Are you having a more difficult time lately swallowing foods you used to have no problem doing? Do you find yourself choking more often on food that gets ‘stuck’ in your throat on the way down? If so, you may be struggling with a condition that affects 1 in 5 people over the age of 50 in the United States - dysphagia.
What Is Dysphagia?
Dysphagia, although it is mostly regarded as a symptom or sign, is sometimes referred to as a condition. Dysphagia is the difficulty in swallowing. Swallowing is actually a much more complex thing than people think, as it’s one of those issues that when you don’t have it, you don’t really think about it. As the food or liquid is chewed or prepared to be swallowed in the mouth, it then passes through the back of the throat and approaches two tubes that serve different functions for different systems - the trachea (airway) and the esophagus (pathway to the stomach). There are several different muscles and nerves that are used in this process of swallowing, working together to make sure the air goes where it should and the food goes where it needs to go. Ultimately, the food and liquids will pass through the LES, or lower esophageal sphincter and then into the stomach.
Are There Different Types of Dysphagia?
There are three different types of Dysphagia: high dysphagia, pharyngeal dysphagia, and esophageal dysphagia. High dysphagia, also called oral dysphagia, is where the issue occurs in the mouth and is due to tongue feebleness which you often find post-stroke. The person might feel pain in moving the food they eat from the mouth through the throat and difficulty in chewing food. Pharyngeal dysphagia occurs when the issue is concerned with the throat. Problems inside the throat occur due to neurological conditions affecting the nerves, such as strokes, amyotrophic lateral sclerosis, and Parkinson's disease. Lastly, esophageal dysphagia, which is also called low dysphagia, occurs inside the esophagus and happens due to irritation or blockage. This type of dysphagia requires surgery.
What are the Symptoms Of Dysphagia?
While a few of the symptoms of dysphagia present themselves in more obvious ways, some people suffer from dysphagia but are unaware of it due to the symptoms being more commonly associated with other conditions. Unfortunately, this mindset causes some to neglect getting evaluated and seeking help, leading to cases in which the person gets malnourished and dehydrated.
These symptoms include:
- Choking while eating
- Gagging or coughing while swallowing
- Drooling
- Acid reflux
- Heartburn
- Hoarseness
- Rapid weight loss
- Regurgitation
- Inability to control food inside the mouth with the tongue
- Pneumonia
- Inability to regulate saliva inside the mouth
It is important to consider that not every episode of choking or gagging while eating or drinking represents a serious or life threatening issue. However, the regular occurrence of dysphagia should warrant further investigation and an evaluation by a gastroenterologist.
What are the Causes of Dysphagia?
There are a number of different causes of dysphagia. If it only happens once or twice, then there is likely not a problem that needs to be checked out. However, if it occurs regularly, the causes could be from one of the following conditions:
- Achalasia - the muscle in the lower part of esophagus does not sufficiently relax for allowing food to enter into the stomach
- Diffuse spasm - the esophageal muscles uncoordinatedly contract.
- Radiation therapy - this treatment for cancer can lead to the throat becoming inflamed and swollen
- A stroke - the death of the brain cells occurs due to oxygen insufficiency caused by reduced blood flow. Strokes are often caused by blood clots.
- Scleroderma - scar tissue develops around the lower esophageal sphincter, allowing stomach acid to flow back up into the throat and cause frequent heartburn
- Esophageal ring - the narrowing of a minor section of the esophagus occurs and prevents the solid food from moving through.
- Multiple sclerosis - the central nervous system (CNS) gets attacked by the destroying myelin, the immune system that guards the neurons.
- Amyotrophic lateral sclerosis - an untreatable type of progressive neurodegenerative condition. The neurons in the brain and the spine lose their function over time.
- Myasthenia gravis - the voluntary muscles become weak due to the lack of stimulation provided by nerves contracting the muscles. This is an autoimmune disease.
- Parkinson's disease - a progressive, deteriorating neurological condition that harms the motor skills of the patient.
What are Treatments for Dysphagia?
In order to determine whether or not you have dysphagia, a doctor will test the patient using a number of different methods. One such method is a swallowing study. In a swallowing study, a patient will chew and swallow different foods that are coated with a contrast that will allow doctors to take images of the foods on the way down. Another test that involves a contrast is a barium x-ray. The patient will swallow a cup or more of a contrast, and when it settles, x-rays will be taken, allowing doctors to see any abnormalities or other problems. Another common test used to determine whether or not a patient has dysphagia is an endoscopy. An endoscopy allows a gastroenterologist to see what is going on in the throat by use of a long tube with a camera and light at the end of it. These are particularly effective as well. The diagnosis from these tests will determine what type of treatment will follow. This will also depend on the type of dysphagia. These treatments could include speech therapies, learning new swallowing techniques, changes in diet, esophageal dilation, and potentially surgery.
If you have been experiencing a prolonged period involving the difficulty with swallowing or with any of the other symptoms, please schedule an appointment. We want to help you get to the bottom of your struggles so you can get the treatment you deserve and need.
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