Causes
The likely cause of the dysphagia is either abnormal motility of this segment of the esophagus or physical impairment to passage (obstruction). The mechanisms mediating normal esophageal peristalsis are not fully understood, but require smoothly coordinatedmuscular contraction in one segment with muscular relaxation in adjacent segments.
Symptoms
There are two types of dysphagia 'high' dysphagia and 'low'dysphagia. The first one is also known as oropharingeal dysphagia while the second one is also called esophageal dysphagia. Most of the neurological problems which lead to 'high' dysphagia are cured by medications or surgical procedures but not to a full extend.
Prevention
Dysphagia has many possible causes and happens most frequently in older adults. Any condition that weakens or damages the muscles and nerves used for swallowing may cause dysphagia. For example, people with diseases of the nervous system, such as cerebral palsy or Parkinson’s disease, often have problems swallowing.
Complications
Symptoms of dysphagia include pain while swallowing, inability to swallow, regurgitation, feeling like food is stuck in the throat, coughing and gagging. A number of factors can cause Dysphagia. Some include neurological conditions, physiological changes in a person’s ability to swallow, dementia, dry mouth, GERD, narrowed esophagus, cancer and radiation therapy. Treatment for dysphagia depends on the cause of the swallowing disorder. Treatment is not one size fits all.
What is the likely cause of the dysphagia?
Is there a cure for dysphagia?
What causes swallowing problems in adults?
What is dysphagia and how to treat its symptoms?
What is the most common cause of dysphagia?
Acid reflux disease is the most common cause of dysphagia. People with acid reflux may have problems in the esophagus, such as an ulcer, a stricture (narrowing of the esophagus), or less likely a cancer causing difficulty swallowing.
How does dysphagia start?
Swallowing is complex, involving many muscles and nerves. Any condition that weakens or damages the muscles and nerves used for swallowing or leads to a narrowing of the back of the throat or esophagus can cause dysphagia.
When should I worry about dysphagia?
You should see your doctor to determine the cause of your swallowing difficulties. Call a doctor right away if you're also having trouble breathing or think something might be stuck in your throat. If you have sudden muscle weakness or paralysis and can't swallow at all, call 911 or go to the emergency room.
What are three disorders that cause dysphagia?
Some neurological causes of dysphagia include:a stroke.neurological conditions that cause damage to the brain and nervous system over time, including Parkinson's disease, multiple sclerosis, dementia, and motor neurone disease.brain tumours.myasthenia gravis – a rare condition that causes your muscles to become weak.
What are the 4 stages of dysphagia?
There are 4 phases of swallowing:The Pre-oral Phase. – Starts with the anticipation of food being introduced into the mouth – Salivation is triggered by the sight and smell of food (as well as hunger)The Oral Phase. ... The Pharyngeal Phase. ... The Oesophageal Phase.
What is the life expectancy of someone with dysphagia?
As shown in Table 1, the mortality rate for these patients is high: 2% to 27% are dead within 30 days, and approximately 50% or more within 1 year. Although informative, these studies cannot provide survival estimates for those who might not choose PEG feedings.
What is the best medicine for dysphagia?
Diltiazem: Can aid in esophageal contractions and motility, especially in the disorder known as the nutcracker esophagus. Cystine-depleting therapy with cysteamine: Treatment of choice for patients with dysphagia due to pretransplantation or posttransplantation cystinosis.
What foods should you avoid with dysphagia?
Foods with a fibrous or 'stringy' texture - e.g. celery, green beans, melted cheese or pineapple. Fruit or vegetables with thick skins, seeds or pips - e.g. baked beans, peas, grapes and tomatoes. Crunchy and crumbly items such as toasts, biscuits, crackers, crisps, pie crusts.
How do you fix dysphagia?
Try eating smaller, more frequent meals. Cut your food into smaller pieces, chew food thoroughly and eat more slowly. If you have difficulty swallowing liquids, there are products you can buy to thicken liquids. Trying foods with different textures to see if some cause you more trouble.
What are the signs that a person may have dysphagia?
coughing or choking when eating or drinking. bringing food back up, sometimes through the nose. a sensation that food is stuck in your throat or chest. persistent drooling of saliva.
What neurological conditions are related to dysphagia?
Some neurological causes of dysphagia include:a stroke.neurological conditions that cause damage to the brain and nervous system over time, including Parkinson's disease, multiple sclerosis, dementia, and motor neurone disease.brain tumours.myasthenia gravis – a rare condition that causes your muscles to become weak.
