What is dysphagia
Under normal conditions people rarely choke during eating. Difficulty swallowing (dysphagia) means it takes more time and effort to move food or liquid from your mouth to your stomach. On occasions food may stick for a few seconds but will pass spontaneously
Persistent dysphagia may indicate a serious medical condition requiring treatment. Dysphagia can occur at any age, but it's more common in older adults. The causes of swallowing problems vary, and treatment depends on the cause.
What are the causes of dysphagia
There are many and varied causes of dysphagia which include
- Oesophageal dysmotility such as achalasia and diffuse spasm,
- A stricture within the oesophagus which can be due to a foreign body, reflux or a tumour
- Oesophageal tumour
- Eosinophilic oesophagitis
- Previous radiation treatment
What are the symptoms of dysphagia
Frequent choking on food, hesitancy in food passage for more than a few seconds, pain when swallowing, weight loss, inability to swallow.
Recurring pneumonia (an indication that food may be going into the lungs rather than the esophagus)
Investigations will vary depending on the history and site of the dysphagia but will include:
- A gastroscopy to look inside the oesophagus and stomach and take any biopsies.
- A barium X-ray/swallow. This allows to see the lining of the oesophagus and how the muscle of the oesophagus is working
- Oesophageal manometry. A tube is inserted into your esophagus via your nose and connected to a pressure recorder to measure the muscle contractions of your esophagus as you swallow.
- Further imaging with CT may be required depending on the results from the initial tests
Treatment varies considerably depending on the diagnosis.
It may involve medical treatment for conditions such as reflux or eosinophilic oesophagitis. Benign strictures can be treated endoscopically with dilatation. Some conditions may require surgery as achalasia and a cancer diagnosis depending on the stage of the cancer.