Dysphagia: Difficulty Swallowing and What It Means
Health ConditionsEar, Nose, & Throat

What Is Dysphagia, or Difficulty Swallowing?

What Is Dysphagia, or Difficulty Swallowing?
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Updated on August 19, 2024
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Swallowing is a basic function that many of us take for granted — until a problem occurs, making daily tasks like drinking and eating a major challenge. Dysphagia is the medical term used to describe trouble swallowing, and it’s a problematic condition that merits medical evaluation.

Dysphagia is often a symptom of an underlying issue and is particularly common in older adults with certain neurological conditions, such as Alzheimer’s disease, Parkinson’s disease, and those resulting from a stroke. Studies show that between 10 and 33 percent of older adults are affected by dysphagia.

 

What Are the Different Types of Dysphagia?

There are two main types of dysphagia, each with different symptoms, categorized by the affected part of the body:

  • Oropharyngeal dysphagia is a swallowing difficulty that occurs from a medical condition or abnormality affecting the throat or mouth and results in the inability to optimally transfer food from the mouth to the esophagus.
  • In esophageal dysphagia, the food passes into the esophagus, however, because of a mechanical or neuromuscular disruption, the food can get stuck or cause the sensation of getting stuck.

What Are the Signs of Oropharyngeal Dysphagia?

Oropharyngeal dysphagia is commonly suspected when an individual coughs or chokes following ingestion of food or liquid. Symptoms of oropharyngeal dysphagia include:

  • Frequent coughing or choking during swallowing
  • Clearing the throat often
  • Swallowing frequently
  • Taking a long time to chew food
  • Moving the head or neck in a strange motion while swallowing
  • Painful swallowing
  • Problems breathing while eating
  • Getting food stuck in the throat often
  • Drooling
  • Expelling liquids out of the nose
  • Signs of malnutrition and dehydration
  • Lack of interest in food
  • Weight loss

    What Are the Signs of Esophageal Dysphagia?

    Esophageal dysphagia is suspected when solids or liquids appear to have difficulty traveling through the esophagus. Some symptoms of esophageal dysphagia include:

    • Pain in the chest when you swallow
    • Coughing in the night that wakes you up
    • Vomiting up food after you swallow it
    • A sensation of food getting stuck in the chest in the area of the breastbone
    • Signs of malnutrition and dehydration
    • Weight loss
    • Lack of interest in food

    What Are the Causes of Dysphagia?

    Common causes of dysphagia include:

    • Strictures that form in the esophagus as a result of GERD (gastroesophageal reflux disease)
    • Diseases that affect the muscles
    • Congenital abnormalities that affect sucking or swallowing
    • A tumor in the throat or on the tongue
    • Eosinophilic esophagitis
    • A stroke
    • Damage to the esophagus (from radiation or ingesting toxic substances)
    • GERD or persistent heartburn
    • Cancer of the head or neck
    • An infection
    • Food allergies
    • Diseases that affect the vascular system, such as lupus or scleroderma
    • Neurological conditions like multiple sclerosis, Parkinson’s disease, and Alzheimer’s disease

    What Are the Complications of Dysphagia?

        The most common complication of dysphagia is choking, which occurs when food gets stuck in the throat. If the food item completely blocks a person’s airway, and medical interventions, such as the Heimlich maneuver, aren’t successful, this can be a life-threatening emergency.

        Dysphagia can also lead to nutritional deficiencies, weakness, too much weight loss, and dehydration.

        The esophagus may also weaken and form a “trap” that allows food to become stuck in it, keeping food and liquid from reaching the stomach.

        Another serious complication, called aspiration pneumonia, can occur when a person aspirates — or inadvertently takes food into the lungs — because of trouble swallowing. The food can become lodged in the lungs, where bacteria may grow and cause an infection.

        What Are the Treatment Options for Dysphagia?

        Treatment options for dysphagia depend on the root cause of the condition and which part of the body is affected. They include medication to treat the underlying condition that is responsible for dysphagia, rehabilitative techniques, diet changes, and surgery.
        Many people need therapy to strengthen their muscles and improve swallowing, particularly in the case of oropharyngeal dysphagia. Exercises can boost coordination and build tone in the muscles of the face to manage dysphagia. For someone with oropharyngeal dysphagia, a speech-language pathologist will perform a swallow evaluation to determine techniques to facilitate swallowing.

        Surgery or endoscopic interventions may be required to fix abnormalities of the throat or esophagus to improve dysphagia.

         In the most severe cases, a feeding tube is necessary to ensure nourishment when a person can no longer chew and swallow independently.

        What Is the Best Diet for Dysphagia?

        Some people with dysphagia find that dietary changes can improve their symptoms. They may have to eat foods that are soft and moist, or carefully dice, mince, mash, or puree foods that aren’t.

         Thickening agents can make swallowing easier for people who tend to choke on or aspirate thin liquids. Getting rid of distractions during mealtime and eating when you’re most alert can also help.

        Individuals with food allergies or eosinophilic esophagitis (EoE) may try an elimination diet, which involves removing suspected food triggers and gradually reintroducing them to try to figure out what’s causing negative reactions.

        The GERD diet — a diet rich in whole grains and vegetables, low-acidic foods like bananas and nuts, and watery foods like watermelon, cucumbers, and lettuce — can also be helpful for people who get strictures as a result of acid reflux. Avoiding foods high in fat, salt, or spices (like fried food, fatty meats, and cheese) is also recommended.

        Finding Help for Dysphagia

        If you have trouble swallowing, you should talk to your doctor. Dysphagia is often a complex condition to treat because swallowing is an intricate process that involves many muscles and nerves to work properly.

        You may need to see one or more of the following specialists:

        • Otolaryngologist
        • Neurologist
        • Gastroenterologist
        • Speech-language pathologist
        • Dietitian

        The Takeaway

        Dysphagia, or difficulty swallowing, is a serious condition that can affect anyone, though it is more common in older adults with certain neurological conditions like Alzheimer’s disease or Parkinson’s disease. Dysphagia often results from underlying conditions like GERD, strictures, and stroke.

        Complications can be severe, including choking, malnutrition, and aspiration pneumonia. Treatment often involves making changes to your diet, taking medication, and sometimes even undergoing endoscopic or surgical interventions. 

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        Akash Goel, MD

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        Akash Goel, MD, is a board-certified gastroenterologist and a clinical assistant professor of medicine at Weill Cornell Medicine in New York City. He practices integrative internal medicine and gastroenterology with a focus on nutrition, metabolic health, mindfulness, evidence-based screenings, and exercise science.

        Dr. Goel is published in peer-reviewed journals on gastroenterology and nutrition, and his work has appeared in networks and publications such as CNN, The New York Times, Time magazine, the Financial Times, and the BBC.

        Goel has received two Cannes Lions Awards and has been recognized by the United Nations for his work in human rights advocacy. He is a term member of the Council on Foreign Relations.

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        Julie Marks is a freelance writer with more than 20 years of experience covering health, lifestyle, and science topics. In addition to writing for Everyday Health, her work has been featured in WebMD, SELF, Healthline, A&E, Psych Central, Verywell Health, and more. Her goal is to compose helpful articles that readers can easily understand and use to improve their well-being. She is passionate about healthy living and delivering important medical information through her writing.

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