Dysphagia is the term used to describe difficulty in swallowing, when more time and effort are required for food to move from the mouth to the stomach. If the condition is not treated correctly, it can lead to poor nutrition, or even malnutrition, and dehydration. Someone with dysphagia is also more prone to aspiration, which is when food is inhaled into the airways. This can in turn cause other conditions, such as pneumonia.
The condition can also be embarrassing, and so often leads to people with the condition avoiding eating or drinking with others.
It should not be confused with occasional difficulties associated with eating too quickly or not chewing food adequately.
Dysphagia is very common in older people, with up to 50% prevalence in some elderly communities. There are many possible underlying causes of dysphagia, which include...
- Disorders of the muscular function of the oesophagus or lower oesophageal sphincter, for example achalasia.
- Brain / heart / neck surgery.
- Brain / neck cancer.
- Brain injury.
- Muscular Dystrophy (or other muscular condition).
- Parkinson's disease.
There are many signs that someone might be suffering from dysphagia. These include...
- Swallowing causes pain (this is referred to as 'odynophagia').
- Difficulty chewing or controlling food while it is in the mouth.
- Gagging/coughing when trying to swallow or after eating/drinking.
- Food feels as if it is becoming lodged in the throat or chest area.
- Dribbling/unable to control saliva (or other liquids) in the mouth.
- Hoarse voice, or 'gurgling' sound to the voice, especially after swallowing.
- Regurgitating food (sometimes through the nose).
- Regular bouts of pneumonia.
- Regular bouts of heartburn or acid reflux.
- Otherwise unexplained weight loss.
- Avoiding some food types due to swallowing difficulties.
- Cutting food into smaller pieces due to swallowing difficulties.
A doctor may perform a number of tests to determine the cause of the condition. These may include...
- Barium 'meal' (sometimes referred to as a 'barium swallow') - this is an x-ray where the barium solution highlights the shape of the oesophagus. This test may also involve swallowing a pill or some food coated with barium to see better if there are any blockages.
- Endoscopy - a visual examination of the oesophagus using an endoscope.
- Manometry (otherwise known as an 'oesophageal muscle test') - the muscle contractions of the oesophagus are measured while you are swallowing using a small tube which is inserted into the oesophagus.
- Other scans such as CT scans, MRI scans, or PET scans.
Treatment of the condition depends on what is diagnosed as the cause of the dysphagia. Causes can include...
- Muscular problems affecting the oesophagus.
- Internal scarring or narrowing of the oesophagus due to GORD or radiation treatment.
- Foreign objects lodged in the oesophagus.
- Presence of one or more tumours, or cancer in the oesophagus.
- Pharyngeal diverticula - this is where a small 'pouch' forms in the throat, allowing food particles to collect.