Home | Health | Dear Doctor
May 22, 2019

Dysphagia: The Struggle to Swallow

Dysphagia: The Struggle to Swallow

Image Courtesy of Shutterstock

Dysphagia, the inability to swallow, is a little understood and potentially dangerous condition, but what are the causes and possible treatments?

The word Dysphagia describes difficulty in swallowing, normally a reflex action which we don’t think about. Sufferers soon discover that without this simple reflex, everyday life can become difficult.

Dysphagia is normally a symptom of another condition, such as stroke, head injury, multiple sclerosis, dementia, oral cancer, COPD (Chronic obstructive pulmonary disease) or gastro-oesophageal reflux disease (GORD) where stomach acid leaks back up into the oesophagus. But it can occur without any of these conditions being present. 

Children can also have dysphagia as a result of a developmental or learning disability, such as cerebral palsy.

Symptoms can include coughing or choking when eating or drinking, bringing up food, a sensation of having food stuck in the throat, persistent salivation or inability to chew food. 

Dysphagia can lead to malnutrition, tooth decay and pneumonia, but perhaps the most worrying aspect is the way it disrupts everyday social life, as sufferers find it impossible to eat naturally or to sleep confidently. 

If you experience the symptoms of dysphagia, a visit to your GP will aid diagnosis. A cure cannot be guaranteed, but dysphagia has a range of possible treatments depending on its cause. 

Hernia: Most Common Form of Dysphagia

The most common type of dysphagia, oesophageal dysphagia, may affect around 10 percent of the population and is caused by hiatal hernia, where the aperture in the diaphragm through which the oesophagus passes is widened. Common symptoms include acidic indigestion, reflux, heartburn, chronic cough, a feeling of ‘a lump in the throat’ or of a blockage in the chest, or difficulties in swallowing solid food.

Hiatal hernia is relatively benign, but if untreated may lead to more persistent symptoms. 

A relatively new approach to treatment of hiatal hernia is the use of a neuromuscular training device which strengthens the muscles used in the swallowing process. By retraining the body’s natural nerve pathways to activate the muscles in the face, mouth, pharynx, oesophagus and diaphragm, the symptoms of dysphagia can be controlled, and with time hopefully eliminated. 

Treatments for Alternative Types of Dysphagia

Treatment for other forms of dysphagia may be managed by specialists including a speech and language therapist (SLT), a dietitian and, possibly, a surgeon.

SLT can teach new swallowing techniques, while changing the diet to softer or liquified foods can make it safer to swallow. If necessary, feeding can be done through a tube into the nose or stomach, or surgery can be performed on the oesophagus to widen it, or to insert a metal stent. 

For anyone who struggles with symptoms of dysphagia without understanding the problem, a diagnosis can be the first step to improving quality of life and hopefully returning to a comfortable, natural relationship with food and drink. 

We take the swallowing reflex for granted, but it’s actually very complicated, requiring the smooth operation of up to 22 muscle pairs and seven cranial nerves. 

See Also:
Reflux, Heartburn And GERD. It’s Not In The Mind, It’s In The Muscle

Get A Healthier Digestive System

Reflux – Common But Curable