The Dysphagia Diagnosis: The Causes of a Tough Problem to Swallow

The process of swallowing is more complex than most people think. It requires the coordinated action of muscles and nerves in the mouth, pharynx, and esophagus (muscular tube leading from the mouth to the stomach) in order to proceed smoothly. As you might imagine, a number of factors can interfere with this complex process, from nerve damage to changes in muscle cell function. When swallowing becomes dysfunctional, it is referred to as dysphagia and can be a serious condition. Here is a look at how dysphagia presents as well as what causes it.

Symptoms of Dysphagia

Dysphagia is characterized by any difficulty with swallowing. This can include everything from pain while swallowing (sometimes called odynophagia) to drooling to a complete inability to swallow. If you have to cut food into small pieces to swallow it, avoid certain foods because they cause trouble with swallowing, have frequent heartburn, or bring food back up (regurgitation), then you may be suffering from dysphagia. When difficulty swallowing becomes routine, leads to weight loss, or is accompanied by regurgitation or vomiting, it is time to visit a doctor.

Causes of Dysphagia

Dysphagia can be caused by a number of different conditions, with gastroesophageal reflux disease (GERD) being the most common. Other causes of dysphagia, while less common than GERD, tend to be more immediately dangerous. While GERD can lead to serious health consequences, like cancer, it is a slowly progressive disease. Other conditions, however, constitute serious problems and, in some cases, may be medical emergencies. Here is a look at some of the major causes of dysphagia.

• GERD

GERD occurs when stomach acid backs up into the esophagus and causes pain, ulceration, scars, and narrowing of the esophagus. GERD is easily treated, so if you have frequent heartburn, make an appointment to see your doctor to determine the case of your GERD and find an effective means of managing it

• Stroke

Stroke is a leading cause of dysphagia. Signs of a stroke include paralysis, difficulty speaking, trouble with vision, changes in bowel or bladder function, and confusion. Any of these symptoms requires immediate emergency medical attention. With proper and timely treatment, stroke symptoms can resolve. Left unattended, the symptoms of stroke become permanent.

• Esophageal Spasm

Esophageal spasm occurs when the muscles of the esophagus become overly active. This can be caused by autoimmune disorders, food allergies, certain medications, and nerve damage. Treatment often involves the use of muscle relaxers. Surgery may be necessary as well.

• Esophagitis

Inflammation of soft tissue that lines the esophagus can lead to dysphagia. This occurs due to GERD, allergies, infection, and as a result of having pills get stuck in the esophagus on a frequent basis. Avoid the latter condition by drinking plenty of fluids when taking medications. Infection, allergies, and GERD can all be treated with prescription and over-the-counter medications.

• Masses

Masses, both inside and outside of the esophagus, can narrow the space that food has to pass. Bone spurs on the vertebrae are one common type of mass that exists outside the esophagus and that can lead to dysphagia. Tumors can cause dysphagia through a mass effect as well and may be malignant (cancerous) or benign.

• Autoimmune Disease

Diseases like polymyositis can weaken the muscular function of the esophagus while other conditions, like Sjogren’s syndrome, can reduce secretions and cause a dry esophagus. Autoimmune diseases may only affect swallowing (e.g. eosinophilic esophagitis), but often cause other problems throughout the body.

Treating Dysphagia

In many cases, treating the cause of the dysphagia can lead to partial or complete resolution of the symptoms. When dysphagia cannot be reversed, focus shifts to preventing or slowing the progression of the disease and to ensuring that proper nutrition can be obtained without compromising the respiratory tract.

The trachea and esophagus share a common pathway for at least part of their transit from the mouth. In some cases of dysphagia, the disordered swallowing causes food to go into the trachea and lungs rather than to the esophagus and stomach. This can lead to serious complications, like infection or respiratory distress. One way to treat this problem is with thickened purees. Finding the right consistency of food can be the key to ensuring that food does not get trapped and that it does not end up “down the wrong pipe.” Individuals interested in food thickeners to add to pureed preparation can visit ThickIt.com for more details.

The Bottom Line

Dysphagia is a serious condition that should not be ignored. While the cause of dysphagia is often benign and easily treated, it is critical to catch less common but more severe conditions early. If you experience frequent difficulty with swallowing, are losing weight because you can’t swallow, have food come back up (especially if undigested), or vomit frequently, it is time to see a doctor.

Laura Thomas works as a nurse. Though demanding work she gets great job satisfaction when a critically ill patient is able to go home again after weeks or months of care. In her spare time Laura occasionally writes articles on health topics to help raise awareness of lesser known ailments.