Dysphagia in Adults: swallowing problems
Dysphagia is where you have problems swallowing. It’s usually caused by certain medicines or another condition, such as acid reflux or a stroke.
Difficulty swallowing may make it difficult to take in enough food and/or drink, resulting in malnutrition or lack of fluid in the body (dehydration). It may make it difficult to take necessary medication, which may go on to cause further medical problems. It leads to a risk of food ‘going down the wrong way’ (aspiration) towards the lungs instead of the stomach. This can cause choking or pneumonia.
Check if it’s dysphagia
Some people with dysphagia have problems swallowing certain foods or drinks, while others cannot swallow at all.
Signs of Dysphagia Include
- coughing or choking when eating or drinking
- bringing food back up, sometimes through the nose
- a feeling that food is stuck in your throat or chest
- a gurgly, wet-sounding voice when eating or drinking
- You may also drool and have problems chewing your food.
Over time, dysphagia can also cause symptoms such as weight loss, dehydration and repeated chest infections.
Causes of Dysphagia
Dysphagia is usually caused by another health condition and can happen at any age.
Common causes of swallowing problems include:
- Some medicines
- Having a learning disability
- A cleft lip and palate in babies
- Heartburn and acid reflux, especially in children or people who have gastro-oesophageal reflux disease
- Problems with your breathing caused by conditions like chronic obstructive pulmonary disease (COPD)
- A condition that affects the nervous system or brain, such as cerebral palsy, a stroke, dementia or multiple sclerosis
- Cancer, such as mouth cancer or oesophageal cancer
Treatments for Dysphagia
Speech and Language therapist or a dietitian for advice about swallowing and your diet.
Treatment for dysphagia depends on what’s causing it and how severe it is.
If your swallowing problems are being caused by a condition like acid reflux, the problem may get better on its own.
But if the cause is longer term, you may need specialist treatment to make eating and drinking as safe as possible.
This may include:
- medicines to treat acid reflux
- swallowing therapy with a speech and language therapist
- making changes to what you eat and drink, such as softer foods and using thickener in drinks
- using special spoons, plates and cups
- feeding tubes through your nose or a hole into your stomach
Stages of Dysphagia
The act of swallowing normally happens in three phases, and dysphagia can occur at any of them.
Oropharyngeal dysphagia. In the first phase of swallowing, food or liquid is contained in the mouth by the tongue and palate (oral cavity). This phase is the only one you can control.
Pharyngeal dysphagia. The second phase begins when your brain makes the decision to swallow. At this point, a complex series of reflexes begin. The food is thrust from the oral cavity into the throat (pharynx). At the same time, two other things happen: A muscular valve at the bottom of the pharynx opens, allowing food to enter the esophagus, and other muscles close the airway (trachea) to prevent food from entering the airways. This phase takes less than half a second.
Esophageal dysphagia. The third phase starts when food enters the esophagus. The esophagus, which is about 9 inches long, is a muscular tube that produces waves of coordinated contractions (called peristalsis). As the esophagus contracts, a muscular valve at the end of the esophagus opens and food is propelled into the stomach. The third phase of swallowing takes 6 to 8 seconds to complete
How Do I Know If I Have a Swallowing Problem?
Under normal circumstances, people rarely choke during a meal. Occasionally, food will stick in the esophagus for a few seconds. But it most often passes on its own or can be washed down easily with liquids. But there are a number of symptoms that could signal a possible swallowing problem, including:
- Frequent choking on food
- It takes more than a few seconds to swallow
- Pain when swallowing
- Repeated pneumonia, which could mean food is going into the lungs rather than the esophagus
Also Read: Dyslexia: Learning Disability
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