An Overview of Dysphagia

Dysphagia is a swallowing disorder which leads to troublesome passing of food or liquid down the throat. Difficulty in swallowing leads to an infection in the chest, dehydration or malnutrition, etc. Dysphagia can be oropharyngeal or esophageal, depending upon its position of occurrence.

Conditions such as stroke, neurological conditions such as Parkinson's disease, multiple sclerosis, dementia, etc, brain tumors, cerebral palsy, mouth cancer, lung cancer, gastro-esophageal reflux disease (GERD), etc lead to dysphagia. These conditions lead to narrowing of the esophagus, ultimately resulting in dysphasia.

Dysphagia to solids and liquids is an important symptom of achalasia. Dysphagia to liquids is not common in structural causes of esophageal obstruction.

Dysphagia leads to pneumonia aspiration, choking, malnutrition, weight loss, dehydration, etc. To determine the severity of dysplasia and conditions associated with it, several tests are recommended such as swallow test, fibreoptic endoscopic evaluation of swallowing (FEES) procedure, cineradiography, biopsy, lung cancer X ray, endoscopy, etc.

The most common symptoms of dysphagia are painful swallowing (also known as odynophagia) and inability to swallow. Other symptoms include feeling of food getting stuck in throat or chest, drooling, regurgitation or backing up of food, heartburn, acidic reflux, unexpected weight loss, etc.

There are chances that some people with dysphagia have a tendency to develop chest infections, such as aspiration pneumonia, which require medical treatment.

Treatment of dysplasia is dependent on the type of dysphagia i.e. either in the mouth or throat which is known as oropharyngeal dysphagia, or in the esophagus which is known as esophageal dysphagia. It is also recommended to consider the cause of dysphagia during this treatment. 

Oropharyngeal dysphagia is referred to the difficulty in emptying material from the oropharynx into the esophagus. This is a result of an abnormal function proximal to the esophagus. It is difficult to treat oropharyngeal dysplasia through medicines or surgery as it is more associated with the nervous system. Oropharyngeal dysphagia is best treated with swallowing therapy, dietary changes, and use of feeding tubes.

During swallowing therapy, a speech and language therapist (SLT) is needed to teach swallowing exercises to the patient. Feeding tubes are used to provide nutrition, if a person is not able to swallow. 

Esophageal dysphagia is a common condition which results in difficulty in passing the food down the esophagus. Usually, esophageal dysphagia results from a motility disorder or a mechanical obstruction.

Medicines, botox injections, and surgery are known treatments recommended for esophageal dysphagia.  Surgery such as Laparoscopic Heller myotomy, esophageal dilation, stent placement, etc is considered only in critical cases.

Dysphagia cannot be cured completely but various options are available that might help in treating the condition.

Diet plays a very important role because swallowing becomes difficult in this condition. Dietician suggests slow consumption of food in small quantities so that it does not get stuck into the esophagus. Other things to remember are:

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