Dysphagia is difficulty eating because of disruption in the swallowing process. If dysphagia is severe, you may not be able to take in enough fluids and calories to stay healthy. In severe cases, even saliva is difficult to swallow. Complications may include aspiration pneumonia]]> (food or liquids are pulled into your lungs), malnutrition, dehydration, weight loss, and airway blockage.
Some causes of dysphagia include:
- Muscle disorders (dermatomyositis, myotonic dystrophy)
- Nervous system problems
- Obstructive lesions in the throat or esophagus, such as tumors
- Central nervous system infections
- Vitamin B12 deficiency
- Head injury
- ]]>Cerebral palsy]]>
- ]]>Parkinson's disease]]>
- ]]>Huntington's disease]]>
- ]]>Myasthenia gravis]]>
- ]]>Amyotrophic lateral sclerosis]]>
- ]]>Multiple sclerosis]]>
- Infection with ]]>herpes]]> simplex virus or yeast
- Narrowing of the esophagus after infection or irritation
- Injury to the swallowing muscles from chemotherapy and radiation for cancer
Narrowing of the Esophagus
- Birth defects (such as ]]>cleft palate]]> )
- ]]>Head and neck cancers]]>
- Scarring after ]]>radiation treatment]]> for cancer
- ]]>Gastroesophageal reflux disorder]]>
- ]]>Alzheimer's disease]]>
- ]]>Postpolio syndrome]]>
- Thyroid disorders
- Potassium tablets
- Iron supplements
- Blood pressure medications
- Narcotic pain relievers
- Lipid-lowering medications
- Nonsteroidal anti-inflammatory medications (NSAIDs)
A risk factor is something that increases your chance of getting a disease or condition.
Risk factors include:
- Trouble swallowing
- Constant feeling of a lump in the throat
- Pain with swallowing
- Coughing or choking with eating or drinking
- Recurrent pneumonia
- Nasal sounding voice
- Sensation of food sticking in the chest
- Weight loss
The doctor will ask about your symptoms and medical history, and perform a physical exam. The exam will focus on the nervous system. The doctor will also watch you chewing and swallowing.
Tests may include:
- Nasopharyngoscopy—using a scope to view the throat
- Blood tests—to check for infection and thyroid function
- Esophagram with Barium Swallow]]> —x-ray test of the esophagus
- Endoscopy—a thin, lighted tube inserted down the throat to examine the esophagus
- Videoradiographic studies—x-rays during which swallowing is filmed on video
- ]]>Ultrasound]]> —a test that uses sound waves to examine structures inside the body
- Manometry—tests the amount of pressure generated in various parts of the esophagus
- pH studies—tests the degree of acidity in the esophagus
- ]]>CT scan]]> —a type of x-ray that uses computers to make pictures of the neck and chest
- ]]>Chest x-ray]]> —to check for pneumonia
Treatment may include:
Treating a Medical Condition
Treating the underlying condition may help improve your swallowing problems.
Swallowing Techniques and Exercises
A speech-language pathologist can teach you:
- Techniques to help you swallow more easily
- Exercises that strengthen the muscles needed for swallowing
In severe cases, you may need to use high-nutrition liquid drinks. If you have trouble swallowing thin liquids, you may need powders to thicken liquids so they are easier to swallow.
If the esophagus is too narrow, instruments may be used to slowly stretch the esophagus.
Other Nonsurgical Treatments
- Nasogastric feeding tube
In severe cases, surgery may be needed to:
- Release an overly tight muscle
- Remove a stricture or web that is blocking the esophagus
- Place a stent (a tiny tube) to hold the esophagus open
- Place a feeding tube through the abdominal wall
American Academy of Otolaryngology–Head and Neck Surgery
American Speech-Language-Hearing Association
Canadian Society of Otolaryngology
Heart and Stroke Foundation of Canada
Dawodu ST. Swallowing disorders. Emedicine website. Available at: www.emedicine.com/pmr/topic152.htm. Accessed 2005.
Spieker MR. Evaluating dysphagia. Am Fam Physician . 2000;61(12). Available at: http://www.aafp.org/afp/20000615/3639.html.
National Institute on Deafness and Other Communication Disorders website. Available at: http://www.nidcd.nih.gov/ .
Paik NJ. Dysphagia. Emedicine website. Available at: www.emedicine.com/pmr/topic194.htm. Accessed 2005.
Sleisenger & Fordtran's Gastrointestinal and Liver Disease . 6th ed. W.B. Saunders Company; 1998.
Last reviewed November 2008 by ]]>Daus Mahnke, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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