Swallowing is a complex process that’s usually completed easily. But if you have dysphagia (difficulty swallowing), the process of moving food or liquid from your mouth into your stomach can become difficult, painful, or even impossible.
In this blog, board-certified Manhattan gastroenterologist Dr. Anthony Borcich outlines the causes of dysphagia.
What are its symptoms?
You may experience one or more of the following symptoms if you have dysphagia:
- Pain when swallowing
- Being unable to swallow
- Feeling like food is stuck in your throat, chest, or behind your breastbone
- Recurring pneumonia (which can indicate food is going into your lungs rather than your esophagus)
- Frequent hoarseness
- Frequently regurgitating food
- Coughing or gagging when you swallow
- Losing weight without another known cause
- Changing your eating habits, such as eating only soft foods that are easy to swallow or eating very small bites
What causes dysphagia?
Any of the following can cause difficulty swallowing:
- Neurological causes – The nervous system is made up of the brain, nerves, and spinal cord. When it’s damaged, it can cause problems with the nerves that start and control swallowing. This damage can include a stroke, Parkinson’s disease, multiple sclerosis, a brain tumor, dementia, or myasthenia gravis.
- Cognitive and developmental causes – You may be born with or develop issues that can cause dysphasia. These include cerebral palsy and a cleft lip and palate.
- Obstruction – Your esophagus (the muscular tube that connects the throat to the stomach) can become blocked by tumors, a stuck piece of food, or an issue with the esophageal ring. Gastroesophageal reflux disease (GERD) can also cause an obstruction since stomach acid backing up into your esophagus can cause scarring or spasms. If you have cancer, radiation treatment can cause inflammation and scarring in your esophagus.
- Muscular conditions – Scleroderma, an immune system disease, causes stiffening of the esophageal muscles. Achalasia occurs when esophageal muscles aren’t able to relax and open to allow food or liquid to enter.
- Other causes – Aging can cause the muscles that are used for swallowing to become weaker and cause difficulty swallowing. Chronic obstructive pulmonary disease (COPD), which affects your breathing, may also affect your ability to swallow.
How is dysphagia diagnosed?
Your doctor will talk to you about your symptoms and medical history. Testing may also be needed to give your doctor more information and may include one of the following types of tests:
- Upper endoscopy (EGD) – your doctor uses a scope to examine your esophagus
- Laryngoscopy – your doctor uses a scope to examine the back of your throat, larynx (voice box), and vocal cords
- Fluoroscopy – a real-time video or digitized X-ray that helps show your swallowing
How is dysphagia treated?
Treatment depends on the cause of your swallowing problems, and conservative treatments will be tried first. For example, lifestyle changes such as sitting upright, remaining sitting or standing for 15 to 20 minutes after eating, and drinking plenty of fluids can help.
Medication can also be used in some cases. For example, if GERD is causing your dysphagia, a medication that reduces the production of acid may help.
You may be referred to a swallowing therapist to learn techniques and exercises to help you swallow more easily.
Procedures and surgeries can also be used if needed. The EGD, which is a helpful diagnostic tool, can also allow your doctor to stretch your esophagus if it’s too narrow.
If you’re having trouble swallowing, make an appointment with Dr. Borcich in NYC today. He’ll accurately determine the cause of your dysphagia and recommend the least invasive type of treatment to help relieve your symptoms.