Pronounced: Dis-fay-gee-uh
En Espaol (Spanish Version)Definition
Dysphagia is difficulty eating because of disruption in the swallowing process. If dysphagia is severe, you may not be able to take in enough fluids and calories to stay healthy. In severe cases, even saliva is difficult to swallow. Complications may include aspiration pneumonia (food or liquids are pulled into your lungs), malnutrition, dehydration, weight loss, and airway blockage.
Causes
Some causes of dysphagia include:
- Muscle disorders (dermatomyositis, myotonic dystrophy)
- Nervous system problems
- Obstructive lesions in the throat or esophagus, such as tumors
- Central nervous system infections
- Vitamin B12 deficiency
- Stroke
- Head injury
- Cerebral palsy
- Parkinson's disease
- Huntington's disease
- Myasthenia gravis
- Amyotrophic lateral sclerosis
- Multiple sclerosis
- Scleroderma
- Infection with herpes simplex virus or yeast
- Narrowing of the esophagus after infection or irritation
- Injury to the swallowing muscles from chemotherapy and radiation for cancer
Narrowing of the Esophagus
2008 Nucleus Medical Art, Inc.
- Birth defects (such as cleft palate )
- Head and neck cancers
- Scarring after radiation treatment for cancer
- Gastroesophageal reflux disorder
- Diabetes
- Alcoholism
- Alzheimer's disease
- Postpolio syndrome
- Thyroid disorders
- Medications, including:
- Antibiotics
- Theophylline
- Potassium tablets
- Iron supplements
- Blood pressure medications
- Antipsychotics
- Narcotic pain relievers
- Steroids
- Lipid-lowering medications
- Colchicine
- Vitamins
- Nonsteroidal anti-inflammatory medications (NSAIDs)
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.
Risk factors include: Diabetes History of polioPrevious treatment for head and neck cancerProgressive neurological disorder or muscle disorderGastroesophageal reflux diseaseHead trauma Symptoms Symptoms include: Trouble swallowingConstant feeling of a lump in the throatPain with swallowingDroolingCoughing or choking with eating or drinkingRecurrent pneumoniaNasal sounding voiceSensation of food sticking in the chestWeight loss DiagnosisThe doctor will ask about your symptoms and medical history, and perform a physical exam. The exam will focus on the nervous system. The doctor will also watch you chewing and swallowing. Tests may include: Nasopharyngoscopyusing a scope to view the throatBlood teststo check for infection and thyroid function Esophagram with Barium Swallow x-ray test of the esophagus Endoscopya thin, lighted tube inserted down the throat to examine the esophagusVideoradiographic studiesx-rays during which swallowing is filmed on videoUltrasound a test that uses sound waves to examine structures inside the body Manometrytests the amount of pressure generated in various parts of the esophaguspH studiestests the degree of acidity in the esophagusCT scan a type of x-ray that uses computers to make pictures of the neck and chest Chest x-ray to check for pneumonia TreatmentTreatment may include:
Treating a Medical ConditionTreating the underlying condition may help improve your swallowing problems. Swallowing Techniques and Exercises A speech-language pathologist can teach you: Techniques to help you swallow more easilyExercises that strengthen the muscles needed for swallowing Diet ChangesIn severe cases, you may need to use high-nutrition liquid drinks. If you have trouble swallowing thin liquids, you may need powders to thicken liquids so they are easier to swallow. Progressive DilatationIf the esophagus is too narrow, instruments may be used to slowly stretch the esophagus. Other Nonsurgical TreatmentsBiofeedbackNasogastric feeding tube Surgery In severe cases, surgery may be needed to: Release an overly tight muscleRemove a stricture or web that is blocking the esophagusPlace a stent (a tiny tube) to hold the esophagus openPlace a feeding tube through the abdominal wall PreventionMost causes of dysphagia cannot be prevented. If you have a medical condition, get treatment so that you don't suffer complications, such as dysphagia. RESOURCES: American Academy of OtolaryngologyHead and Neck Surgeryhttp://www.entnet.org American Speech-Language-Hearing Associationhttp://www.asha.org CANADIAN RESOURCES:
Canadian Society of Otolaryngologyhttp://www.entcanada.org/default.asp Heart and Stroke Foundation of Canadahttp://ww2.heartandstroke.ca References: Dawodu ST. Swallowing disorders. Emedicine website. Available at: www.emedicine.com/pmr/topic152.htm. Accessed 2005. Spieker MR. Evaluating dysphagia. Am Fam Physician . 2000;61(12). Available at: http://www.aafp.org/afp/20000615/3639.html. National Institute on Deafness and Other Communication Disorders website. Available at: http://www.nidcd.nih.gov/ . Paik NJ. Dysphagia. Emedicine website. Available at: www.emedicine.com/pmr/topic194.htm. Accessed 2005. Sleisenger & Fordtran's Gastrointestinal and Liver Disease . 6th ed. W.B. Saunders Company; 1998. Last reviewed February 2008 by Elie Edmond Rebeiz, MD, FACSPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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