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Difficulty Swallowing (Dysphagia) - Overview

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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.

How is it treated?

Your treatment will depend on what is causing your dysphagia. Treatment for dysphagia includes:

  • Exercises for your swallowing muscles. If you have a problem with your brain, nerves, or muscles, you may need to do exercises to train your muscles to work together to help you swallow. You may also need to learn how to position your body or how to put food in your mouth to be able to swallow better.
  • Changing the foods you eat. Your doctor may tell you to eat certain foods and liquids to make swallowing easier.
  • Dilation. In this treatment, a device is placed down your esophagus to carefully expand any narrow areas of your esophagus. You may need to have the treatment more than once.
  • Endoscopy. In some cases, a long, thin scope can be used to remove an object that is stuck in your esophagus.
  • Surgery. If you have something blocking your esophagus (such as a tumor or diverticula), you may need surgery to remove it. Surgery is also sometimes used in people who have a problem that affects the lower esophageal muscle (achalasia).
  • Medicines. If you have dysphagia related to GERD, heartburn, or esophagitis, prescription medicines may help prevent stomach acid from entering your esophagus. Infections in your esophagus are often treated with antibiotic medicines.

In rare cases, a person who has severe dysphagia may need a feeding tube because he or she is not able to get enough food and liquids.

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WebMD Medical Reference from Healthwise

Last Updated: June 27, 2011
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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