What is Dysphagia?
Dysphagia is a condition in which a person faces difficulty in swallowing. Swallowing involves several; different muscles and nerves and is a complex process. A difficulty anywhere in the process of swallowing can cause Dysphagia. In Dysphagia, it takes more time and effort than normal to move the food and liquid from the mouth to the stomach and may sometimes be associated with pain. In some cases of Dysphagia, swallowing becomes impossible.
The condition is usually caused by muscle or nerve problems and is more common in babies and older people. In medical terms, Dysphagia is often regarded as a sign or a symptom.
Three general types of Dysphagia exist. They are:
- Oral Dysphagia
- Pharyngeal Dysphagia
- Esophageal Dysphagia
Dysphagia symptoms include:
- Choking when eating
- Gagging or coughing when swallowing
- Stomach acid or food backing up into the throat
- Recurrent heartburn
- A sensation of food getting stuck in the throat or the chest
- Unexplained weight loss
- Regurgitation or bringing food back up
- Difficulty in controlling food in the mouth
- Difficulty in the swallowing process
- Recurrent pneumonia
- Inability to control the saliva in the mouth
Who is at risk?
Dysphagia risk factors include:
- Old age
- Certain old age diseases such as Parkinson’s disease
- Certain nervous system disorders
Reasons for Dysphagia include certain conditions that make the food stick or get hung up at the base of the throat or weaken the throat muscles. Potential causes of Dysphagia include:
- Amyotrophic lateral sclerosis
- Diffuse spasm
- Esophageal ring
- Eosinophilic esophagitis
- Multiple sclerosis
- Myasthenia gravis
- Parkinson’s disease and Parkinsonism syndromes
- Radiation therapies
- Cleft lip and palate
- Esophageal cancer
- Esophageal stricture
How is Dysphagia diagnosed?
Dysphagia diagnosis may begin with a speech-language pathologist trying to determine the area where the problem lies or the part of the swallowing process that is causing difficulty.
A Dysphagia doctor may ask the patient about the symptoms, how long they have been present, and if the problem is with solids, liquids, or both.
A swallow study may be administered by a speech therapist. This may include testing different consistencies of food and liquids to check for what is causing difficulty. They may also perform a Dysphagia test such as a video swallowing test to see where the problem lies.
Other tests for Dysphagia include:
- Barium swallow test: in this test, a barium-containing liquid is swallowed by the patient which shows up in X-rays and helps the doctor in looking at the activities of the muscles and what is happening in the esophagus in more detail.
- Endoscopy: During this test, a camera is used by the doctor to look down into the esophagus.
- Manometry: it measures the pressure changes produced when the muscles in the esophagus are working and may be used when nothing is found in the endoscopy.
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How is Dysphagia treated?
Dysphagia treatment depends upon the type of Dysphagia.
In the case of oropharyngeal Dysphagia, providing effective treatment or medicine for Dysphagia may be challenging since it is often a neurological problem. Treatment options include:
- Swallowing therapy: A speech and language therapist ay help an individual in learning new ways of swallowing properly. The muscles and their response may be improved with certain exercises.
- Diet: adding easiest-to-swallow foods, or food and liquids that are easier to swallow may help. However, the patient needs to have a well-balanced diet.
- Feeding through a tube: in cases where the patient is at risk of dehydration, malnutrition, or pneumonia, they may be fed through a nasal tube or nasogastric tube, or a PEG ( percutaneous endoscopic gastrostomy).
An esophageal Dysphagia cure usually requires surgical intervention. Treatment options include:
- Dilation: due to a stricture, if the esophagus needs to be widened, a small balloon may be inserted and inflated and then removed.
- Botulinum toxin (Botox): It is commonly used in cases where the muscles in the esophagus have become stiff. Botox is a strong toxin that can paralyze the stiff muscle resulting in a reduction in the constriction.
In cases, where Dysphagia is caused by cancer, the patient is referred to an oncologist for treatment and may need surgical removal of the tumor.
How can Dysphagia be prevented?
While the prevention of Dysphagia is not entirely possible, the risk of occasional difficulty in swallowing can be reduced by eating slowly and chewing your food well.
The risk of developing Dysphagia associated with esophageal stricture can be reduced by early detection and effective treatment of GERD.