Dysphagia makes it hard or impossible to swallow food, fluids or, in some cases, saliva. As a result, dysphagia can cause weight loss, choking and regular chest infections. It can also make you feel awkward when you’re eating and drinking, and sometimes may be painful.
Although it can happen occasionally, dysphagia is usually a long-term (chronic), persistent condition. It’s more likely to develop when you’re older but dysphagia can affect adults and children of all ages.
Dysphagia tends to be the result of another health condition, which may be serious and need treatment. It is usually caused by a problem with your gullet (oesophagus), but in some cases may be caused by a problem at the back of your mouth or something pressing on your gullet.
Although it isn’t always possible to cure dysphagia, in many cases dysphagia symptoms can successfully be managed and improved.
Difficulty swallowing or an inability to swallow is the main symptom of dysphagia. Other symptoms include:
You may also unintentionally lose weight and have to cut your food into smaller pieces to make it easier to swallow. You may need to avoid certain foods altogether.
Children with dysphagia may show signs of delayed development and behavioural problems at mealtimes.
If you’re having problems swallowing, pain when swallowing or any other dysphagia symptoms, however mild, see your GP as soon as possible. This is because mild dysphagia that gets worse over time can be the first sign of a serious condition, such as cancer of the gullet (oesophageal cancer), which is more successfully treated the earlier it is caught.
Your GP will discuss your dysphagia symptoms and examine your throat. To rule out or confirm possible causes of your dysphagia, they may refer you for tests, including:
Other tests include:
If you’ve lost weight and your GP is concerned that you might be malnourished, they may refer you to a dietitian. Your GP may also refer you to a consultant, such as a neurologist (a doctor who specialises in treating the brain and nervous system), a gastroenterologist (a doctor who specialises in treating the digestive system) or a geriatrician (a doctor who specialises in treating the elderly).
There are two main types of dysphagia:
Obstruction can be caused by:
Conditions that affect the muscles that push food down your gullet and into your stomach can cause dysphagia. These conditions are rare but include:
Gastro-oesophageal reflux disease (GORD) is caused by stomach acid escaping into your gullet, which leads to frequent heartburn. This consequently can cause narrowing, scarring or spasming of your gullet, which leads to oesophageal dysphagia.
Damage to your nervous system (brain, spinal cord and nerves) can prevent the nerves that control your swallowing from working properly, causing dysphagia. Conditions include:
Aspiration pneumonia is a serious complication of dysphagia and needs medical treatment. It is caused by accidentally inhaling food, saliva or stomach acid. If you have dysphagia, seek immediate medical attention if:
If you only have occasional dysphagia, try chewing your food slowly and properly before swallowing.
Chronic, persistent dysphagia requires medical attention. Your dysphagia treatment will depend on the condition that has triggered your difficulty swallowing.
Once the condition causing your dysphagia has been diagnosed, your GP or consultant will arrange your treatment.
Your GP or consultant may arrange speech and swallowing therapy so you can learn different ways of swallowing. If you have severe dysphagia, they may suggest other treatments, such as surgery or alternative feeding methods.
You may be referred to a speech and swallowing therapist for therapy. This may include learning exercises to help coordinate your swallowing muscles or stimulate the nerves that control your swallowing reflex. You may also be taught swallowing techniques. This involves learning ways to place food in your mouth or to position your body and head to aid swallowing. Swallowing techniques are often used to treat dysphagia caused by neurological conditions, such as Alzheimer's disease or Parkinson's disease.
If your dysphagia is so severe that it stops you from eating and drinking enough, your doctor may recommend a feeding tube to bypass the part of your throat or gullet that isn't working properly. In very severe cases, they may recommend a special liquid diet to help maintain a healthy weight and prevent dehydration.
Your doctor may recommend surgery to treat oesophageal cancer, or if your dysphagia is caused by narrowing or blockages of your throat, which can be caused by:
The type of surgery you have will depend on the cause of your dysphagia. Types of surgery include:
Laparoscopic heller myotomy
This involves cutting the ring of muscle (sphincter) at the bottom of your gullet if it is not opening properly or at all.
Peroral endoscopic myotomy (POEM)
This involves passing an endoscope into your throat via your mouth, making a cut in the lining of your gullet and cutting the sphincter at the bottom of your gullet.
