Risk factors
Due to natural
aging and normal wear and tear on the esophagus, older adults are at
higher risk of dysphagia. Babies born prematurely are more prone to
developmental problems, including gastrointestinal disorders that may
cause difficulty swallowing. People with neurologic or nervous system
disorders are more likely to experience dysphagia.
When to seek medical advice
If an obstruction
causes an inability to swallow or interferes with breathing, call for
emergency help or go to the nearest emergency department immediately.
Slight or
occasional difficulty swallowing usually isn't cause for concern. But
dysphagia can indicate a serious medical problem, such as esophageal
cancer. See your doctor if you regularly have difficulty swallowing.
Your doctor will likely perform a physical examination to determine the
cause of your swallowing problem. Depending on the cause, your doctor
may refer you to an ear, nose and throat specialist (otolaryngologist),
a doctor specialized in treating disorders of the esophagus
(gastroenterologist), or an expert in diseases of the nervous system
(neurologist).
Screening and diagnosis
Your
doctor may use a variety of tests to determine the cause of dysphagia.
These may include:
-
Barium
X-ray.
For this test, you drink a barium solution. The barium coats the
inside of your esophagus, allowing it to show up better on X-rays.
Your doctor can then see changes in the shape of your esophagus and
can assess the muscular activity.
-
Endoscopy.
A thin, flexible, lighted instrument (endoscope) is passed down your
throat so that your doctor can view your esophagus.
-
Esophageal
muscle test.
In this test, called manometry, a small tube is inserted into your
esophagus and connected to a pressure recorder. This allows
measurement of the muscle contractions of your esophagus as you
swallow.
Complications
Dysphagia can make
it difficult for you to take in enough food and fluids to stay
adequately nourished. People with swallowing difficulties are at risk of
malnutrition and dehydration. If food or liquid enters your airway
(aspiration) as you attempt to swallow, respiratory problems or
infections can occur, such as frequent bouts of pneumonia or upper
respiratory infections.
Treatment
Treatment
for dysphagia is often tailored to the particular type or cause of your
swallowing disorder:
-
Oropharyngeal dysphagia.
For oropharyngeal dysphagia, your doctor will most likely refer you
to a throat specialist or neurologist for further diagnostic
testing, and a speech or swallowing specialist for therapy. Certain
exercises may help coordinate your swallowing muscles or restimulate
the nerves that trigger the swallowing reflex. You may also learn
simple ways to place food in your mouth or to position your body and
head to help you swallow successfully.
-
Esophageal
dysphagia.
For a tight esophageal sphincter (achalasia) or an esophageal
stricture, your doctor may use an endoscope with a special balloon
attached to gently stretch and expand the width of your esophagus
(dilatation). For an esophageal tumor or pharyngeal diverticula, you
may need surgery to clear your esophageal path. Dysphagia associated
with GERD can be treated with prescription oral medications to
reduce stomach acid after a stricture is dilated. You may need to
take these medications for an extended period of time.
-
Severe
dysphagia.
If dysphagia prevents you from eating and drinking enough to
maintain a healthy weight and avoid dehydration, your doctor may
recommend special liquid diets. In severe cases of dysphagia, you
may need a feeding tube to bypass the part of your swallowing
mechanism that isn't working normally.
Prevention
Although dysphagia
can't be prevented when the cause is neurologic damage or disorders, you
can reduce your risk of occasional difficulty swallowing by eating
slowly and chewing your food well. Early detection and effective
treatment of GERD can lower your risk of developing dysphagia associated
with an esophageal stricture.
Coping skills
Living with
dysphagia can be difficult. Dysphagia may affect your interaction with
friends and family, your productivity at work and the overall quality of
your life.
Difficulty swallowing
-
Dysphagia
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