(Dysphagia, Esophageal; Difficulty Swallowing [Esophagus])
Rebecca J. Stahl, MA
Dysphagia refers to difficulties during the swallowing process. There are two main types:
- Oropharyngeal dysphagia
— swallowing problems happen in the mouth and pharynx (the part of the throat behind the mouth)
- Esophageal dysphagia—swallowing problems happen in the esophagus (tube that transports food from the throat to the stomach)
This article focuses on esophageal dysphagia.
Esophagus and Stomach
Copyright © Nucleus Medical Media, Inc.
A number of conditions can cause esophageal dysphagia, such as:
—affects the muscles at the bottom of the esophagus
—causes thickening and stiffening of tissues, joints, and organs; can lead to problems with the esophageal muscles
or esophageal ring—causes the esophagus to become more narrow
Many conditions and factors may increase your risk of esophageal dysphagia, like:
- Difficulty swallowing solids, liquids, or both
- A sensation of food being stuck in the esophagus
- Pain when swallowing
- Heartburn, regurgitation
- Coughing or choking when eating or drinking
- Wheezing, hoarse voice
Weight loss, malnutrition, and
(due to problems with eating and drinking)
The doctor will:
Ask about your symptoms, such as:
- Where do you feel the pain when you swallow?
- What foods or liquids lead to symptoms?
- Do the symptoms happen every time you eat or drink? Is the problem getting worse?
- Do you have heartburn?
- Take your medical history.
- Do a physical exam.
Tests may include:
- Swallow test (to observe what happens when you swallow)
- Videofluorographic swallowing study (VFSS)—an imaging test that involves swallowing food mixed with barium solution (This allows the doctor to watch the swallowing process on a monitor.)
- Barium swallow
—an imaging test that involves swallowing a barium solution and having x-rays taken of the esophagus
—a thin, lighted tube is inserted down the throat to examine the esophagus
- Esophageal manometry—a test to measure the functioning of the esophageal muscles
Treatment may include:
Procedures, such as:
- Esophageal dilation
—This involves placing a tube-shaped device into the esophagus to widen the narrow part.
- Botox injection
into the esophageal muscle to make swallowing easier
- Surgery (eg, to remove an esophageal tumor)
- Dietary changes—You may need to avoid eating foods that cause problems, like meat. Or you may need to eat only pureed food. In severe cases, a feeding tube may be needed to provide nutrition.
- Therapy to improve swallowing—such as learning ways to prevent choking while eating.
- Medicine (eg, to treat GERD or to relax the esophagus)
You can reduce your risk by getting early treatment for any related condition, like GERD.
American Speech-Language-Hearing Association
Dysphagia Research Society
Heart and Stroke Foundation of Canada
Ontario Association of Speech-Language Pathologists and Audiologist
Communication facts: special populations: dysphagia—2008 edition. American-Speech-Language-Hearing Association website. Available at:
. Published 2008. Accessed September 26, 2011.
Difficulty swallowing. Mayo Clinic website. Available at:
. Updated October 10, 2009. Accessed September 26, 2011.
Dysphagia. EBSCO DynaMed website. Available at:
. Updated September 8, 2011. Accessed September 26, 2011.
Dysphagia. World Gastroenterology Organisation website. Available at:
. Published 2007. Accessed September 26, 2011.
Esophageal dysphagia. Rehab PBWorks website. Available at:
. Accessed September 26, 2011.
Font J, Underbrink M. Esophageal dysphagia. University of Texas Medical Branch website. Available at:
. Published February 6, 2008. Accessed September 26, 2011.
Palmer J, Drennan J, Baba M. Evaluation and treatment of swallowing impairments. American Family Physician website. Available at:
. Published April 15, 2000. Accessed September 26, 2011.
Last reviewed October 2011 by Daus Mahnke, MD
Last updated 11/3/2011