Dysphagia

Dysphagia means having trouble swallowing, and it can affect people of all ages. Many people do not realize how common this problem is or how many different health issues can cause it. Nerve or muscle disorders, damage to the throat or esophagus, and certain diseases such as stroke, Parkinson’s disease, and head or neck cancer most often cause dysphagia.

Problems in the mouth or throat, or issues with the esophagus, can lead to dysphagia. Injuries, dry mouth, or autoimmune diseases can also make swallowing difficult.

Definition of Symptom

Dysphagia means difficulty swallowing. People with this symptom struggle to move food, liquids, or even saliva from the mouth to the stomach. Swallowing problems can range from mild discomfort to complete inability to swallow. Some may feel as if food is “stuck” in the throat or chest.

Swallowing difficulties can affect eating, drinking, and taking medicine. In some cases, it may also cause coughing or choking during meals. Common signs of dysphagia include:

• Pain when swallowing
• Coughing or choking while eating
• A sensation of food sticking in the throat
• Drooling or inability to control saliva
• Hoarseness or changes in voice

There are two main types:

Type	Description
Oropharyngeal	Trouble starting a swallow, often linked to nerve or muscle problems in the mouth or throat.
Esophageal	The feeling of food getting stuck or slowed in the esophagus (the tube leading to the stomach).

Dysphagia can happen at any age but is more common in older adults. Many different conditions, including problems with nerves, muscles, or a physical blockage, can cause it.

Possible Causes/Diseases Condition

Many medical conditions can cause dysphagia. These conditions may affect the mouth, throat, or esophagus.

Common Causes

• Neurological Disorders: Stroke, Parkinson’s disease, and multiple sclerosis can disrupt nerves and muscles needed for swallowing.
• Muscle Diseases: Muscular dystrophy and scleroderma can weaken or stiffen swallowing muscles.
• Obstructions: Tumors, esophageal cancer, or growths can make swallowing hard.

Gastroesophageal reflux disease (GERD) and acid reflux can irritate and narrow the esophagus, leading to swallowing problems. Some people develop eosinophilic esophagitis, often linked to food allergies, causing the esophagus to swell and tighten. Below is a table of medical conditions that may lead to dysphagia:

Condition	Main Effect on Swallowing
Stroke	Disrupts brain control of muscles.
Parkinson’s Disease	Weakens muscles, slows movement.
Achalasia	Prevents opening of esophagus muscle.
Esophageal Cancer	Blocks or narrows the esophagus.
GERD/Acid Reflux	Causes inflammation and strictures.
Muscular Dystrophy	Weakens swallowing muscles.
Scleroderma	Hardens and tightens esophagus.
Eosinophilic Esophagitis	Allergic swelling of esophagus.
Zenker’s Diverticulum	Pouch traps food near throat.
Radiation Therapy	Causes scarring and swelling.
Hypothyroidism	Slows muscle activity.

Not everyone with these conditions will have dysphagia, but each can raise the risk. Some conditions mainly affect the mouth and throat (oropharyngeal dysphagia), while others impact the esophagus (esophageal dysphagia).

Other Non-Disease Causes

Not all cases of dysphagia come from diseases. Sometimes, lifestyle choices or physical changes lead to swallowing problems. Dental issues can make chewing and swallowing painful. Missing teeth, loose dentures, or mouth pain may cause someone to avoid certain foods or chew less, which increases choking risks.

Eating too quickly can also cause swallowing problems. People who eat fast may not chew food well, which can cause food to get stuck in the throat or esophagus. This may result in discomfort, coughing, or mild regurgitation. Regurgitation—the feeling of food coming back up the throat—can occur if food is not swallowed properly.

Eating big bites, not chewing enough, or eating while distracted can cause this. Heartburn may also contribute. It can irritate the esophagus, making swallowing slightly uncomfortable even without any chronic disease. The table below lists some non-disease causes of dysphagia and related symptoms:

Cause	How it Leads to Dysphagia	Possible Symptoms
Dental problems	Poor chewing	Pain, choking
Eating fast	Inadequate breakdown of food	Food stuck, coughing
Regurgitation	Food comes back up	Soreness, discomfort
Heartburn	Irritation of esophagus	Mild pain, burning

How It Causes the Symptom

Dysphagia happens when something goes wrong with how the throat or esophagus moves food from the mouth to the stomach. The normal swallowing process needs muscles and nerves to work together in a certain way. If the swallowing muscles become weak or damaged, food can get stuck or move slowly. This can make swallowing hard.

Diseases that affect the nerves or muscles can cause muscle weakness. Structural problems, like a narrowed esophagus or a tumor, can block the normal flow of food and liquids. These obstructions make swallowing painful or difficult. Scar tissue from injury or acid reflux can also cause narrowing.

Stroke, head injury, or conditions like Parkinson’s disease can damage nerves and disrupt signals from the brain to the swallowing muscles. This can cause poor coordination or loss of control over the muscles needed for swallowing.

Table: Examples of How Dysphagia Causes Swallowing Problems

Cause	How It Affects Swallowing
Muscle Weakness	Food moves slowly or gets stuck in the throat.
Neurological Damage	Poor muscle coordination, choking, or coughing.
Structural Problems	Blockage restricts flow of food and liquid.

Healthy throat and esophagus function are important for normal swallowing.

Possible Complications

Dysphagia can lead to serious problems if not managed well. People with trouble swallowing have a greater risk of choking, since food or drinks can block the airway. Food or liquid can enter the airway or lungs instead of the stomach, which can cause a lung infection called aspiration pneumonia.

Pneumonia is a dangerous complication for people with dysphagia, especially for older adults or those with weakened immune systems. Other issues include malnutrition and dehydration. If a person cannot swallow safely, they may not eat or drink enough. This leads to weight loss, weakness, and fatigue. Common complications of dysphagia include:

Complication	Possible Effects
Choking	Blockage of the airway, emergency risk
Aspiration	Entry of food or liquid into airways
Pneumonia	Infection in the lungs
Malnutrition	Not enough nutrients for the body
Dehydration	Not enough fluids, dizziness, weakness
Weight Loss	Loss of body weight, muscle loss

Emotional and social complications are also possible. People may avoid meals with others or feel isolated or anxious.

When to Seek Medical Attention

People with dysphagia should watch for certain warning signs that may need quick medical care. Swallowing problems can sometimes be mild, but they can also signal serious health concerns. Seek medical attention right away if any of these occur:

• Trouble swallowing both liquids and solids
• Sudden or severe difficulty swallowing
• Choking, coughing, or frequent throat clearing during meals
• Unintended weight loss
• Chest pain or discomfort when swallowing
• Repeated pneumonia or lung infections

If symptoms continue or get worse, see a doctor. A doctor may send you to a speech-language pathologist. These specialists check swallowing and can make safe eating plans. They may also teach swallowing exercises to help strengthen muscles.

Doctors sometimes use tests like endoscopy or manometry to look at the esophagus and see how it works. If someone cannot eat or drink safely, doctors may use feeding tubes for nutrition. In some cases, they may widen a narrowed esophagus with esophageal dilation.