Difficulty swallowing (dysphagia) means it takes more time and effort to move food or liquid from your mouth to your stomach. Dysphagia may also be associated with pain. In some cases, swallowing may be impossible.
Signs and symptoms associated with dysphagia may include:
• Having pain while swallowing (odynophagia)
• Being unable to swallow
• Having the sensation of food getting stuck in your throat or chest or behind your breastbone (sternum)
• Being hoarse
• Bringing food back up (regurgitation)
• Having frequent heartburn
• Having food or stomach acid back up into your throat
• Unexpectedly losing weight
• Coughing or gagging when swallowing
• Having to cut food into smaller pieces or avoiding certain foods because of trouble swallowing
Tests may include:
• X-ray with a contrast material (barium X-ray).You drink a barium solution that coats your esophagus, allowing it to show up better on X-rays. Your doctor can then see changes in the shape of your esophagus and can assess the muscular activity.
• Dynamic swallowing study
• A visual examination of your esophagus (endoscopy). A thin, flexible lighted instrument (endoscope) is passed down your throat so your doctor can see your esophagus.
• Fiber-optic endoscopic swallowing evaluation (FEES).Your may examine your throat with special camera (endoscope) and lighted tube as you try to swallow.
• Esophageal muscle test (manometry). In manometry (muh-NOM-uh-tree), a small tube is inserted into your esophagus and connected to a pressure recorder to measure the muscle contractions of your esophagus as you swallow.
• Imaging scans. These may include
a) CT scan
b) MRI scan
c) Positron emission tomography (PET) scan,.
Treatment for dysphagia depends on the type or cause of your swallowing disorder.
a) Oropharyngeal dysphagia
For oropharyngeal dysphagia, doctor may refer you to a speech or swallowing therapist, and therapy may include:
• Exercises. Certain exercises may help coordinate your swallowing muscles or restimulate the nerves that trigger the swallowing reflex.
• Learning swallowing techniques.
b) Esophageal dysphagia
Treatment approaches for esophageal dysphagia may include:
• Esophageal dilation. For a tight esophageal sphincter (achalasia) or an esophageal stricture, doctor may use an endoscope with a special balloon attached to gently stretch and expand the width of your esophagus or pass a flexible tube or tubes to stretch the esophagus (dilatation).
• Surgery. For an esophageal tumor, achalasia or pharyngeal diverticula, you may need surgery to clear your esophageal path.
• Medications. Difficulty swallowing associated with GERD can be treated with prescription oral medications to reduce stomach acid. You may need to take these medications for an extended period. If you have eosinophilic esophagitis, you may need corticosteroids.
If you have esophageal spasm but your esophagus appears normal and without GERD, you may be treated with medications to relax your esophagus and reduce discomfort.
c) Severe dysphagia
If difficulty swallowing prevents you from eating and drinking adequately, doctor may recommend:
• Special liquid diets. This may help you maintain a healthy weight and avoid dehydration.
• Feeding tube. In severe cases of dysphagia, you may need a feeding tube to bypass the part of your swallowing mechanism that isn't working normally.