Patient education: Dysphagia (The Basics)

What is dysphagia? — Dysphagia is the medical term for "trouble swallowing." Sometimes, dysphagia happens if you eat too fast or don't chew your food well enough. But if you have dysphagia, you might have a serious medical problem that needs to be treated right away.

What causes dysphagia? — Dysphagia is usually caused by a problem in the upper part of your digestive tract (figure 1). Often, the problem is in the esophagus, the tube that connects your mouth to your stomach. But it can also happen because of a problem in the mouth or throat.

What are the symptoms of dysphagia? — The symptoms include:

●Not being able to swallow

●Pain while swallowing

●Feeling like food is stuck in your throat or chest

●Coughing or gagging while swallowing

●Drooling

●Trouble speaking

Should I see a doctor or nurse? — See your doctor or nurse if you have any of the above symptoms. Do so right away if you are unable to swallow your own saliva and are drooling or have trouble speaking.

Are there tests for dysphagia? — Yes. Your doctor or nurse will do an exam and ask about your symptoms. Other tests might include:

●Barium X-ray – For this test, you drink a thick liquid called a "barium solution." It coats the inside of your esophagus. The barium shows up on X-rays, so the doctor can see any problems in the esophagus.

●Swallowing study – For this test, you eat different foods coated with barium. X-rays taken throughout the test show if you have problems with the muscles in your mouth or throat. This test is also called a "videofluoroscopy."

●Upper endoscopy – For this test, the doctor puts a thin, flexible tube into your mouth, down your throat, and into your esophagus. The tube (called an endoscope) has a camera and a light on it, so the doctor can see inside the esophagus.

●Manometry – This test measures the pressure at different places inside your esophagus. To do this, a small tube that senses pressure is inserted through your nose, down your throat, and into your esophagus. The results of the test can tell your doctor how well the muscles that help you swallow are working.

How is dysphagia treated? — The treatment depends on what is causing the dysphagia.

If you have dysphagia because of a problem in your mouth and the upper part of your throat, your doctor might refer you to a speech or swallowing specialist. This person can teach you exercises to help you swallow, and might also suggest ways to change your diet.

If the problem affects your esophagus, treatments can include:

●Esophageal dilation – For this procedure, the doctor uses an endoscope (see above) with a special balloon on the end to gently stretch and widen your esophagus.

●Surgery – Doctors can do surgery to remove any tumors or other abnormal tissue in the esophagus.

●Medicines – Medicines used to treat dysphagia include:

•Medicines that reduce stomach acid, such as proton pump inhibitors (table 1)

•Medicines to treat an infection of the esophagus

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