Dysphagia simply means difficulty swallowing. This is a very complex condition that can be quite serious and requires the expertise of a medical professional trained in diagnosing and treating people with this condition. It is usually a Speech Pathologist or a medical doctor. Dysphagia can occur at any age, from a wide variety of diseases, accidents or illnesses. While it is reported that approximately 22% of adults over the age of 50 years old have dysphagia, it is felt that the total number of incidents are underestimated.
There are basically three stages to the swallow mechanism which involve approximately 50 pairs of muscles and many nerves all working together to help get the food and liquids into our stomach and avoid getting into the airway. The oral stage which occurs in your mouth, involves chewing and manipulating foods and preparing to move the foods/liquids into the throat. The next stage, the pharyngeal stage, is where the foods and liquids are moved through your throat and assisted by various muscles to advance into the esophagus. The third stage, the esophageal stage, is where foods and liquids move through the esophagus into the stomach. While this is a very simplified description, be aware that this is a very complex process that involves many muscles and nerves and occurs very quickly.
Problems can occur at any point during the process and depending upon where it occurs, you will have different symptoms. Some common symptoms that someone may have would include difficulty chewing foods, holding foods or liquids(pocketing) in their mouth for extended periods of time, coughing or choking when swallowing, feeling as if something is stuck in the throat, wet sounding voice after swallowing, shortness of breath after eating/drinking, having foods “come back up” after swallowing, chest pain with meals, weight loss and developing pneumonia. While this is not an exhaustive list, this is an example of some of the things that someone may experience.
There are many different causes of dysphagia, such as a stroke, Parkinson’s disease, ALS, dementia/Alzheimer’s disease, head and neck cancer, COPD, multiple sclerosis and brain injury. Again this is not a full list, but rather just some of the reasons that may cause someone to have difficulty swallowing.
There are various tests that can help to further understand how someone is swallowing. These include a Modified Barium Swallow(MBS) which is a test where you are given various foods and liquids that have barium in them. You will then swallow these during an X-ray procedure to help determine what is happening when you swallow. A barium swallow is very similar but usually you are given just barium liquids to swallow, again during an X-ray procedure. This test usually looks at the esophagus and into the stomach for problems whereas the MBS looks more at the throat area. There are additional tests that may be needed to further evaluate the swallowing mechanism.
Just as there are various causes of dysphagia, there are various ways to treat it. Usually a Speech Pathologist is the one who will be providing this treatment. There are different ways you may be instructed to hold your head or eat/drink that can help minimize the swallow difficulty. The food or liquid texture may be altered to help compensate for the swallowing problems or you may be given exercises, targeting certain areas, that can help improve the swallow mechanism.
Dysphagia is a complex and potentially very dangerous condition that requires prompt diagnosis and treatment. Should you have any of these symptoms or know of someone who has, it is recommended that you contact your physician and discuss these issues.
ASHA is a great place to find out more information on this issue and help provide additional resources.