An endoscope with a special balloon attached is passed into your gullet to gently stretch it. In some cases, instead of using a balloon, a tube or tubes of different diameters will be used. This treatment is used if your dysphagia is caused by:
This involves inserting a metal or plastic tube (stent) to hold open your gullet if it has narrowed or is blocked. Your stents may be permanent or temporary.
Speech and swallowing therapy is usually beneficial after surgery.
If you are living with dysphagia, there are things you can do to help manage your symptoms. These include:
Dysphagia can make you choke or cough when food goes down your windpipe instead of your gullet. This may make you anxious about eating and reduce how often you eat or drink, causing dehydration, malnutrition and unintentional weight loss. Dysphagia can also stop you from enjoying meals and social events that involve eating or drinking in front of others.
In some cases, dysphagia may increase your risk of chest infections, such as aspiration pneumonia. Symptoms of aspiration pneumonia to look out for include:
In children with dysphagia, they may develop behavioural problems and act out at mealtimes.
You can reduce your risk of having episodes of dysphagia by eating slowly and chewing your food thoroughly. As GORD can lead to dysphagia, getting treatment for GORD as soon as possible will reduce your risk of swallowing difficulties.
What is the likely cause of dysphagia?
Dysphagia can be caused by food or a foreign object partially blocking your throat or gullet. It can also be caused by a variety of underlying medical conditions, including those that affect the muscles in your throat (eg achalasia), neurological conditions that affect the nerves that control swallowing (eg multiple sclerosis and Parkinson’s disease), as well as brain trauma (eg injury to your brain or spine and stroke). It can also be caused by infections, inflammation and obstructions of the throat and gullet, as well as GORD (gastrointestinal reflux disease).
How do you treat dysphagia?
If your dysphagia is occasional, chewing your food more thoroughly and eating slowly can help. For chronic (long-term) dysphagia, you may also need speech and swallowing therapy so you can learn new techniques to help you swallow more easily. Depending on the cause of your dysphagia, you may be prescribed medication or be referred for surgery.
What are three disorders that cause dysphagia?
Dysphagia can be caused by a variety of underlying medical conditions, including GORD (gastrointestinal reflux disease), muscular conditions such as achalasia where the muscles of your gullet can’t relax and neurological conditions affecting the nerves that control swallowing, such as multiple sclerosis.
Does dysphagia go away?
Occasional dysphagia may go away if you make sure to chew your food more thoroughly and eat more slowly. Chronic (long-term) dysphagia usually needs treatment. Depending on the cause, dysphagia treatment may cure your dysphagia or reduce your dysphagia symptoms.
What are the stages of dysphagia?
There are no defined stages of dysphagia. However, dysphagia can affect different stages of the swallowing process and may start off mild and worsen over time, particularly if the underlying cause is throat or gullet cancer.
Does anxiety cause dysphagia?
No, anxiety does not cause dysphagia.
What does dysphagia feel like?
Dysphagia makes it difficult or impossible to swallow properly. This can make you feel as if a piece of food is stuck in your throat or chest or behind your breastbone (sternum). It may also feel painful and you may experience heartburn.
What type of doctor treats dysphagia?
Depending on the cause of your dysphagia you may be treated by a neurologist (a doctor who specialises in treating the brain and nervous system), a gastroenterologist (a doctor who specialises in treating the digestive system) or a geriatrician (a doctor who specialises in treating the elderly).
What foods are good for dysphagia?
Depending on the cause and severity of your dysphagia, you may find it easier to swallow smooth, pureed foods. Some people with dysphagia struggle with very thin fluids (eg juice and coffee) and sticky foods (eg caramel and peanut butter). Whatever foods you are eating, make sure you cut your food up into small pieces, chew thoroughly and eat slowly.
What autoimmune disorders cause dysphagia?
The autoimmune disorder scleroderma can cause dysphagia. It occurs when your immune system mistakenly attacks your healthy tissue, causing your throat and gullet muscles to stiffen.
What risks are increased due to dysphagia?
Dysphagia increases your risk of choking or coughing when eating or drinking. This can make mealtimes stressful, so much so that you may reduce how often you eat or drink. This puts you at increased risk of dehydration, malnutrition and unintentional weight loss. Dysphagia can also increase your risk of chest infections, such as aspiration pneumonia.