Esophageal Dysphagia
Condition
(Difficulty Swallowing [Esophagus])
Definition
Esophageal dysphagia is a problem that happens with swallowing. It feels like food is stuck in the food pipe (esophagus). The esophagus is the tube that connects the throat to the stomach.
Treatment can improve swallowing.
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Causes
Esophageal dysphagia is caused by:
- Conditions that narrow the food pipe, such as:
- Conditions that cause problems with how the food pipe works, such as:
- Inflammation—esophagitis
- Achalasia—food or drink does not move toward the stomach
- Damage to nerves
Risk Factors
Things that raise the risk of esophageal dysphagia are:
- Any of the problems above
- Injury or illness of nervous system such as:
- Gastroesophageal reflux disease (GERD)
- Cancer treatment—current or past
- Past surgery
- Premature birth
- Certain medicine
Symptoms
Symptoms of esophageal dysphagia are:
- Problems or pain with swallowing
- A feeling of food being stuck
- Food comes back up
- Drooling, coughing, or choking
- Wheezing
- Hoarse voice
- Problems getting enough fluids or nutrition
Diagnosis
The doctor will ask about symptoms and past health. A physical exam will be done. The doctor will run tests to find the cause of swallowing problems. Tests may include:
- A test to look for problems while swallowing
- An upper gastrointestinal (GI) endoscopy—a scope to view the throat from the back of the mouth to the stomach
- A barium swallow—x-ray that uses a special dye to view the throat
- Tests on the muscles of the food pipe
Treatment
Treatment depends on the cause. Options may be
- Managing symptoms with eating habits, such as:
- Chewing food well
- Staying upright while eating
- Not hurrying during meals
- Not eating later at night
- Diet changes such as:
- Not eating foods that cause problems
- Eating softer or pureed foods
- Using a feeding tube if needed
- Esophageal dilation—to make the food pipe wider
- Surgery—to treat GERD or remove something that is blocking the food pipe
- Speech therapy—to learn how to swallow without choking
- Medicines—to treat specific causes, relax muscles, or reduce acid
Prevention
There are no known guidelines to prevent esophageal dysphagia.
American Speech-Language-Hearing Association
Dysphagia Research Society
CANADIAN RESOURCES:
Heart and Stroke Foundation of Canada
Ontario Association of Speech-Language Pathologists and Audiologist
American Speech-Language-Hearing Association
Dysphagia Research Society
CANADIAN RESOURCES:
Heart and Stroke Foundation of Canada
Ontario Association of Speech-Language Pathologists and Audiologist
References
- Chilukuri P, Odufalu F, et al. Dysphagia. Mo Med. 2018;115(3):206-210.
- Dysphagia. Cedars-Sinai website. Available at: https://www.cedars-sinai.org/health-library/diseases-and-conditions/d/dyphagia.html.
- Dysphagia. EBSCO DynaMed website. Available at: https://www.dynamed.com/approach-to/esophageal-dysphagia.
- Dysphagia. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/gastrointestinal-disorders/esophageal-and-swallowing-disorders/dysphagia.
- Swallowing disorders in adults. American-Speech-Language-Hearing Association website. Available at: https://www.asha.org/public/speech/swallowing/Swallowing-Disorders-in-Adults.
Contributors
- Daniel A. Ostrovsky, MD
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