Dysphagia is the medical term for difficulty swallowing. It’s common to occasionally have minimal trouble swallowing, but persistent difficulty swallowing may indicate a serious medical condition that requires an experienced ear, nose and throat doctor’s assistance.

Symptoms

Symptoms of swallowing disorders may include:

  • Drooling
  • A foreign body sensation in the throat
  • Discomfort in the throat or chest, especially when gastroesophageal reflux (GERD) is present
  • Unexpected weight loss
  • Inadequate nutrition due to prolonged or more significant problems with swallowing
  • Coughing or choking during eating or drinking
  • Frequent throat clearing

 

Causes
Difficulty swallowing can occur at any age, but is more common in older adults. The causes can be as simple as ill-fitting dentures or the common cold. One of the more common causes is gastroesophageal reflux disease (GERD), which allows stomach acid to move back up the esophagus to the pharynx. Other causes of swallowing difficulties vary, but can include:

  • Tonsil infection
  • Stroke
  • Neurologic disorders such as myasthenia gravis and Parkinson’s disease
  • Functional disorders of the throat
  • Vocal cord paralysis or weakness
  • Thyroid disease
  • Tumor in the mouth, throat or esophagus
  • Problems that affect the opening of the upper esophageal sphincter

Treatment
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The causes of swallowing difficulties vary, and treatment depends upon the cause. Many common conditions such as viral respiratory infections or gastroesophageal reflux are recognized and treated effectively by primary care physicians.  Further evaluation by a specialist involves procedures for diagnosing the cause of the dysphagia including flexible fiberoptic laryngoscopy, CT scans, and video fluoroscopy.

Flexible fiberoptic laryngoscopy is an office procedure in which a small fiberoptic endoscope is passed into the nose or the mouth to visualize the larynx and lower throat areas. In a video fluoroscopic swallowing study, or VFSS, the study is conducted by a speech pathologist and a camera is used to record and document the swallowing difficulties and the anatomy involved.

Once the cause is determined, swallowing disorders may be treated with:

  • Medication such as H2 blockers and proton pump inhibitors  used to slow stomach acid production, agents to improve esophageal motility, and antacids
  • Swallowing therapy provided in conjunction with a speech pathologist
  • Surgery directed against specific problems such as an esophageal tumor or pharyngeal diverticula. A procedure called a myotomy may be performed if the upper esophageal sphincter is too tight and needs to be released.

Neurologic disorders require referral to the appropriate medical specialists.