Dysphagia is a condition where the muscles in your esophagus do not work properly, causing difficulty swallowing and allowing food to stick along the sides of your esophagus. In some cases it can be painful and can occur at any age, but is more common in older adults.
There are many medical conditions that can impact swallowing, for this reason the cause of dysphagia is difficult to assess. However, specialists have been able to categorize dysphagia into 2 types, Esophageal and Oropharyngeal.
Esophageal dysphagia occurs when an individual feels like food is sticking or caught in the base of the throat or chest.
The following conditions cause esophageal dysphagia:
- Achalasia: When the esophageal muscle doesn’t function properly and allows food to flow back up the stomach and into the esophagus. A patient may also have weak esophagus muscles, which grow weaker in time.
- Esophageal stricture: When an individual has a narrowed esophagus, which can cause large pieces of food to become trapped. The condition can produce tumors and scar tissue caused by GERD (gastroesophageal reflux disease).
- Esophageal ring: An area of the lower esophagus that thins out over time, causing difficulty in swallowing.
- Esophageal tumors: Tumors in the esophagus cause dysphagia.
- GERD: Stomach acid that flows back up into the esophagus can cause damage to the esophagus, leading to spasms, difficulty swallowing, or narrowing of the esophagus.
- Scleroderma: Scar-like tissue that results in the stiffening and hardening of tissue in the body. This can weaken the lower esophageal sphincter, which will allow stomach acids to flow back up and into the esophagus.
With Oropharyngeal Dysphagia, patients will experience difficulty swallowing almost immediately. The conditions causing the difficulty in swallowing often have to do with the muscles involved in chewing and pushing food to the back of the throat. If the muscles protecting the larynx and voice box are not functioning, the individual may swallow food and liquids through their voice box. This will cause a person’s voice to become husky and, in some patients, trigger a pneumonia called aspiration pneumonia. Some patients will report that choking or difficulty swallowing feels like it occurs at the back of the throat.
Dysphagia symptoms include:
- Unable to swallow
- Coughing or gagging when swallowing
- Being hoarse
- Regurgitating food
- Have heartburn or acid reflux
- Losing weight suddenly
- Feeling like you have food stuck in your throat or chest
- Pain when trying to swallow
The first thing your Dysphagia specialist will do is diagnose you as having esophageal or oropharyngeal dysphagia. They will ask you for your medical history and review with the care team prior to your visits. Depending on your diagnosis your doctor may perform a number of screenings or procedures including neurologic examination, Barium swallow test or endoscopy.
Treatment for dysphagia will depend greatly on the diagnosis. There are several options for dilating a narrowed esophagus using a balloon or stents to make swallowing possible; medications to reduce acid reflux can also help; surgery or BOTOX injections to help relax the esophageal muscles.
Care Team Approach
Digestive Health, a clinical partnership between Ascension Seton and UT Health Austin, takes a multidisciplinary approach to your care. This means you will benefit from the expertise of multiple specialists across a variety of disciplines. Your care team will include gastroenterologists, surgical and non-surgical heartburn and esophageal disorders specialists, physician assistants, nurses, advanced practice providers, dietitians, social workers, and more, providing unparalleled care for patients every step of the way. We collaborate with our colleagues at the Dell Medical School and The University of Texas at Austin to utilize the latest research, diagnostic, and treatment techniques, allowing us to identify new therapies to improve treatment outcomes. We are committed to communicating and coordinating your care with your other healthcare providers to ensure that we are providing you with comprehensive, whole-person care.