Dysphagia is difficulty eating because of disruption in the swallowing process. If dysphagia is severe, you may not be able to take in enough fluids and calories to stay healthy. In severe cases, even saliva is difficult to swallow. Complications may include aspiration pneumonia, malnutrition, dehydration, weight loss, and airway blockage.

Causes

Some causes of dysphagia include:

• Muscle disorders (dermatomyositis, myotonic dystrophy)

• Nervous system problems

• Obstructive lesions in the throat or esophagus

• Central nervous system infections

• Vitamin B12 deficiency

• Stroke

• Head injury

• Cerebral palsy

• Parkinson's disease

• Huntington's disease

• Myasthenia gravis

• Amyotrophic lateral sclerosis

• Multiple sclerosis

• Scleroderma

• Infection with herpes simplex virus or yeast

• Narrowing of the esophagus after infection or irritation

• Birth defects (such as cleft palate)

• Head and neck cancers

• Scarring after radiation treatment for cancer

• Gastroesophageal reflux disorder

• Diabetes

• Alcoholism

• Alzheimer's disease

• Postpolio syndrome

• Thyroid disorders

• Medications, including:

• • Antibiotics

• • Theophylline

• • Potassium tablets

• • Iron supplements

• • Blood pressure medications

• • Antipsychotics

• • Narcotic pain relievers

• • Steroids

• • Lipid-lowering medications

• • Colchicine

• • Vitamins

• • Nonsteroidal anti-inflammatory medications (NSAIDs)

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

Risk factors include:

• Diabetes

• History of polio

• Previous treatment for head and neck cancer

• Progressive neurological disorder or muscle disorder

• Head trauma

Symptoms

Symptoms include:

• Trouble swallowing

• Constant feeling of a lump in the throat

• Pain with swallowing

• Drooling

• Coughing or choking with eating or drinking

• Recurrent pneumonia

• Nasal sounding voice

• Sensation of food sticking in the chest

• Weight loss

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. The exam will focus on the nervous system. The doctor will also watch you chewing and swallowing.

Tests may include:

• Nasopharyngoscopy – using a scope to view the throat

• Blood tests to check for infection

• Blood tests to check thyroid function

• Esophagram with barium swallow – x-ray test of the esophagus

• Endoscopy – a thin, lighted tube inserted down the throat to examine the esophagus

• Videoradiographic studies – x-rays during which swallowing is filmed on video

• Ultrasound – a test that uses sound waves to examine structures inside the body

• Manometry – tests the amount of pressure generated in various parts of the esophagus

• pH studies – tests the degree of acidity in the esophagus

• Chest x-ray – to check for pneumonia

Treatment

Treatment may include:

Prevention

Most causes of dysphagia cannot be prevented. If you have a medical condition, get treatment so that you don't suffer complications, such as dysphagia.

RESOURCES:

American Academy of Otolaryngology–Head and Neck Surgery
http://www.entnet.org

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

References:

Dawodu ST. Swallowing disorders. Emedicine website. Available at: www.emedicine.com/pmr/topic152.htm. Accessed 2005.

Spieker MR. Evaluating dysphagia. Am Fam Physician. 2000;61(12). Available at: http://www.aafp.org/afp/20000615/3639.html.

National Institute on Deafness and Other Communication Disorders website. Available at: http://www.nidcd.nih.gov/.

Paik NJ. Dysphagia. Emedicine website. Available at: www.emedicine.com/pmr/topic194.htm. Accessed 2005.

Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 6th ed. W.B. Saunders Company; 1998.