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    Swallowing Problems

    How Do I Know If I Have a Swallowing Problem?

    Under normal circumstances, individuals rarely choke during a meal. Occasionally, food will stick in the esophagus for a few seconds (especially solid foods), but will pass spontaneously or can be washed down easily with liquids. However, there are a number of symptoms that require evaluation for a possible swallowing problem, including:

    • Frequent choking on food
    • Hesitancy in food passage for more than a few seconds
    • Pain when swallowing
    • Recurring pneumonia (an indication that food may be going into the lungs rather than the esophagus)

    Immediate medical attention is needed when food becomes lodged in the esophagus for more than 15 minutes and doesn't pass spontaneously or with liquids.

    Some people are unaware that they have swallowing problems, because they compensate unconsciously by choosing foods that are easier to eat, or they eat more slowly. However, untreated swallowing problems increases the risk for choking or having large pieces of solid food lodge in the esophagus.

    How Are Swallowing Problems Diagnosed?

    If you think you have a swallowing problem, talk to your health care provider. Tests are available to determine the cause of a swallowing problem and may include:

    • Cineradiography: An imaging test in which a camera is used to film internal body structures. During the test, you will be asked to swallow a barium preparation (liquid or other form that lights up under X-ray). An X-ray machine with videotaping capability will be used to view the barium preparations movement through the esophagus. This is often performed under the guidance of a speech pathologist, an expert in swallowing as well as speech.
    • Upper endoscopy: A flexible, narrow tube (endoscope) is passed into the esophagus and projects images of the inside of the pharynx and esophagus on a screen for evaluation.
    • Manometry: This test measures the timing and strength of esophageal contractions and muscular valve relaxation.
    • Impedance and pH test: This test can determine if acid reflux is causing a swallowing problem.

    How Are Swallowing Problems Treated?

    Treatment depends on the type of swallowing problem you have. Sometimes, a swallowing problem will resolve itself without treatment. On other occasions, swallowing problems can be managed easily. Complex swallowing problems may require treatment by a specialist or several specialists.

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