Difficulty swallowing

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Difficulty swallowing is usually an indication of an issue in the throat or esophagus. Even though this can occur to anyone, it is quite common among infants, elderly and those who have brain or nervous system problems.

There are various conditions that can prevent the throat or esophagus from functioning properly. Some are relatively minor but others can be serious. If an individual has difficulty swallowing once or twice, it might not be a medical issue. On the other hand, if it occurs regularly, it might be an indication of a serious condition that necessitates treatment.

What are the possible causes of difficulty swallowing?

Generally, the muscles in the throat and esophagus contract or squeeze to drive food and liquids from the mouth to the stomach without any issues. Some of the issues that causes difficulty for food and liquids to move down the esophagus include:

  • Stroke or injury to the brain or spinal cord
  • Certain conditions involving the nervous system such as multiple sclerosis, Parkinson’s disease or muscular dystrophy
  • Immune system conditions that results to swelling and weakness
    Difficulty swallowing
    Choking, coughing or gagging when swallowing.
  • Scleroderma in which the esophageal tissues harden and narrow. It weakens the lower esophageal muscle that can cause food and stomach acid to move back up into the throat and mouth.
  • Esophageal spasm in which the muscles of the esophagus abruptly squeeze. This can oftentimes prevent food from reaching the stomach.
  • There is blockage in the throat or esophagus such as esophageal tumors, esophagitis or gastroesophageal reflux disease (GERD).

What are the indications?

Difficulty swallowing might come and go, mild or severe or worsen over time. The usual indications include the following:

  • Difficulty getting food or liquids down on the first attempt
  • Choking, coughing or gagging when swallowing
  • Pain when swallowing
  • Liquids or food back up through the throat, nose or mouth after ingested
  • Sensation that food or liquids are trapped in the throat or chest
  • Pressure or pain in the chest or heartburn
  • Weight loss due to not getting enough food or liquids

Management

The treatment for difficulty swallowing usually depends on the cause. The commonly used treatment options include:

  • Exercise for the swallowing muscles. If there is an issue with the nerves, brain or muscles, the individual requires exercises to train the muscles to work together to assist with swallowing. There might also be a need to learn how to position the body or how to place food in the mouth to be able to swallow.
  • Changes in the diet might be required in which the doctor will recommend certain foods and liquids to make swallowing easier.
  • Dilation involves placing a device down the esophagus to carefully expand any constricted areas. This might require more than one treatment.
  • Endoscopy involves using a thin, long scope to remove an object that is stuck in the esophagus.
  • Medications are given if difficulty swallowing is linked to heartburn, GERD or esophagitis. These medications work by preventing the stomach acid from entering the esophagus. Infections in the esophagus are usually managed with antibiotics.
  • Surgery is required if there is blockage in the esophagus such as a tumor.

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