Dysphagia is the term given to difficulties with swallowing. It can mean you’re unable to swallow foods or liquids easily and may choke when trying to swallow. Dysphagia is usually caused by problems with your mouth or throat, or by problems with your gullet (oesophagus).
There are two types of dysphagia that affect different stages of the swallowing process.
The act of swallowing occurs in four phases: oral preparatory, oral, pharyngeal and oesophageal. Dysphagia that affects the first three phases is called oropharyngeal dysphagia. When dysphagia affects the final stage, it is called oesophageal dysphagia.
Also known as high dysphagia, oropharyngeal dysphagia is caused by problems with your mouth or weakening of your throat muscles. Weakened muscles or a nerve disorder make it difficult to swallow without gagging or choking.
This type of dysphagia can be caused by a range of conditions, many of which primarily affect the nervous system, including:
Oropharyngeal dysphagia can also be caused by head or neck cancer, or by oesophageal cancer. In some cases, it can be caused by a rare condition called Zenker's diverticulum or a pharyngeal pouch, where food collects in a bulge in your throat (pharynx), causing an obstruction.
Oesophageal dysphagia feels as though you have something caught in your throat. It can be caused by several things, including:
There are several symptoms of dysphagia, which can differ depending on which type you have.
Symptoms of oropharyngeal dysphagia
As well as having to clear your throat often, you may experience coughing or choking when you swallow. Food getting stuck in the throat can lead to:
If you have difficulty swallowing your meals, you may lose interest in food, which can cause weight loss, dehydration and malnutrition.
Symptoms of oesophageal dysphagia
You may experience pain in your chest when you swallow and feel as if food is getting stuck. Other symptoms include:
If you only have occasional dysphagia, it may help to eat more slowly to ensure that your food is properly chewed before swallowing.
If you have persistent dysphagia, you should make an appointment with your GP to have it investigated.
Your GP will ask questions about your symptoms and how they affect you. Depending on your initial assessment, you may be referred for tests and treatment with a speech and language therapist (SLT), a neurologist (a doctor specialising in treating the brain and nervous system) or a gastroenterologist (a doctor specialising in treating the gut).
Tests can include:
Testing will show which type of dysphagia you have. You may also be referred for other tests if it is likely that your dysphagia is being caused by an underlying health condition.
Treatment of dysphagia will depend on the type of dysphagia you’re diagnosed with. If dysphagia is caused by an underlying illness, treating this illness will relieve the issues with swallowing.
Treatments for oropharyngeal dysphagia
This type of dysphagia can be hard to treat as it’s often caused by a condition that affects your nervous system. It therefore can’t usually be treated with medication or surgery. Instead, three main treatments are used to help make eating and drinking as safe as possible:
Treatments for oesophageal dysphagia
The cause of your dysphagia will determine the best course of treatment. Options include:
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