Learn About Swallowing Difficulty

What is the definition of Swallowing Difficulty?

Difficulty with swallowing is the feeling that food or liquid is stuck in the throat or at any point before the food enters the stomach. This problem is also called dysphagia.

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What are the alternative names for Swallowing Difficulty?

Dysphagia; Impaired swallowing; Choking - food; Globus sensation

What are the causes of Swallowing Difficulty?

The process of swallowing involves several steps. These include:

  • Chewing food
  • Moving it into the back of the mouth
  • Moving it down the esophagus (food pipe)

There are many nerves that help the muscles of the mouth, throat, and esophagus work together. Much of swallowing occurs without you being aware of what you are doing.

Swallowing is a complex act. Many nerves work in a fine balance to control how the muscles of the mouth, throat, and esophagus work together.

A brain or nerve disorder can alter this fine balance in the muscles of the mouth and throat.

  • Damage to the brain may be caused by multiple sclerosis, Parkinson disease, or stroke.
  • Nerve damage may be due to spinal cord injuries, amyotrophic lateral sclerosis (ALS or Lou Gehrig disease), or myasthenia gravis.

Stress or anxiety may cause some people to feel tightness in the throat or feel as if something is stuck in the throat. This sensation is called globus sensation and is unrelated to eating. However, there may be some underlying cause.

Problems that involve the esophagus often cause swallowing problems. These may include:

  • An abnormal ring of tissue that forms where the esophagus and stomach meet (called Schatzki ring).
  • Abnormal spasms of the esophagus muscles.
  • Cancer of the esophagus.
  • Failure of the muscle bundle at the bottom of the esophagus to relax (achalasia).
  • Scarring that narrows the esophagus. This may be due to radiation, chemicals, medicines, chronic swelling, ulcers, infection, or esophageal reflux.
  • Something stuck in the esophagus, such as a piece of food.
  • Scleroderma, a disorder in which the immune system mistakenly attacks the esophagus.
  • Tumors in the chest that press on the esophagus.
  • Plummer-Vinson syndrome, a rare disease in which webs of mucosal membrane grows across the opening of the esophagus.
What are the symptoms of Swallowing Difficulty?

Chest pain, the feeling of food stuck in the throat, or heaviness or pressure in the neck or upper or lower chest may be present.

Other symptoms may include:

  • Cough or wheezing that becomes worse.
  • Coughing up food that has not been digested.
  • Heartburn.
  • Nausea.
  • Sour taste in the mouth.
  • Difficulty swallowing only solids (may indicate a tumor or stricture) suggests a physical blockage such as a stricture or a tumor.
  • Difficulty swallowing liquids but not solids (may indicate nerve damage or spasm of the esophagus).

You may have problems swallowing with any eating or drinking, or only with certain types of foods or liquids. Early signs of swallowing problems may include difficulty when eating:

  • Very hot or cold foods
  • Dry crackers or bread
  • Meat or chicken
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What are the current treatments for Swallowing Difficulty?

The treatment for your swallowing problem depends on the cause.

It is important to learn how to eat and drink safely. Incorrect swallowing may lead to choking or breathing food or liquid into your main airway. This can lead to pneumonia.

To manage swallowing problems at home:

  • Your provider may suggest changes to your diet. You may also get a special liquid diet to help you stay healthy.
  • You may need to learn new chewing and swallowing techniques.
  • Your provider may tell you to use substances to thicken water and other liquids so that you do not aspirate them into your lungs.

Medicines that may be used depend on the cause, and may include:

  • Certain medicines that relax the muscles in the esophagus. These include nitrates, which is a type of medicine used to treat angina pectoris, and dicyclomine.
  • Injection of botulinum toxin.
  • Medicines to treat heartburn due to gastroesophageal reflux disease (GERD).
  • Medicines to treat an anxiety disorder, if present.

Procedures and surgeries that may be used include:

  • Upper endoscopy: The provider can dilate or widen a narrowed area of your esophagus using this procedure. For some people, this needs to be done again, and sometimes more than once.
  • Radiation or surgery: These treatments may be used if cancer is causing the swallowing problem. Achalasia or spasms of the esophagus may also respond to surgery or injections of botulinum toxin.