Can dysphagia be caused by anxiety?
Some cases of dysphagia are due to structural abnormalities or disease, and some are considered functional, where there is no apparent physical cause. Psychiatric reasons for dysphagia include anxiety disorders, phobias, somatic symptom disorder, and more.
What are the 3 phases of dysphagia?
Swallowing is a complex act that involves coordinated movement of muscles that make up three primary phases of swallowing: oral phase (mouth), pharyngeal phase (throat) and esophageal phase (food tube). When there is a problem in one or more of these phases, it is called dysphagia.
How fast does dysphagia progress?
Benign strictures typically progress slowly (over a period of months to years) and are associated with minimal weight loss. Malignant esophageal strictures usually cause rapidly progressing dysphagia (over a period of weeks to months) with substantial weight loss.
Can dysphagia go away?
About 1 in 25 people will experience dysphagia in their lives. Difficulty swallowing doesn't always indicate a medical condition. It may be temporary and go away on its own.
Can dysphagia be caused by anxiety?
Some cases of dysphagia are due to structural abnormalities or disease, and some are considered functional, where there is no apparent physical cause. Psychiatric reasons for dysphagia include anxiety disorders, phobias, somatic symptom disorder, and more.
What causes dysphagia?
Dysphagia has many possible causes and happens most frequently in older adults. Any condition that weakens or damages the muscles and nerves used for swallowing may cause dysphagia. For example, people with diseases of the nervous system, such as cerebral palsy or Parkinson’s disease, often have problems swallowing. Additionally, stroke or head injury may weaken or affect the coordination of the swallowing muscles or limit sensation in the mouth and throat.
How does dysphagia occur?
Dysphagia occurs when there is a problem with the neural control or the structures involved in any part of the swallowing process. Weak tongue or cheek muscles may make it hard to move food around in the mouth for chewing. A stroke or other nervous system disorder may make it difficult to start the swallowing response, a stimulus that allows food and liquids to move safely through the throat. Another difficulty can occur when weak throat muscles, such as after cancer surgery, cannot move all of the food toward the stomach. Dysphagia may also result from disorders of the esophagus.
What is dysphagia?
People with dysphagia have difficulty swallowing and may even experience pain while swallowing (odynophagia). Some people may be completely unable to swallow or may have trouble safely swallowing liquids, foods, or saliva. When that happens, eating becomes a challenge. Often, dysphagia makes it difficult to take in enough calories and fluids to nourish the body and can lead to additional serious medical problems.
What are some problems caused by dysphagia?
Dysphagia can be serious. Someone who cannot swallow safely may not be able to eat enough of the right foods to stay healthy or maintain an ideal weight.
What research is being done on dysphagia?
Every aspect of the swallowing process is being studied in people of all ages, including those who do not have dysphagia, to give researchers a better understanding of how normal and disordered processes compare.
Where can I find additional information about dysphagia?
The NIDCD maintains a directory of organizations that provide information on the normal and disordered processes of hearing, balance, taste, smell, voice, speech, and language.
How do we swallow?
This happens in three stages. During the first stage, called the oral phase, the tongue collects the food or liquid, making it ready for swallowing. The tongue and jaw move solid food around in the mouth so it can be chewed. Chewing makes solid food the right size and texture to swallow by mixing the food with saliva. Saliva softens and moistens the food to make swallowing easier. Normally, the only solid we swallow without chewing is in the form of a pill or caplet. Everything else that we swallow is in the form of a liquid, a puree, or a chewed solid.
Why is dysphagia so common in elderly people?
The muscles used for swallowing can become weaker with age. This may explain why dysphagia is relatively common in elderly people.
What causes dysphagia in the brain?
Some neurological causes of dysphagia include: a stroke. neurological conditions that cause damage to the brain and nervous system over time, including Parkinson's disease , ...
Why does eosinophilic oesophagitis cause swallowing problems?
eosinophilic oesophagitis – a type of white blood cell (eosinophil) builds up in the lining of the oesophagus due to a reaction to foods, allergens or acid reflux; the build-up damages the lining of the oesophagus and causes swallowing difficulties.
Why is swallowing difficult?
