DYSPHAGIA

General Information

DEFINITION--Difficulty or pain in swallowing. It is a fairly common symptom with a wide variety of causes that can be benign or possibly malignant. Chances of a serious disorder are slight, but if it is a serious disorder, early diagnosis is essential.

BODY PARTS INVOLVED--Pharynx; esophagus.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

• Pain associated with swallowing.
• The feeling that food "gets stuck" on the way down.
• The swallowing difficulty may progress over several weeks.
• Choking.
• Pressure sensation in mid chest.

CAUSES

• Foreign object lodging at back of throat.
• A scratch in the throat lining caused by a foreign object.
• Insufficient production of saliva.
• Esophageal spasm.
• Tumors (benign or cancer).
• Stricture (narrowing of the passage).
• Inflammation (esophagitis).
• In children, may be caused by malformation, delayed maturation, cerebral palsy, muscular dystrophy.
• Hernia of part of the esophagus through a weak area in the surrounding muscle.
• Nervous system disorder (stroke, myasthenia gravis).
• Outside pressure on the esophagus possibly caused by a goiter or aortic aneurysm.

RISK INCREASES WITH

• Older adults.
• Smoking.
• Some medications.
• Long history of esophageal reflux.

HOW TO PREVENT--No specific preventive measures.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Test may include endoscopy, esophageal manometry, barium x-ray examination, CT scan of the chest (See Glossary for all).

APPROPRIATE HEALTH CARE

• Self-care.
• Doctor's treatment.
• Hospitalization may be required for severe disorders.
• Surgery may be needed for some benign or malignant disorders.

POSSIBLE COMPLICATIONS--Complications will depend on underlying disorder (may include aspiration, esophageal "asthma," pneumonia, Barrett's esophagus).

PROBABLE OUTCOME--Outcome will vary depending on the cause.

How To Treat

GENERAL MEASURES----Specific recommendations will need to be based on the cause of the dysphagia. Some patients may need to learn how to chew food differently or have speech therapy that will teach them swallowing techniques.

MEDICATION--Medication will be determined by the cause. If a drug is causing the problem, your doctor may discontinue it, reduce the dosage or substitute a different drug.

ACTIVITY--Usually no restrictions apply, but will be determined by diagnosis and treatment.

DIET--Can range from normal to total intravenous feeding depending on degree of obstruction.

Call Your Doctor If

• You develop difficulty or pain while swallowing. Do not delay calling as this is a major symptom of what could be a malignant disorder. Early diagnosis is essential.
• New or unexplained symptoms develop. Drugs used in treatment may cause side effects.