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Difficulty Swallowing (Dysphagia) - Overview

What are the symptoms?

Dysphagia can come and go, be mild or severe, or get worse over time. If you have dysphagia, you may:

  • Have problems getting food or liquids to go down on the first try.
  • Gag, choke, or cough when you swallow.
  • Have food or liquids come back up through your throat, mouth, or nose after you swallow.
  • Feel like foods or liquids are stuck in some part of your throat or chest.
  • Have pain when you swallow.
  • Have pain or pressure in your chest or have heartburn.
  • Lose weight because you are not getting enough food or liquid.

How is dysphagia diagnosed?

If you are having difficulty swallowing, your doctor will ask questions about your symptoms and examine you. He or she will want to know if you have trouble swallowing solids, liquids, or both. He or she will also want to know where you think foods or liquids are getting stuck, whether and for how long you have had heartburn, and how long you have had difficulty swallowing. He or she may also check your reflexes, muscle strength, and speech. Your doctor may then refer you to one of the following specialists:

To help find the cause of your dysphagia, you may need one or more tests, including:

  • X-rays. These provide pictures of your neck or chest.
  • A barium swallow. This is an X-ray of the throat and esophagus. Before the X-ray, you will drink a chalky liquid called barium. Barium coats the inside of your esophagus so that it shows up better on an X-ray.
  • Fluoroscopy. This test uses a type of barium swallow that allows your swallowing to be videotaped.
  • Laryngoscopy. This test looks at the back of your throat, using either a mirror or a fiber-optic scope.
  • Esophagoscopy or upper gastrointestinal endoscopy. During these tests, a thin, flexible instrument called a scope is placed in your mouth and down your throat to look at your esophagus and perhaps your stomach and upper intestines. Sometimes a small piece of tissue is removed for a biopsy. A biopsy is a test that checks for inflammation or cancer cells.
  • Manometry. During this test, a small tube is placed down your esophagus. The tube is attached to a computer that measures the pressure in your esophagus as you swallow.
  • pH monitoring, which tests how often acid from the stomach gets into the esophagus and how long it stays there.
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