Obstruction. Conditions that cause an obstruction in the throat or a narrowing of the oesophagus (the tube that carries food from your mouth to the stomach) can make swallowing difficult. Some causes of obstruction and narrowing include: mouth cancer or throat cancer, such as laryngeal cancer or oesophageal cancer – once these cancers are treated, ...
What causes scar tissue in the throat?
radiotherapy treatment – can cause scar tissue, which narrows the passageway in your throat and oesophagus. gastro-oesophageal reflux disease (GORD) – stomach acid can cause scar tissue to develop, narrowing your oesophagus.
What is the term for a disorder that affects the movement of the upper lip?
cerebral palsy – a group of neurological conditions that affect movement and co-ordination. a cleft lip and palate – a common birth defect that results in a gap or split in the upper lip or roof of the mouth.
What can interfere with swallowing?
Damage to the nervous system (in the brain and spinal cord) can interfere with the nerves responsible for starting and controlling swallowing.
What are the consequences of dysphagia?
Consequences of dysphagia include malnutrition and dehydration, aspiration pneumonia, compromised general health, chronic lung disease, choking, and even death. Adults with dysphagia may also experience disinterest, reduced enjoyment, embarrassment, and/or isolation related to eating or drinking.
What causes dysphagia in the neck?
Dysphagia may also occur from problems affecting the head and neck, including. cancer in the oral cavity, pharynx, nasopharynx, or esophagus; radiation and/or chemoradiation for head and neck cancer treatment; trauma or surgery involving the head and neck; decayed or missing teeth; and.
What is the American Board of Swallowing and Swallowing Disorders?
The American Board of Swallowing and Swallowing Disorders, under the auspices of ASHA’s specialty certification program, offers clinical specialty certification in swallowing and swallowing disorders . Specialty certification is a voluntary program and is not required by ASHA to practice in any disorder area.
Why are epidemiological numbers by condition or disease poorly defined?
This, in part, is due to the concomitant medical conditions being reported and the timing and type of diagnostic procedures being used to identify swallowing disorders across neurological populations.
What does silent aspiration mean?
Silent aspiration may be present, meaning the patient presents without overt signs or symptoms of dysphagia.
What is the term for food or liquid remaining in the oral cavity after swallowing?
food or liquid remaining in the oral cavity after the swallow (oral residue ); inability to maintain lip closure, leading to food and/or liquids leaking from the oral cavity (anterior loss of bolus); extra time needed to chew or swallow; food and/or liquids leaking from the nasal cavity (nasopharyngeal regurgitation);
Does dysphagia occur in stroke patients?
A later study by Falsetti et al. (2009) found that dysphagia occurs in over one third of patients admitted to stroke rehabilitation units.
What is esophageal dysphagia?
Esophageal dysphagia: This is a problem of the esophagus. This can be caused when something blocks or compresses the esophagus, there’s a muscular disorder or there are pouches in the esophagus .
What causes swallowing difficulties?
Parkinson’s disease, multiple sclerosis, amyotrophic lateral sclerosis ( ALS) and stroke can lead to swallowing difficulties. Muscle disorders: Myasthenia gravis (an autoimmune condition) and muscular dystrophy affect muscles all over the body.
Why is my esophagus narrowing?
Esophagus narrowing and blockages: Esophageal cancer, a tumor or a swollen thyroid gland can constrict the esophagus ( make it narrower). A narrowed esophagus can make swallowing a challenge. Some people develop webs or Schatzki rings (pieces of tissue inside the esophagus). This tissue narrows the tube and makes it hard to swallow chunks of food. Disorders of the opening of the esophagus can also contribute to difficulty swallowing such as cricopharyngeal hypertrophy. Swallowing can be difficult or impossible if anything is stuck in your throat.
What is swallowing disorder?
Dysphagia is simply defined as a swallowing disorder. It can occur in any of the three phases of swallowing: Oral. Pharyngeal. Esophageal. Dysphagia is often noted in stroke survivors and can affect the oral and/or pharyngeal phase of swallowing. The patient may cough or choke while attempting to swallow saliva, liquids, or food.
Why does my esophagus have scars?
Scarring from acid reflux: Scar tissue can form in your esophagus as a result of GERD (acid reflux disease). GERD can lead to Barrett’s esophagus (irritation in the esophagus lining).
What causes tongue weakness after stroke?
Oral cavity dysphagia: The problem is in the mouth. Typical causes include tongue weakness after stroke, difficulty chewing food or neuromuscular problems. Oropharyngeal dysphagia: The problem is in the throat. This can be a result of a neurological or muscular problem. Esophageal dysphagia: This is a problem of the esophagus.
