Dysphagia is a medical condition which is characterized by difficulty with swallowing, wherein much more effort is needed than usual to accomplish the movement of food from mouth to stomach. It is most often caused by nerve or muscle problems, and dysphagia can be uncomfortable at times, or sometimes even painful.
It generally afflicts babies and older people more than any other grouping of people, although it can trouble persons of literally any age group at all. There are a number of causes of dysphagia, and when it only happens occasionally, there usually isn’t any serious problem underlying the swallowing difficulty.
However, when it happens that dysphagia occurs with greater regularity, that’s a situation which should be brought to the attention of the family doctor. Treatments recommended by your doctor will depend on what the underlying cause of the dysphagia is.
What Exactly is Dysphagia?
Whenever you take a swallow, there are several different muscles and nerves which participate in the process, and it is considerably more complex than you might think. Any disruption to the sequence of events which is necessary in the swallowing process can result in dysphagia.
Oral dysphagia is the type which is attributable to a problem situated in the mouth, and that can be triggered by tongue weakness following a stroke event, some kind of difficulty with chewing, or even problems with the transportation of food to the stomach. Pharyngeal dysphagia is characterized by some kind of disruption to the swallowing process which is centered in the throat. This kind of dysphagia is generally caused by some type of neurological problem affecting people’s nerves, and it is very common in conditions like stroke, Parkinson’s disease or amyotrophic lateral sclerosis.
Esophageal dysphagia is the type which is situated somewhere in the esophagus, and it is usually triggered by some kind of irritation or blockage in that area. It happens very frequently that a surgical solution is necessary to resolve esophageal dysphagia.
It should be borne in mind that pain in swallowing, which is known as odynophagia, is a very different problem than dysphagia, although it happens frequently enough that the same person will be afflicted by both at the same time.
Common Causes of Dysphagia
As can be seen below, there are a wide variety of causes for dysphagia, and in some cases, more than one of the conditions described are contributors to the problem:
- myasthenia gravis – voluntary control muscles become weak and tired because of a problem with how nerves produce muscle contraction
- multiple sclerosis – this condition is caused by the central nervous system coming under attack from the immune system
- amyotrophic lateral sclerosis – this is an incurable form of progressive neurodegeneration, in which over a period of time brain and spinal nerves lose function
- cleft lip and palate – these are abnormal facial developments which are caused by incomplete fusion of head bones
- eosinophilic esophagitis – this is characterized by elevated levels of white blood cells in the esophagus, which grow in at uncontrolled rate, and attack the gastrointestinal system
- diffuse spasm – esophagus muscles contract in an eccentric manner
- achalasia – the lower esophageal muscle cannot sufficiently relax to allow the passage of food to stomach
- esophageal ring – some portion of the esophagus narrows down, thus preventing the passage of solid foods
- Parkinson’s disease – a gradually progressive degenerative disorder which degrades a patient’s motor skills
- stroke – in this medical condition, brain cells die off because there is insufficient oxygen supply to the brain
- radiation – patients who have previously undergone radiation treatments in the area of the neck or head will sometimes develop difficulty swallowing.
Treatment for Dysphagia
The treatment for dysphagia will depend on whether it is characterized as high dysphagia or low dysphagia. In the case of high dysphagia, swallowing therapy may be recommended, and this will be carried out with the assistance of a language and speech therapist. The patient is helped to learn alternate ways of proper swallowing, and exercises are engaged in regularly toward that end.
At the same time, the patient is put on a diet which makes swallowing easier, while still providing all the necessary nutritional benefits. In cases where a patient is at risk of malnutrition, dehydration, or pneumonia, they may have to be fed through a nasal tube. In situations where this is the recommended process, the tube will be surgically implanted directly in the stomach, and will be passed through a tiny abdominal incision.
When low dysphagia is diagnosed, it would generally be necessary for some kind of surgical intervention. In cases where the esophagus is constricted for some reason and must be widened, a tiny balloon is slowly inserted and inflated until the passageway has become dilated, after which the balloon would again be extracted.
In cases where the muscles of the esophagus have become stiff, Botox is sometimes recommended because it is a toxin which has the effect of paralyzing the stiff muscle, thereby minimizing any constriction which has taken place.
In the event of dysphagia being caused by cancer, a patient would always be referred to an oncologist, and a program of treatment would generally involve surgical remover removal of the cyst or tumor which has been identified.