Dysphagia

The leading sign of dysphagia is difficulty swallowing. If you also experience any of the symptoms below, contact our Underwood Center specialists:

• Coughing or choking with intake of food or drink
• Hypersalivation – Persistent drooling of saliva 
• Regurgitation – Backflow of food or liquid from the esophagus into the mouth
• Sensation that food is stuck in your throat or chest after swallowing; usually an indicator of esophageal dysphagia

See your doctor today if you have advanced symptoms, such as unintended weight loss or repeated chest infections.

Swallowing is a multi-stage process that begins in the mouth and flows through the esophagus. Because approximately 50 pairs of muscles and nerves help digest food and liquid, there may be many reasons for your dysphagia symptoms.

Damage to the nervous system can interfere with proper swallowing. Neurological causes can be:

• Brain and spinal cord diseases – Parkinson's, multiple sclerosis, dementia and motor neuron disease
• Brain tumors
• Myasthenia gravis – A rare condition that causes your muscles to weaken
• Stroke

Conditions that cause a narrowed esophagus or an obstruction in the throat can make swallowing difficult. Some causes include:

• Mouth cancer or throat cancer
• Zenker diverticulum – outpouching that form in the throat at the top of the esophagus 
• Eosinophilic esophagitis – allergic inflammation in the lining of the esophagus
• Radiotherapy treatment – Can lead to scar tissue buildup in your throat and esophagus
• Yeast or fungal infection causing inflammation of the esophagus

There are rare conditions that affect the muscles used to push food down the esophagus and into the stomach. With scleroderma, the immune system causes esophageal muscles to weaken and stiffen when it attacks the healthy tissue it believes to be harmful.

Other causes include head or neck surgery complications, as well as head and neck cancer or dental issues.

Underwood Center researchers and doctors work together to make definitive diagnoses. First, we’ll investigate the location of the injury to distinguish the type of dysphagia present.

We may choose from the following procedures based on the duration and frequency of your symptoms, your ability to swallow solids, liquids or both and whether you've had an unexplained weight loss.

• Barium swallow – A white liquid that traces the pathway from the esophagus into the stomach
• Esophageal manometry – Measures how well the esophagus squeezes to aid digestion
• pH probe test – Measures backflow of acid from the stomach into the esophagus
• Nasoendoscopy – A thin, flexible tube and camera inserted in the nose to examine your throat 
• Nutritional assessment – Blood tests and a check of your body mass index
• Water swallow test – An initial assessment of your swallowing abilities done by a speech and language therapist (SLT)

Because dysphagia can have minor to major causes, we offer a variety of medical or surgical solutions based upon the problem that is diagnosed to be the cause. The equipment we use will depend on the location of your swallowing problem.

Oropharyngeal dysphagia is swallowing difficulties caused by problems with the mouth or throat. There are three primary treatments for dysphagia at the level of the head and neck (oropharyngeal):

• Dietary changes
• Feeding tubes – Tubes used to prevent malnutrition and dehydration
• Swallowing therapy – An SLT teaches you swallowing exercises and therapies
• Esophageal dysphagia is swallowing difficulty caused by a narrowed, scarred or obstructed esophagus. Esophageal dysphagia can be treated with medication or surgery, such as:
• Proton pump inhibitors (PPIs) – Acid reduction medication
• Endoscopic dilatation – Stretching the narrowed area of the esophagus