysphagia can occur, the root cause is contingent on medication. Several distinct muscles and nerves are involved in a regular "swallow", it is a remarkably complex operation. Dysphagia can be due to difficulty in any part of the swallowing process.
  • Types:

    • Oral dysphagia (high dysphagia), the problem is in the mouth, sometimes caused by weakness of the tongue after a stroke, difficulty chewing food, or problems carrying food from the mouth.
    • Pharyngeal dysphagia, the problem is in the throat. Throat problems are often caused by a neurological problem that affects the nerves (such as Parkinson's disease, stroke, or amyotrophic lateral sclerosis).
    • Esophageal dysphagia (low dysphagia), the problem is in the esophagus. Usually, this is due to blockage or irritation. Oftentimes, a surgical procedure is required.

    Causes:

    • Acid Reflux and GERD: Acid reflux symptoms occur when stomach contents flow from the stomach into the esophagus, causing symptoms such as heartburn, stomach pain, and belching.
    • Heartburn: Heartburn is a burning sensation in the chest that often presents with a bitter taste in the throat or mouth.
    • Goiter: The thyroid is a gland found in the neck, just below Adam's apple. A condition is called a goiter, which raises the size of the thyroid.
    • Esophagitis: Esophagitis is an inflammation of the esophagus that can be caused by acid reflux or certain medications.
    • Esophageal cancer: Esophageal cancer occurs when a malignant (cancerous) tumor forms in the lining of the esophagus, which can cause difficulty swallowing.
    • Stomach cancer (gastric adenocarcinoma): Stomach cancer occurs when cancer cells form in the lining of the stomach. Because it is difficult to detect, it is often not diagnosed until it is more advanced.
    • Esophagitis: Esophagitis is an inflammation of the esophagus that can be caused by acid reflux or certain medications.
    • Herpes esophagitis: Herpes esophagitis is caused by the herpes simplex virus type 1 (HSV-1).
    • Recurrent cold sores: Recurrent cold sores, also known as oral or orolabial herpes, are an infection of the mouth area caused by the herpes simplex virus.

    Risk Factors:

  • Risk factors for dysphagia include:
  • Aging: Older adults are more at risk. Over time, this is due to general wear and tear on the body. Dysphagia, such as Parkinson's disease, may also be caused by certain old age diseases.
  • Neurological conditions: Certain disorders of the nervous system increase the likelihood of dysphagia.
  • Diagnosis:

    Cineradiography:

  • An imaging test in which a camera is used to film structures inside the body. During the test, you will be asked to swallow a barium preparation (liquid or other forms that light up with X-rays). An x-ray machine with video recording capabilities will be used to view the movement of the barium preparations through your esophagus. This is often done under the guidance of a speech pathologist, an expert in swallowing and speech.
  • Upper Endoscopy:

  • A narrow, flexible tube (endoscope) is inserted into the esophagus and projects images of the inside of the pharynx and esophagus onto a screen for evaluation.
  • Manometry:

  • The time and strength of esophageal contractions and muscle valve relaxation was calculated by this procedure.
  • Impedance and pH test:

  • This test can determine if acid reflux is causing a problem swallowing.
  • Treatment:

  • Treatment depends on the type of dysphagia.
  • Treatment for oropharyngeal dysphagia (upper dysphagia):

    • Swallowing treatment: With a speech and language therapist, this will be done. The individual will learn alternative ways to swallow properly. The exercises will help improve your muscles and how they respond.
    • Diet: Some foods and liquids, or combinations of them, are easier to swallow. When eating foods that are easier to swallow, it is also important that the patient has a well-balanced diet.
    • Tube feeding: If the patient is at risk for pneumonia, malnutrition, or dehydration, they may need to be fed through a nasal tube (nasogastric tube) or PEG (percutaneous endoscopic gastrostomy). The PEG tubes are surgically implanted directly into the stomach and passed through a small incision in the abdomen.

    Treatment for esophageal dysphagia (low dysphagia):

    • For esophageal dysphagia, surgical intervention is typically needed.
    • Dilation: If the esophagus needs to be widened, a small balloon can be inserted and then inflated (then removed).
    • Botulinum toxin (Botox): Commonly used if the muscles of the esophagus have become stiff (achalasia). Botulinum toxin is a strong toxin that can paralyze stiff muscles and reduce constriction.
  • If cancer causes dysphagia, the patient may be treated for treatment by an oncologist and will require surgical removal of the tumor.
  • When to visit a Doctor?

  • Schedule an appointment with your doctor if your pain when swallowing occurs in conjunction with any of the following:
    • difficulty opening your mouth
    • trouble swallowing
    • the extreme sore throat that gets worse
    • shortness of breath
    • blood when coughing
    • symptoms that last a week or more
    • a hoarse voice that lasts more than two weeks
    • joint pain
    • a lump on your neck
    • a rash

    Frequently Asked Questions:

  • Another health condition, such as a condition that affects the nervous system, such as a stroke, brain injury, multiple sclerosis, or dementia, typically causes dysphagia.
  • Dysphagia is another medical name for difficulty swallowing. This symptom is not always indicative of a medical condition. This condition can be temporary and go away on its own.
  • A swallowing study is a test that shows what your throat and esophagus are doing while you swallow. The test uses real-time X-rays (fluoroscopy) and records what happens when you swallow. As you swallow, the doctor and speech pathologist see a video screen.
  • A person who cannot safely swallow may not be able to eat enough of the right foods to stay healthy or maintain an ideal weight. Pieces of food that are too large to swallow can enter the throat and block the passage of air.
  • Stress or anxiety can cause some people to feel a tightness in their throat or feel like something is stuck in their throat. This sensation is called a balloon sensation and is not related to eating.
  • Citations:

  • Science Direct - https://www.sciencedirect.com/science/article/abs/pii/S0197457207003990
  • Jumper - https://link.springer.com/article/10.1007/BF02493526
  • Europe PMC - https://europepmc.org/article/med/8209677