Why does my tongue feel weak after a stroke?
Typical causes include tongue weakness after stroke, difficulty chewing food or neuromuscular problems. Oropharyngeal dysphagia: The problem is in the throat. This can be a result of a neurological or muscular problem. Esophageal dysphagia: This is a problem of the esophagus. This can be caused when something blocks or compresses the esophagus, ...
What is the cause of dysphagia?
Trusted Source. . Dysphagia can be caused by a difficulty anywhere in the swallowing process. There are three general types of dysphagia: Oral dysphagia (high dysphagia) — the problem is in the mouth, sometimes caused by tongue weakness after a stroke, difficulty chewing food, or problems transporting food from the mouth.
Why are older people at risk for dysphagia?
Aging — older adults are more at risk. This is due to general wear and tear on the body over time. Also, certain diseases of old age can cause dysphagia, such as Parkinson’s disease.
What causes a brain to die from lack of oxygen?
Diffuse spasm — the muscles in the esophagus contract in an uncoordinated way. Stroke — brain cells die due to lack of oxygen because blood flow is reduced. If the brain cells that control swallowing are affected, it can cause dysphagia.
How to tell if you have dysphagia?
Symptoms linked to dysphagia include: 1 Choking when eating. 2 Coughing or gagging when swallowing. 3 Drooling. 4 Food or stomach acid backing up into the throat. 5 Recurrent heartburn. 6 Hoarseness. 7 Sensation of food getting stuck in the throat or chest, or behind the breastbone. 8 Unexplained weight loss. 9 Bringing food back up (regurgitation). 10 Difficulty controlling food in the mouth. 11 Difficulty starting the swallowing process. 12 Recurrent pneumonia. 13 Inability to control saliva in the mouth.
Why is it so hard to swallow food?
Dysphagia refers to a difficulty in swallowing – it takes more effort than normal to move food from the mouth to the stomach. Usually caused by nerve or muscle problems, dysphagia can be painful and is more common in older people and babies. Although the medical term “dysphagia” is often regarded as a symptom or sign, ...
Why do we need a barium swallow test?
A barium swallow test can be useful for understanding the reason behind a case of dysphagia.
Why does my throat hurt?
Issues in the throat are often caused by a neurological problem that affects the nerves (such as Parkinson’s disease, stroke, or amyotrophic lateral sclerosis ). Esophageal dysphagia (low dysphagia) — the problem is in the esophagus. This is usually because of a blockage or irritation. Often, a surgical procedure is required.
What causes stomach pain when swallowing?
In other words, there are lots of things that can go wrong and lead to problems swallowing. Some conditions include: Acid reflux and GERD: Acid reflux symptoms are caused when stomach contents flow up from the stomach back into the esophagus, causing symptoms like heartburn, stomach pain, and burping.
What is the inflammation of the esophagus that can be caused by acid reflux?
Esophagitis: Esophagitis is inflammation of the esophagus that can be caused by acid reflux or certain medications. Learn more about the types of esophagitis and their treatments.
What is it called when you feel something stuck in your throat?
Esophageal dysphagia is the feeling that something is stuck in your throat. This condition is caused by: spasms in the lower esophagus, such as diffuse spasms or the inability of the esophageal sphincter to relax. tightness in the lower esophagus due to an intermittent narrowing of the esophageal ring.
Why is it so hard to swallow without choking?
Oropharyngeal dysphagia is caused by disorders of the nerves and muscles in the throat. These disorders weaken the muscles, making it difficult for a person to swallow without choking or gagging. The causes of oropharyngeal dysphagia are conditions that primarily affect the nervous system such as: multiple sclerosis.
What is the name of the condition where you can't swallow?
People who have a hard time swallowing may choke on their food or liquid when trying to swallow. Dysphagia is a another medical name for difficulty swallowing. This symptom isn’t always indicative of a medical condition.
What are the phases of swallowing?
Types of dysphagia. Swallowing occurs in four phases: oral preparatory, oral, pharyngeal, and esophageal. Swallowing difficulty can be broken down into two categories: oropharyngeal (which includes the first three phases) and esophageal.
Can swallowing cause dehydration?
