Dysphagia: Causes, Treatment, Symptoms and Therapeutic Approaches

What is dysphagia (difficulty swallowing)?

Dysphagia, or difficulty swallowing, refers to a condition where an individual struggles to pass food or liquid from the mouth to the stomach. This condition can cause pain while swallowing or even make swallowing impossible in severe cases. However, occasional swallowing difficulties caused by eating too quickly or chewing improperly are usually nothing to worry about, whereas persistent dysphagia may indicate a serious health problem that requires an appropriate dysphagia treatment.

What are the types of dysphagia?

Dysphagia, or difficulty swallowing, is categorised into two main types based on where the swallowing problem occurs:

• Esophageal dysphagia: This type occurs in the esophagus, the tube that carries food from the throat to the stomach. Esophageal dysphagia can be caused by structural issues that narrows or blocks the oesophagus, such as tumours, strictures (narrowing), or conditions like GERD (Gastroesophageal Reflux Disease). Symptoms may include pain or discomfort while swallowing, sensation of food getting stuck in the chest or throat, regurgitation of food, or heartburn.
• Oropharyngeal dysphagia: This type occurs in the mouth (oro-) and throat (pharyngeal) areas. It is often caused by neurological conditions that affect the muscles and nerves that control swallowing. The most common causes includes stroke, Parkinson's disease, multiple sclerosis, and head or neck injuries. Symptoms may include coughing or choking while eating, difficulty swallowing, and food sticking to the throat.

What causes dysphagia?

Swallowing is a complex process involving many muscles and nerves, Dysphagia causes can be attributed to any condition that weakens or damages these muscles or nerves or narrows the back of the throat.

Some common dysphagia causes include:

• Neurological disorders: Conditions like multiple sclerosis, muscular dystrophy and Parkinson's Disease can cause dysphagia.
• Esophageal conditions: Certain diseases such as GERD (gastroesophageal reflux disease), esophageal tumors, and Achalasia can cause difficulty swallowing.
• Radiation Therapy: Treatments for cancer can cause inflammation and scarring in the esophagus, leading to dysphagia.

What are the risk factors for Dysphagia?

Risk factors for dysphagia, or difficulty swallowing, include aging (due to natural wear and tear on the esophagus) and certain health conditions. People with neurological or nervous system disorders are more likely to experience difficulty swallowing.

How is Dysphagia diagnosed?

Diagnosing dysphagia involves several steps to identify the underlying causes and determine the appropriate treatment. Healthcare providers begin with a comprehensive assessment, which may include:

• Assessment and History: A detailed medical history is obtained, including symptoms, onset, and any underlying conditions that may contribute to dysphagia. This often involves questions about eating habits, swallowing difficulties, and associated symptoms such as coughing or choking.
• Physical Examination: A thorough examination of the mouth, throat, and neck to check for abnormalities that could cause difficulty swallowing
• Swallowing Tests: Various tests may be conducted, such as:
  • Modified Barium Swallow (MBS): Involves swallowing food or liquid mixed with barium to monitor swallowing function using X-ray imaging.
  • Flexible Endoscopic Evaluation of Swallowing (FEES): A scope with a camera is inserted through the nose to view the swallowing process directly.
  • Flexible endoscopic evaluation of swallowing (FEES): A scope with a video camera is inserted into the nose to directly observe the swallowing process.
• Imaging Studies: CT scans or MRIs may be used to assess structural abnormalities or injuries affecting swallowing.
• Esophageal manometry: Measures muscle contractions of the esophagus to assess its function

How is dysphagia treated?

Dysphagia treatment depends on the underlying cause and severity of the difficulty swallowing.

Options include:

• Behavioural Therapy: A speech therapist can teach exercises to strengthen the swallowing muscles and improve coordination.
• Dietary Modifications: Adjusting food texture (e.g., pureed, soft) or consistency (e.g., thickened liquids) to make swallowing easier and safer
• Medical Interventions: Medications may be prescribed to reduce acid reflux, treat infections, or manage underlying conditions like Parkinson's disease.
• Surgical Procedures: In cases of structural abnormalities or tumors, surgery may be necessary to correct or alleviate blockages affecting swallowing.
• Feeding Tubes: In severe cases where swallowing is severely impaired, a feeding tube may be inserted to ensure adequate nutrition and hydration.
• Lifestyle Changes: Improving posture while eating, taking smaller bites, and eating slowly can help manage dysphagia symptoms.

Each dysphagia treatment plan is tailored to the specific needs of the individual and may involves a multidisciplinary approach which involves healthcare professionals such as gastroenterologists, neurologists, and nutritionists. Regular follow-up and adjustments to the treatment plan are essential to monitor progress and manage any ongoing challenges related to dysphagia.

Rehabilitation for swallowing problems

Rehabilitation for problems related to difficulty swallowing, often performed by speech therapists, focuses on strengthening the swallowing muscles, improving coordination, and teaching techniques to improve safe and effective swallowing.

What are the complications or risks of not treating Dysphagia?

Failure to treat dysphagia can lead to several complications and risks.

• These include malnutrition and dehydration due to difficulty eating and drinking safely
• Aspiration pneumonia is a serious risk, where food, liquid or saliva entering the airways can cause lung infections
• Weight loss and reduced quality of life may also occur
• Additionally, untreated dysphagia can worsen underlying conditions such as neurological disorders or esophageal diseases, potentially leading to more serious health problems down the line
• Early dysphagia diagnosis and appropriate dysphagia treatment are crucial to prevent these complications and improve swallowing function and overall health

When to see a doctor about difficulty swallowing?

Frequent discomfort while swallowing is a cause for concern. If you’re regularly having difficulty swallowing or suffer from weight loss, regurgitation, or vomiting along with it, consult a healthcare professional immediately.

Conclusion

Understanding dysphagia, or difficulty swallowing, is the first step in effectively treating this condition. While it can be concerning, knowing the causes and types can provide reassurance and guide you towards appropriate diagnostic methods and treatments. Consult your doctor if you regularly have difficulty swallowing.

At Metropolis Healthcare, we're committed to aiding your journey towards better health with our expert pathology lab services. Our team of qualified technicians will easily collect blood samples from your home, ensuring that careful results are provided through our user-friendly Truealth app.

Prioritizing your health is within reach with accurate knowledge and quality medical care. Stay informed, stay healthy!