Difficulty swallowing is a symptom of various medical conditions. These include disorders of the nervous system, brain, and muscle disorders. Treatment for swallowing problems may involve medications and changes in eating habits. Here, we will explore the most important and common causes of difficulty swallowing, along with the latest methods of diagnosis and treatment.
What does difficulty swallowing mean, and what are its types?
During swallowing, various muscles and nerves work together to move food or drink from your mouth to your stomach. When there is a problem in how these parts work, you may experience discomfort, slowness, and difficulty swallowing. You may cough or choke when trying to swallow water or food.
Difficulty swallowing can be classified into three types based on the location of the problem: the oral cavity, the pharynx, and the esophagus.
What are the causes of difficulty swallowing?
Any disorder or disease that affects the muscles or nerves that assist in swallowing can cause difficulty swallowing. These include:
- Amyotrophic lateral sclerosis (ALS)
- Brain tumors
- Cerebral palsy
- Multiple sclerosis (MS)
- Parkinson’s disease
In addition to muscle disorders, conditions that prevent the muscles of the head and neck from assisting in swallowing include:
- Oropharyngeal spasms
- Esophageal spasms
- Myasthenia gravis
- Myositis
- Scleroderma
Conditions that cause obstruction in the esophagus leading to difficulty swallowing include:
- Cancer: Tumors in the head and neck can obstruct food and drink. Esophageal cancer is the most common type of cancer causing difficulty in swallowing.
- Eosinophilic esophagitis: A condition that occurs when a large number of white blood cells accumulate in the esophagus, causing stiffness.
- Esophageal diverticula that form in the lining of the esophagus and can trap food particles, creating a sensation of something stuck in your throat.
- Gastroesophageal reflux disease (GERD): Stomach acid can flow into the esophagus, causing scarring known as Barrett’s esophagus, making swallowing painful and difficult.
- Infections, such as bacterial tonsillitis, can cause difficulty swallowing.
- Swallowing difficulties may occur after head and neck surgery or other types of treatment. For example, radiation therapy for head and neck cancer.
How is difficulty swallowing diagnosed?
- Barium swallow test: A radiologist gives you a barium solution to drink, and your throat and esophagus are clearly visible on X-rays.
- Esophageal endoscopy: A gastroenterologist places a scope down your throat to capture images of the throat, esophagus, and stomach. Narrowing and tumors, such as Barrett’s esophagus, may appear.
- Laryngoscopy: An ear, nose, and throat doctor places a small scope through your nose to examine your throat and voice box for any problems.
- Fiberoptic Endoscopic Evaluation of Swallowing (FEES): Doctor places a small camera in your nose to see the upper part of the esophagus. Once the camera is in place, the speech-language pathologist monitors the swallowing process.
- Esophageal pressure measurement: A gastroenterologist passes a tube from your nose to your stomach. Then, they ask you to drink water. The tube is connected to a pressure recorder that measures contractions in the esophagus during fluid swallowing.
Difficulty swallowing treatment
The treatment of difficulty swallowing depends on its cause and severity. Your treatment may include:
- Medication: Your doctor may prescribe antibiotics to treat infections typically caused by viruses or fungi, leading to difficulty swallowing. Also, reflux treatment involves using medications to control acid reflux.
- Lifestyle changes: You may need to consume soft foods that are easy to chew. Avoiding extremely hot or cold foods and beverages may be necessary.
- Tube feeding: Your doctor may recommend using a feeding tube if you are not getting enough food or drink, or if you are at risk of choking. The feeding tube delivers nutrients directly to the intestines or stomach.
- If there is a neurological condition causing difficulty swallowing, treatment options may include Botox injections to relieve muscle spasms. You may also need a procedure to dilate the esophagus or remove obstructions.
What are the complications of difficulty swallowing?
Difficulty swallowing can lead to serious health problems, including:
- Dehydration
- Malnutrition
- Choking
- Pneumonia
Who is the best doctor to treat difficulty swallowing?
Dr. Mohamed El Boraie is considered the best doctor for treating difficulty swallowing. He is a consultant in liver, digestive system, and endoscopy, a fellow of the Royal College of Physicians in England, and a member of the American College of Gastroenterology. Dr. Mohamed Al Boraie is currently a lecturer in internal medicine, liver, and digestive system at Al-Azhar University in Cairo.
Dr. Mohamed Al Boraie participates in various local and international scientific conferences regularly and has many scientific research papers published in prestigious medical journals.
Book your appointment now if you would like to consult with Dr. Mohamed Al Boraie regarding difficulty swallowing, its causes, symptoms, and the latest methods of diagnosis and treatment.