Dysphagia, or difficulty swallowing, is known as a symptom of many different medical conditions. It can often be caused by nervous system disorders, muscle disorders or physical blockages in the throat. While it is often a symptom of a different disease, in some cases it can also be the primary cause. Dysphagia, which can be painful, is more common in infants and the elderly. Treatment for dysphagia varies depending on the underlying cause.
If dysphagia occurs only once or twice, it does not indicate a serious condition. However, when it is a recurring condition, people with this problem should see a specialist and the underlying cause of the problem should be investigated.
What Causes Dysphagia (Difficulty Swallowing)?
Dysphagia can be caused by many different disorders and problems. Since dysphagia can be a symptom of any disease, in some cases it may not be possible to determine what is causing the problem.
Health problems and some conditions that can cause dysphagia can be listed as follows:
Nervous System and Brain Disorders
Some conditions can affect the nervous system and cause brain disorders. These neurological conditions include Parkinson's disease, multiple sclerosis, stroke, trauma or dementia. Such conditions can be characterized by swallowing.
Muscle Disorders
Myasthenia gravis (MG) is an autoimmune muscle disease that can cause muscles in the body to weaken. Muscles associated with swallowing can also be affected.
Cancer and Radiotherapy
Some cancers and some cancer treatments, such as radiotherapy, can cause difficulty swallowing. There may be inflammation, hardening or difficulty swallowing in the esophagus.
Gastroesophageal Reflux Disease (GERD)
It is associated with stomach acid coming back into the esophagus. Stomach acid can cause the esophagus to narrow, leading to problems such as difficulty swallowing.
Achalasia
When the lower muscle of the esophagus does not relax enough to allow food to enter the stomach, food can come back up into the throat and cause difficulty swallowing.
Scleroderma
It is a rheumatologic disorder that causes hardening of the tissues. It may be one of the causes of dysphagia by weakening the lower esophageal sphincter.
Pharyngoesophageal Diverticulum (Zenker's diverticulum)
A small sac on the esophagus that forms and collects food particles, causing difficulty swallowing, wheezing, bad breath and repeated throat clearing or coughing.
Eosinophilic Esophagitis
This condition, which can be linked to food allergy, is caused by the presence of a large number of cells called eosinophils in the esophagus. The number of eosinophils can increase and attack the cells of the digestive system. This can cause symptoms such as difficulty swallowing and vomiting.
What are the Symptoms of Dysphagia?
While some people with dysphagia have difficulty swallowing only some foods or liquids, some people may experience this problem continuously. Symptoms of dysphagia can be listed as follows:
- Pain and pain during swallowing
- Not swallowing
- Feeling of food getting stuck in the throat or chest
- Hoarseness
- Food coming back
- Heartburn
- Stomach acid in the throat or mouth
- Coughing or gagging during swallowing
- Weight loss
In case of symptoms and signs, it is important for people to go to the nearest health institution immediately. In such cases, early investigations are important for the diagnosis and treatment of serious conditions such as cancer.
What are the Types of Dysphagia?
For swallowing to occur naturally, muscles and nerves must work together. A functional problem or disorder in any of the muscles or nerves can trigger dysphagia.
Dysphagia can occur in one of the 3 stages of swallowing. Types of dysphagia can be listed as follows:
Oral Dysphagia
It is a swallowing difficulty that develops due to a problem that occurs in the mouth. It can usually be caused by problems such as weakening of the tongue after a neurological disorder such as a stroke or the inability to move food in the mouth.
Pharyngeal Dysphagia
It is caused by a problem in the throat. It can often be the result of neurological or muscular problems such as Parkinson's disease and stroke.
Esophageal Dysphagia
It is a swallowing difficulty that originates in the esophagus. It can often develop as a result of a blockage or irritation in the throat. Surgery is usually required for its treatment.
How is dysphagia (difficulty swallowing) diagnosed?
For the diagnosis of dysphagia, it may be necessary to determine the underlying causes and perform some tests. The tests deemed necessary by the specialist doctor and performed to diagnose the disease are as follows:
Swallowing Test
This test is usually performed by a specialist or a speech and language therapist. This test determines whether it is food or liquids that are causing the swallowing difficulty.
Barium swallowing test
The patient is asked to swallow a liquid containing barium. X-rays, which are among the imaging techniques, are used to examine the function of the muscles in the esophagus and examine them in detail.
Endoscopy
The patient's esophagus is examined with the help of a camera. This procedure helps to determine whether there are any functional problems in the throat and esophagus.
Manometry
Pressure changes of the muscles in the esophagus are measured. This procedure may be deemed necessary by the doctor if no problems are encountered during endoscopy.
Dysphagia (Swallowing Difficulty) Treatment
The treatment of dysphagia may differ depending on the underlying cause and the type of swallowing difficulty. In some cases, swallowing difficulties may resolve spontaneously without any treatment.
However, if there are different underlying causes, these conditions may need to be treated by one or more specialists. If it is caused by neurological disorders, it may be difficult to provide a definitive treatment.
In addition, people who have difficulty swallowing due to Parkinson's disease can be treated with medication, which can give good results. The methods applied in oral and pharyngeal dysphagia treatments are as follows:
Swallowing Therapy
It is performed by a speech and language therapist. New methods are taught to reduce dysphagia problems and for effective swallowing. In addition, some physical therapy methods can be applied to strengthen the weakened muscles.
Diet
Some cases may have prolonged difficulty swallowing food or liquids. For this reason, people are recommended foods that are easier to swallow. Meanwhile, a balanced and regular diet program should be followed.
Tube Feeding
If people are at risk of pneumonia, malnutrition or dehydration, they need to be fed with a nasal tube (nasogastric tube) or PEG (percutaneous endoscopic gastrostomy). PEG tubes are surgically inserted directly into the stomach.
Esophageal treatment is usually performed with surgical interventions. These methods include dilatation and botox injection. Dilatation is performed as a result of narrowing of the esophagus. This is done by inserting a small balloon into the esophagus and inflating it. Botox injection is applied to correct the hardening of the muscles in the esophagus.