Patient education: Dysphagia (The Basics)

What is dysphagia? — 

This is trouble swallowing. Sometimes, it happens if you eat too fast or don't chew your food enough. But if you have dysphagia, you might have a serious medical problem that needs to be treated right away.

What causes dysphagia? — 

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

What are the symptoms of dysphagia? — 

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 cannot 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 – 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 your esophagus.

●Swallowing study, also called "videofluoroscopy" – You eat different foods coated with barium. X-rays are taken throughout the test and can show if you have problems with the muscles in your mouth or throat.

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

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

How is dysphagia treated? — 

Treatment depends on what is causing your 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. They 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:

●Medicines – These include:

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

•Medicines to treat an infection of the esophagus

●Esophageal dilation – The doctor gently stretches and widens your esophagus. They can do this using an endoscope (see above) with a special balloon on the end or another type of "dilator."

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

More on this topic

Patient education: Dysphagia in adults – Discharge instructions (The Basics)
Patient education: Acid reflux and GERD in adults (The Basics)
Patient education: Upper endoscopy (The Basics)
Patient education: Eosinophilic esophagitis (The Basics)
Patient education: Myasthenia gravis (The Basics)
Patient education: Esophageal stricture (The Basics)
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Patient education: Malnutrition (The Basics)
Patient education: Full liquid diet (The Basics)
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Patient education: Upper gastrointestinal series and esophagram (The Basics)
Patient education: Laryngoscopy (The Basics)