Swallowing Disorders

What are Swallowing Disorders?

Swallowing disorder, also known as dysphagia, is a difficulty in swallowing food or liquids. Swallowing is a set of coordinated muscle movements that control the mouth, the back of the throat (pharynx), and the food tube (oesophagus). Swallowing disorder may result from a lack of coordination of the nerves or muscles, or sometimes from infections and tumours. Swallowing problems can occur at any stage of the normal swallowing process as food and liquid move from the mouth, down the back of the throat, through the oesophagus, and into the stomach.

Causes of Swallowing Disorders

Swallowing problems can occur at any age and may be an indication of a serious medical issue. There are several causes for swallowing disorders ranging from muscle and nerve issues, head and neck injuries, ill-fitting dentures, missing teeth, previous mouth or neck surgery, cancer of the mouth, throat, or oesophagus, brain disorders, or even some medications.

 Signs and Symptoms of Swallowing Disorders

Swallowing disorders can cause a variety of symptoms. General signs and symptoms of swallowing disorders may include:

  • Choking on food
  • Food getting stuck in the throat
  • Coughing during or immediately post drinking or eating
  • Pain during swallowing
  • Inability to swallow liquid or food
  • Hoarseness or gurgly sounding
  • Heartburn
  • Dehydration
  • Aspiration (liquid or food leaking into airway)
  • A sensation of a “lump” in the throat
  • Wheezing
  • Shortness of breath
  • Sore throat
  • Chest discomfort or pain
  • Regurgitation

Diagnosis of Swallowing Disorders

Swallowing disorders can be effectively treated by a gastroenterologist or your family physician by determining the location and the extent of the problem based on a physical examination, symptoms, diagnostic tests, and x-rays. Some of the methods involved in diagnosing swallowing disorders include:

  • A barium swallow study, which is a special video x-ray study, that shows your physician the entire swallowing process and anatomy as food containing barium passes through the mouth, pharynx, and oesophagus.
  • A motility study to record pressure and movement of the oesophagus
  • Endoscopy to examine the interior of the oesophagus
  • 24-hour pH test to ascertain the amount of acid reflux that may be causing regurgitation
  • Endoscopic ultrasound to ascertain the extent and nature of the lesions or other tumours in the swallowing channel
  • X-rays of the head, neck, or thyroid to look for any abnormalities causing swallowing problem

Treatment for Swallowing Disorders

Various strategies are used to treat swallowing disorders ranging from physical techniques to improve swallowing ability, medical intervention, and/or surgery in severe cases.

General strategies may include:

  • Eat smaller and frequent meals
  • Lubricate food by blending with a sauce
  • Chew well and swallow food completely prior to taking another bite
  • Keep away from eating when stressed or tired
  • Adjust your head stance and posture while swallowing
  • Refrain from food that may get stuck in the throat, such as bread
  • Consume thickened liquids that are easy to swallow

Sometimes non-invasive medical interventions may be necessary such as oesophageal dilation, where a narrowed area of your oesophagus is stretched to aid in comfortable swallowing. Also, medications can be effective in treating some patients with a swallowing disorder by reducing stomach acid, decreasing contractions of the oesophagus, and improving nerve functions that support swallowing.

Surgical treatment may depend upon the site of the swallowing disorder and involve loosening or strengthening of the upper or lower valves of the oesophagus or eliminating tumours or obstructions from the oesophagus.