In simple terms, dysphagia refers to difficulty in swallowing. When you eat food, it seems simple. But the whole process is actually very complicated. Your muscular valves, several nerves, and an empty food pipe in coordination with the brain help you to swallow the food.
Food moves from the mouth to the esophagus in three phases.
- First, the food or liquid stays in the mouth with the help of the tongue and oral cavity. This is the only phase that you can control voluntarily.
- The second phase is the most important. The brain here starts making decisions to swallow. A set of reflexes occur simultaneously. The food moves from the oral cavity to the throat while the valve at the bottom of the throat opens so that the food can pass through. At the same time, muscles near the windpipe close it to prevent the food from entering it. Can you imagine all this happens under ten seconds?
- The last phase encompasses food entering the food pipe. The food moves through the pipe by continuous contraction and relaxation. When the food reaches the end of the esophagus, a valve at the end opens and the food moves into the stomach.
As the whole process can be divided into three parts, a problem can arise in any of the three phases. Hence, there are three types of dysphagia that can occur-
- Oral or high dysphagia– This is referred to as difficulty in transporting food from the mouth due to tongue weakness after a stroke or difficulty in chewing food.
- Pharyngeal dysphagia– This is referred to as any problem that occurs in the throat due to any neurological problems.
- Esophageal or low dysphagia – This is referred to as any problem that occurs in the esophagus or food pipe.
Also Read: Something Stuck in my Throat Remedy
Causes of dysphagia
Dysphagia can occur due to a number of causes. Some of them are discussed below-
- Amyotrophic lateral sclerosis– The nerves in the spine and brain degenerate over time. This is an incurable form of neurodegeneration.
- Achalasia– The muscles in the lower esophagus does not relax so that the food can enter the stomach.
- Diffuse spasm– The esophageal muscles do not contract or relax in a coordinated way.
- Stroke– Some of the cells that control the movement of the tongue or muscles can die due to a stroke.
- Esophageal ring– The esophagus narrows that doesn’t allow food to pass.
- Multiple sclerosis– The central nervous system is attacked by the immune system.
- Parkinson’s disease– In this neurological disease, the patient’s motor skills are hampered.
- Radiation– Exposure of the head and neck area to radiation therapy can lead to dysphagia.
- Scleroderma– A type of autoimmune disease where the skin and connective tissues become hard.
- Esophageal cancer– The cancer of the food pipe that occurs due to drinking alcohol or smoking.
- Dry mouth– This doesn’t allow the food to become moist which makes it difficult to swallow.
Also Read: 10 Most Common Causes for Sore throat
Symptoms of dysphagia
Dysphagia can remain undiagnosed. Most of the times the condition doesn’t show any symptoms which further complicates the condition. Dysphagia, if remains undiagnosed, can lead to dehydration and malnutrition. Some of the symptoms you can look out for-
- Choking while you are eating.
- Coughing or gagging while swallowing.
- Continuous drooling
- Acid reflux which means food or stomach acid backing up in the throat
- A feeling that food is stuck in the throat
- Weight loss without any reason
- Difficult controlling food in the mouth
- Difficulty pushing food down the throat
Treatment of dysphagia
The treatment depends on the type of dysphagia that has occurred.
For high dysphagia
As high dysphagia mainly occurs due to neurological disorders, finding the right treatment is quite difficult. But the following are prescribed-
- Proper Positioning-
- Sit straight while sitting to eat
- Don’t lie immediately after eating a meal. Sit upright or stand for 15-20 mins after eating.
- Suitable environment-
- Minimize distractions while eating
- Concentrate on eating and chewing
- Do not talk with food in your mouth
- Chew properly until the food becomes moist and eat slowly
- Don’t take big bites and cut food into small pieces
- Swallow at least twice per bite or sip
- If food gets stuck, cough gently and then swallow again
- Drink lots of liquids
- To increase saliva, have more ice creams and popsicle
- Puree the food in a blender
- If you are scared of taking pills, crush them into a powder and mix it in a pudding
Keep an eye on what you eat. Certain foods and liquids or the combination of both are easier to swallow. But you should remember to eat a balanced diet.
For low dysphagia
For dysphagia in the lower portion of the esophagus, surgery is the treatment option. The doctor performs any of the following two-
- Dilation– In this procedure, the doctor inserts a small balloon and inflates it to widen the esophagus.
- Botulinum toxin (Botox)– This is performed in cases of achalasia in which the esophagus becomes stiff.
In conclusion, dysphagia affects the quality of life you are leading and get into the way of social life. If you have a continuous feeling of hoarseness or frequent difficulty in swallowing, don’t let it go unnoticed. Prolonged cases of dysphagia can lead to malnutrition and dehydration. Also, older adults are at a higher risk of suffering from this condition. You can visit our E.N.T specialist if you are experiencing the symptoms of dysphagia.