You may need a feeding tube if:

  • Your symptoms are severe and you are unable to eat and drink enough.
  • You have problems due to choking or pneumonia.

A feeding tube is inserted directly into the stomach through the abdominal wall (G-tube).

Who are the top Swallowing Difficulty Local Doctors?
Elite
Highly rated in
12
conditions
Gastroenterology

Northwestern Medicine

Northwestern Medicine Digestive Health Center

259 E Erie St 
Chicago, IL 60611

Dustin Carlson is a Gastroenterologist in Chicago, Illinois. Dr. Carlson has been practicing medicine for over 13 years and is rated as an Elite doctor by MediFind in the treatment of Swallowing Difficulty. He is also highly rated in 12 other conditions, according to our data. His top areas of expertise are Achalasia, Swallowing Difficulty, Esophagitis, and Gastroesophageal Reflux Disease. He is licensed to treat patients in Illinois. Dr. Carlson is currently accepting new patients.

Elite
Highly rated in
14
conditions
Gastroenterology

Northwestern Medicine

Northwestern Medicine Digestive Health Center

259 E Erie St 
Chicago, IL 60611

John Pandolfino is a Gastroenterologist in Chicago, Illinois. Dr. Pandolfino has been practicing medicine for over 29 years and is rated as an Elite doctor by MediFind in the treatment of Swallowing Difficulty. He is also highly rated in 14 other conditions, according to our data. His top areas of expertise are Achalasia, Gastroesophageal Reflux Disease, Swallowing Difficulty, and Hiatal Hernia. He is licensed to treat patients in Illinois. Dr. Pandolfino is currently accepting new patients.

 
 
 
 
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Elite
Highly rated in
36
conditions
Thoracic Surgery
General Surgery

University of Pittsburgh Medical Center

University Of Pittsburgh Physicians, Department Of Thoracic Surgery

200 Lothrop St 
Pittsburgh, PA 15213

James Luketich is a Thoracic Surgeon and a General Surgeon in Pittsburgh, Pennsylvania. Dr. Luketich has been practicing medicine for over 36 years and is rated as an Elite doctor by MediFind in the treatment of Swallowing Difficulty. He is also highly rated in 36 other conditions, according to our data. His top areas of expertise are Hiatal Hernia, Swallowing Difficulty, Hernia, and Esophageal Cancer. He is licensed to treat patients in Pennsylvania. Dr. Luketich is currently accepting new patients.

When should I contact a medical professional for Swallowing Difficulty?

Call your provider if swallowing problems do not improve after a few days, or they come and go.

Call your provider right away if:

  • You have a fever or shortness of breath.
  • You are losing weight.
  • Your swallowing problems are getting worse.
  • You cough or vomit up blood.
  • You have asthma that is becoming worse.
  • You feel as if you are choking during or after eating or drinking.
Esophagus
What are the latest Swallowing Difficulty Clinical Trials?
Do Intraoperative Topical Corticosteroids Aid in the Prevention of Postoperative Dysphagia Following Elective Anterior Cervical Discectomy and Fusion? A Randomized, Controlled, Double Blinded Clinical Trial
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Value of Neuromuscular Ultrasound and Blood Biomarkers for the Detection, Monitoring and Prognostication of Neuromuscular Complications in Critically Ill Patients: a Prospective Single-center Observational Study
What are the Latest Advances for Swallowing Difficulty?
Fostering eating after stroke (FEASt) trial for improving post-stroke dysphagia with non-invasive brain stimulation.
Bilateral Cerebellar Intermittent Theta Burst Stimulation Combined With Swallowing Speech Therapy for Dysphagia After Stroke: A Randomized, Double-Blind, Sham-Controlled, Clinical Trial.
Tired of the same old research?
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Effect of acupuncture for dysphagia after stroke based on fiberoptic endoscopic swallowing function evaluation.
Who are the sources who wrote this article ?

Published Date: July 01, 2021
Published By: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Kavitt RT, Vaezi MF. Diseases of the esophagus. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 68.

Munter DW. Esophageal foreign bodies. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 39.

Pandolfino JE, Kahrilas PJ. Esophageal neuromuscular function and motility disorders. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 44.