However, if swallowing problems are persistent, they can result in malnutrition and dehydration, especially in the very young and in older adults. Recurrent respiratory infections and aspiration pneumonia are also likely. All of these complications are serious and life-threatening and must be treated definitively.
What causes dysphagia in different age groups?
Causes of Dysphagia Among Different Age Groups. Dysphagia is a common problem that has the potential to result in severe complications such as malnutrition and aspiration pneumonia. Based on the complexity of swallowing, there may be many different causes.
Why is dysphagia so variable?
The enormous variability in dysphagia reporting in patients who have had strokes (25%–81%) is caused by differences in assessment as well as stroke location. Other neurologic diseases commonly associated with dysphagia include :
What age group is most affected by dysphagia?
Dysphagia in middle age is associated with gastroesophageal and immunologic causes. The age group older than 60 years is more affected by oncologic and neurologic causes of dysphagia. Older age groups have more prominent dysphagia related to stroke, neurodegenerative disease, and dementia.
Why were the authors of the Neuroanatomical Model of Dysphagia limited to the infratent?
They intended to develop a neuroanatomical model of dysphagia for the brain but were limited to the infratentorial region because of limitations in the quality of the literature.
How many articles have been written on gastroesophageal causes of dysphagia?
Sixteen articles were written on gastroesophageal causes of dysphagia, analyzing 547,156 patients. Although most articles focused on a patient population with 1 specific disease, 2 studies were broader in scope, attempting to diagnose a myriad of patients presenting with the common complaint of dysphagia. When analyzing a national endoscopy database for all patients whose indication for endoscopy was dysphagia, 40.8% of patients had a stricture, 22.1% showed evidence of esophagitis, 13.3% had Schatzki ring, 2.2% had acute food impaction, and 0.9% had malignancy. Tsuboi and colleagues reviewed 24 years of data for all patients undergoing esophageal manometry and 12.1% of patients had nonspecific motility disorder, 6.9% had nutcracker esophagus, 4.6% had diffuse esophageal spasm, and 3.1% had achalasia, whereas most (73.4%) had normal motility.
What is the upper esophageal sphincter?
Upper Esophageal Sphincter. Abbreviations: Causes of Dysphagia. In addition to the elderly population, a growing awareness of dysphagia in other age groups is appreciated, and associated with a different spectrum of diseases, such as gastroesophageal or laryngopharyngeal reflux.
How many articles have been published on immunologic causes of dysphagia?
Thirty-one articles were published on immunologic causes of dysphagia, representing 338,071 patients. Most of these articles (21 of 31) are about EE. Other disease processes that were analyzed include lymphocytic esophagitis (2 articles), inflammatory myopathies (5 articles), systemic sclerosis (2 articles), and Sjögren syndrome (1 article).
How Are Swallowing Problems Treated?
Treatment depends on the type of swallowing problem you have. Sometimes, a swallowing problem will resolve itself without treatment. On other occasions, swallowing problems can be managed easily. Complex swallowing problems may require treatment by a specialist or several specialists.
How Do I Know If I Have a Swallowing Problem?
Occasionally, food will stick in the esophagus for a few seconds (especially solid foods), but will pass spontaneously or can be washed down easily with liquids. But there are a number of symptoms that you should get checked for a possible swallowing problem, including:
How does swallowing work?
Swallowing seems simple, but it's actually pretty complicated. It takes your brain, several nerves and muscles, two muscular valves, and an open, unconstricted esophagus, or swallowing tube to work just right.
What happens during the second phase of swallowing?
The second phase begins when the brain makes the decision to swallow. At this point, a complex series of reflexes begin. The food is thrust from the oral cavity into the throat (pharynx). At the same time, two other things happen: A muscular valve at the bottom of the pharynx opens, allowing food to enter the esophagus, and other muscles close the airway ( trachea) to prevent food from entering the airways. This second phase takes less than half a second.
What test measures the timing and strength of esophageal contractions and muscular valve relaxation?
Manometry: This test measures the timing and strength of esophageal contractions and muscular valve relaxation.
How to increase saliva production?
Periodically suck on Popsicles, ice chips or lemon ice, or drink lemon-flavored water to increase saliva production, which will increase swallowing frequency. Food consistency. Minimize or eliminate foods that are tough to chew and eat more soft foods. Puree food in a blender.
What to do if food catches in throat?
If food or liquid catches in your throat, cough gently or clear your throat, and swallow again before taking a breath. Repeat if necessary.
