Dysphagia refers to difficulties during the swallowing process. There are two main types:
— swallowing problems happen in the mouth and pharynx (the part of the throat behind the mouth)
Esophageal dysphagia—swallowing problems happen in the esophagus (tube that transports food from the throat to the stomach)
This article focuses on esophageal dysphagia.
Esophagus and Stomach
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A number of conditions can cause esophageal dysphagia, such as: Achalasia
—affects the muscles at the bottom of the esophagus
—causes thickening and stiffening of tissues, joints, and organs; can lead to problems with the esophageal muscles
or esophageal ring—causes the esophagus to become more narrow
Symptoms include: Difficulty swallowing solids, liquids, or bothA sensation of food being stuck in the esophagusPain when swallowingHeartburn, regurgitationCoughing or choking when eating or drinkingDroolingWheezing, hoarse voice
Weight loss, malnutrition, and
(due to problems with eating and drinking)
The doctor will:
Ask about your symptoms, such as:
Where do you feel the pain when you swallow?What foods or liquids lead to symptoms?Do the symptoms happen every time you eat or drink? Is the problem getting worse?Do you have heartburn?Take your medical history.Do a physical exam.
Tests may include:
Swallow test (to observe what happens when you swallow)Videofluorographic swallowing study (VFSS)—an imaging test that involves swallowing food mixed with barium solution (This allows the doctor to watch the swallowing process on a monitor.)Barium swallow
—an imaging test that involves swallowing a barium solution and having x-rays taken of the esophagus
—a thin, lighted tube is inserted down the throat to examine the esophagus
Esophageal manometry—a test to measure the functioning of the esophageal muscles
Treatment may include:
Procedures, such as:
—This involves placing a tube-shaped device into the esophagus to widen the narrow part.
into the esophageal muscle to make swallowing easier
Surgery (eg, to remove an esophageal tumor)Dietary changes—You may need to avoid eating foods that cause problems, like meat. Or you may need to eat only pureed food. In severe cases, a feeding tube may be needed to provide nutrition.Therapy to improve swallowing—such as learning ways to prevent choking while eating.Medicine (eg, to treat GERD or to relax the esophagus)
You can reduce your risk by getting early treatment for any related condition, like GERD.
Palmer J, Drennan J, Baba M. Evaluation and treatment of swallowing impairments. American Family Physician website. Available at:
. Published April 15, 2000. Accessed September 26, 2011.
Last reviewed October 2011 by Daus Mahnke, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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