Swallowing Disorders

Swallowing disorders, collectively known as dysphagia, are characterized by painful or difficult swallowing. Some people can’t swallow at all, while others have trouble with foods, liquids, or saliva. People with swallowing disorders often have trouble getting enough calories and fluids, putting them at risk for malnourishment.

It’s easy to take the act of swallowing for granted. Most of the time, it’s an automatic process, and requires no thought. Occasionally we’ll experience the sensation of food getting stuck in the throat or chest, or something will “go down the wrong pipe” when eating. But these are isolated events that occur as the result of eating too quickly or not chewing our food thoroughly. Otherwise, when we swallow, the muscles in our throat and esophagus contract, allowing food and liquids to move from the mouth to the stomach, where they are digested. This process can be interrupted by a blockage in the throat or esophagus, or when the muscles and nerves don’t work correctly. Food becomes lodged in the throat or esophagus, resulting in painful swallowing and symptoms that include choking, gagging, hoarseness, drooling, regurgitation, chest pain, and acid reflux.

Causes & Treatment

Essentially, there are two types of swallowing disorders: esophageal dysphagia, the sensation of food getting stuck in the base of your throat or chest; and oropharyngeal dysphasia, difficulty moving food from your mouth to your throat and esophagus due to weakened nerves or throat muscles. Conditions associated with the former include achalasia, acid reflux (GERD), diffuse spasm, esophageal stricture, esophageal ring, eosinophilic esophagitis, foreign bodies, hiatal hernias, scleroderma, and tumors. The latter may be caused by cancer, neurological disorders or damage, and pharyngeal diverticula.

Your doctor can diagnose the cause of a swallowing disorder through a barium swallow study or fluoroscopy. X-rays, laryngoscopy, and other tests can help with the diagnosis. Treatment varies, depending on the cause, but could include medication, surgery, lifestyle changes, or swallowing exercises.