What is dysphagia?

Dysphagia is the medical term to describe difficulty in swallowing. This includes problems with:

• sucking
• swallowing
• drinking
• chewing
• eating
• dribbling saliva
• closing your lips,

Eating and drinking is a vital part of life. Difficulty swallowing can limit what you can eat and drink, leading to frustration, stress and health problems.

What are the symptoms of dysphagia?

Signs and symptoms associated with dysphagia include:

• gagging or choking when eating or drinking

• food or drink getting stuck in your throat or going down the “wrong way”
• eating a meal takes a long time (more than 30 minutes)
• the need to cough or clear your throat during or after eating and drinking
• being short of breath when eating and drinking
• avoiding some foods because they are hard to swallow
• regular chest infections for no obvious reason

What causes dysphagia?

Dysphagia can be caused by problems with the:

• nerves that control swallowing
• muscles and other structures in the mouth, throat and neck
• oesophagus (food pipe)

Sometimes there are multiple problems causing dysphagia.

Some of the conditions that can cause dysphagia include the following.

Reflux

Reflux occurs when stomach acid leaks from your stomach and moves up into your oesophagus.

Nervous system problems

Conditions that damage your brain and nerves can cause dysphagia. These include:

• stroke – almost 1 in 2 people who have had a stroke will have difficulty swallowing
• head injury
• Parkinson’s disease
• motor neurone disease (MND)
• dementia
• cerebral palsy

Muscle problems

Muscle problems in your face or neck, or spasms of the oesophagus, can cause problems with swallowing.

Achalasia is a condition that prevents food from entering the stomach properly. It is due to problems with the muscles in the oesophagus.

Structural problems

Swallowing problems can also develop due to damage to structures such as your lips or palate.

Sometimes growths, like cancers of the airway or oesophagus, can cause swallowing difficulties.

When should I see my doctor?

Dysphagia can be a sign of a serious medical condition. Because of this, if you think you or someone you care for has difficulty swallowing, talk to your doctor.

How is dysphagia diagnosed?

Your doctor will ask about your symptoms and examine you. They might also refer you for tests such as:

• a barium swallow test
• an endoscopy – to see inside your oesophagus and stomach
• muscle testing – to see if your oesophagus is working properly
• a CT scan
• an MRI scan

A barium swallow test is a series of x-rays that are taken as you swallow a liquid containing barium. This shows an outline of your throat and oesophagus and can point to the cause of your symptoms.

How is dysphagia treated?

If you have dysphagia, the most appropriate treatment will depend on the cause.

Treatment can sometimes include:

• changing the textures of foods or drinks
• learning new swallowing techniques
• doing exercises to help muscles work better and stimulate nerves that trigger the swallowing reflex
• taking medicine to reduce stomach acid reflux or relax your oesophagus

In severe cases, you might need to change to a liquid diet. Another option is to have food and drink given through a feeding tube that goes directly into your stomach.

A range of health professionals can help with dysphagia, including doctors, speech pathologists, occupational therapists, physiotherapists, dietitians, and lactation consultants.

Can dysphagia be prevented?

Dysphagia cannot be prevented. However, dysphagia treatments can help prevent complications.

Complications of dysphagia?

Dysphagia and can lead to dehydration and malnutrition if not managed properly,

Dysphagia can also lead to aspiration, which means that food or drink go into your airways rather than your stomach. Aspiration can lead to pneumonia.

If dysphagia is being caused by a more serious condition, this can cause further complications unless treated.