Dysphagia

Dysphagia, which refers to trouble swallowing, makes it more difficult to get food or drink from your mouth to your stomach. Dysphagia can cause discomfort. Swallowing is not always possible.

Sometimes having trouble swallowing, such as when you eat too quickly or don't chew your food thoroughly, is often nothing to worry about. Yet, chronic dysphagia can be a significant medical problem that has to be treated.Any age can get dysphagia, however, older persons are more likely to experience it. Treatment for swallowing issues is based on etiology, which might vary.

Any age can get dysphagia, however, older persons are more likely to experience it. Treatment for swallowing issues is based on etiology, which might vary.

Dysphagia: Causes

The process of swallowing requires a variety of muscles and nerves. Dysphagia can be brought on by any disorder that impairs or harms the swallowing muscles and nerves, or that causes the esophagus or throat to narrow.

Generally speaking, dysphagia fits into one of the following groups.

Dysphagia of the Throat

Esophageal dysphagia is the term used to describe the feeling that food is stuck or is becoming lodged in your chest or the base of your throat after you have started to swallow. The following are a few causes of esophageal dysphagia −

• Achalasia. Food can come back up into the throat when the lower esophageal muscle (sphincter) does not relax sufficiently to allow food to reach the stomach. It's also possible that the esophageal wall's muscles are weakened.

• Broad spasm. This syndrome causes the esophagus to constrict at high pressure and with poor coordination, typically after eating. The lower esophageal walls' involuntary muscles are affected by diffuse spasms.

• Esophageal narrowing. Large chunks of food might become stuck in a constricted esophagus. The narrowing may be brought on by tumors or scar tissue, both of which are frequently brought on by GERD.

• Stomach tumors. Due to the constriction of the esophagus brought on by esophageal tumors, swallowing difficulties frequently grow progressively worse.

• External entities. The throat or esophagus can occasionally get partially blocked by food or another item. Food fragments becoming stuck in the throat or esophagus may be more likely to happen to older folks with dentures and people who have trouble chewing their meals.

• Epigastric ring. Off and on having trouble swallowing solid foods might be a result of a thin region of constriction in the lower esophagus.

• GERD. Lower esophageal spasm, scarring, and constriction can result from damage to esophageal tissues brought on by stomach acid backing up into the esophagus.

• Esophagitis with eosinophilia. This illness is brought on by an overabundance of eosinophils in the esophagus, which may be connected to a food allergy.

• Scleroderma. The lower esophageal sphincter may become less effective due to the development of scar-like tissue that causes tissues to stiffen and harden. As a result, acid builds up and frequently causes heartburn in the esophagus.

• Radiation treatment. The esophagus may become inflamed and scarred as a result of this cancer treatment.

Dysphagia of the Oropharynx

The muscles in your throat may become weak as a result of certain illnesses, making it challenging to transport food from your mouth into your neck and esophagus when you begin to swallow. As you try to swallow, you can choke, gag, or cough. You might also feel as though food or liquids are entering your trachea or coming up your nose. Pneumonia may result from this.

Oropharyngeal dysphagia can be brought on by −

• Neurological conditions. Dysphagia can be brought on by several conditions, including Parkinson's disease, muscular dystrophy, and multiple sclerosis.

• Harm to the brain. The capacity to swallow may be impacted by sudden neurological impairment, such as that caused by a stroke, brain injury, or spinal cord injury.

• Zenker's diverticulum, or pharyngoesophageal diverticulum.

Dysphagia: Symptoms

The patient with dysphagia mainly presents with the following symptoms that include −

• Difficulty swallowing

• Difficulty swallowing

• A feeling that food is becoming trapped in your throat, chest, or breastbone (sternum)

• Drooling

• Hoarseness

• Food resurfacing (regurgitation)

• Chronic heartburn

• Backing up stomach acid or food into the throat

• Loss of weight

• Swallowing while coughing or gagging

Dysphagia: Risk Factors

Several factors play an important role in the development of dysphagia which includes −

• Aging. Older persons are more likely to experience swallowing problems due to aging naturally, typical esophageal wear and tear, as well as a higher chance of specific diseases like Parkinson's disease or stroke. Nonetheless, dysphagia is not seen as a typical aging symptom.

• Certain health issues. The likelihood of having trouble swallowing is higher in those with specific neurological or nervous system problems.

Dysphagia: Diagnosis

The diagnosis of dysphagia is mainly done based on history and some of the tests may be required for confirmation and to rule out underlying causes

• X-ray with contrast medium (barium X-ray). You consume a barium solution, which covers your esophagus and improves its visibility on X-rays.

• Research of dynamic swallowing. Barium-coated meals of various textures are swallowed. This test shows you how these meals look as they pass down your throat.

• An inspection of your esophagus visually (endoscopy). Your healthcare professional will put an endoscope (a tiny, flexible, lit instrument) down your throat to view your esophagus.

• Fiber-optic endoscopy swallowing assessment (FEES). While you attempt to swallow, your doctor may check your throat using an endoscope, a special camera, and an illuminated tube.

• Stomach muscle test (manometry).

• Scanning images. An MRI scan employs a magnetic field and radio waves to provide precise pictures of organs and tissues, while a CT scan combines many X-ray scans with computer processing to produce cross-sectional images of your body's bones and soft tissues.

Dysphagia: Treatment

The treatment is based on the severity of the symptoms. Your doctor may advise conservative or surgical treatment.

Conservative Treatment

Medications. GERD-related difficulty swallowing may be managed with prescription-only oral medicines that lower stomach acid. These drugs may be necessary for a considerable amount of time. Eosinophilic esophagitis could benefit from corticosteroids. Smooth muscle relaxants may be beneficial for treating esophageal spasms.

Esophageal enlargement. Your healthcare practitioner may put a flexible tube or tubes into your esophagus to extend it if you have an esophageal stricture or tight esophageal sphincter (achalasia).

Surgical Treatment

Surgical Heller myotomy. When the esophagus fails to open and deliver food into the stomach in those with achalasia, this entails cutting the muscle at the lower end of the esophagus (sphincter).

Dysphagia: Prevention

Although it is impossible to completely avoid swallowing problems, you may lower your risk by chewing your food thoroughly and eating slowly. Nonetheless, you should consult your doctor if you experience any dysphagia symptoms or indications.

Conclusion

Research being done by scientists will help doctors and speech-language pathologists better diagnose and treat patients with swallowing difficulties. Researchers are studying every element of swallowing in people of all ages, including those who do not have dysphagia, to better understand how healthy and abnormal processes differ.

Some patients will be able to prevent deadly lung infections thanks to this information, while others will be spared tube feedings.