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Esophageal Dysphagia

(Difficulty Swallowing [Esophagus])

Definition

Dysphagia is a problem that happens when you swallow. It’s hard to get food down the tube that goes from the mouth to the stomach.

Esophagus and Stomach
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Causes

Esophageal dysphagia is caused by damage or disease of the throat. :

  • Achalasia—food or drink doesn’t move toward the stomach as it should
  • Damage to nervous system that affects how muscles in the throat work
  • Narrowing of the throat— esophageal stricture
  • Esophageal cancer
  • Inflammation—esophagitis

Risk Factors

Factors that increase the risk of esophageal dysphagia include:

Symptoms

Common symptoms include:

  • Having a hard time when you swallow
  • A feeling of food being stuck
  • Pain when you swallow
  • Regurgitation
  • Drooling, coughing, choking
  • Wheezing
  • Hoarse voice
  • Problems getting enough fluids or nutrition

Diagnosis

You will be asked about your symptoms and past health. A physical exam will be done. The doctor will run tests to find out what is causing swallowing problems. Tests may include:

  • A test to look for problems while you swallow
  • An upper GI endoscopy—a scope is used to view throat from back of mouth to the stomach
  • A barium swallow—x-ray that uses a special dye to highlight throat
  • Tests on the muscles of the esophagus

Treatment

Treatment depends on the cause. You may need:

  • Esophageal dilation —making the esophagus wider where it narrows
  • Surgery—to treat GERD or take out something that is blocking the path
  • Dietary changes such as:
    • Not eating foods that cause problems
    • Eating softer or pureed foods
    • Using a feeding tube if needed
  • Speech therapy—this will teach you to swallow without choking
  • Medicines—to treat specific causes, relax muscles, or reduce acid

Prevention

There are not steps to prevent esophageal dysphagia.

RESOURCES:

American Speech-Language-Hearing Association
https://www.asha.org

Dysphagia Research Society
https://dysphagiaresearch.site-ym.com

CANADIAN RESOURCES:

Heart and Stroke Foundation of Canada
https://www.heartandstroke.ca

Ontario Association of Speech-Language Pathologists and Audiologist
https://www.osla.on.ca

REFERENCES:

Dysphagia. Cedars-Sinai website. Available at: https://www.cedars-sinai.org/health-library/diseases-and-conditions/d/dyphagia.html. Accessed August 14, 2018.

Dysphagia. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T906517/Dysphagia. Updated March 21, 2017. August 14, 2018.

Dysphagia. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/gastrointestinal-disorders/esophageal-and-swallowing-disorders/dysphagia. Updated April 2018. Accessed August 14, 2018.

Swallowing disorders in adults. American-Speech-Language-Hearing Association website. Available at: https://www.asha.org/public/speech/swallowing/Swallowing-Disorders-in-Adults. Accessed August 14, 2018.

Last reviewed February 2019 by Daniel A. Ostrovsky, MD  Last Updated: 2/12/2019