What is Dysphagia?

Swallowing disorders, also called dysphagia (dis-FAY-juh), can occur at different stages in the swallowing process. 

  • Oral phase – sucking, chewing, and moving food or liquid into the throat

  • Pharyngeal phase – starting the swallowing reflex, squeezing food down the throat, and closing off the airway to prevent food or liquid from entering the airway (aspiration) or to prevent choking

  • Esophageal phase – relaxing and tightening the openings at the top and bottom of the feeding tube in the throat (esophagus) and squeezing food through the esophagus into the stomach

  • Dysphagia can occur in children or adults.  This section discusses adult swallowing difficulties more specifically. 

 

What are some signs or symptoms of swallowing disorders?

Several diseases, conditions, or surgical interventions can result in swallowing problems.

Some general signs may include:

  • coughing during or right after eating or drinking

  • wet or gurgly sounding voice during or after eating or drinking

  • extra effort or time needed to chew or swallow (especially if it was not an issue before)

  • food or liquid leaking from the mouth or getting stuck in the mouth

  • recurring pneumonia or chest congestion

  • weight loss or dehydration from not being able to eat enough

As a result, adults may have:

  • poor nutrition or dehydration

  • risk of aspiration (food or liquid entering the airway), which can lead to pneumonia and chronic lung disease

  • less enjoyment of eating or drinking

  • embarrassment or isolation in social situations involving eating

 

How are swallowing disorders diagnosed?

A speech-language pathologist (SLP) who specializes in swallowing disorders can evaluate individuals who are experiencing problems eating and drinking. The SLP will:

  • take a careful history of medical conditions and symptoms

  • look at the strength and movement of the muscles involved in swallowing

  • observe feeding to see posture, behavior, and oral movements during eating and drinking

  • possibly perform special tests to evaluate swallowing, such as:

modified barium swallow – individual eats or drinks food or liquid with barium in it, and then the swallowing process is viewed on an X-ray; this test is easy to tolerate for most people and is painless. 

endoscopic assessment – a lighted scope is inserted through the nose, and then the swallow can be viewed on a screen; this test is slightly more invasive, but it is still relatively easy to tolerate.  Topical sprays are used to numb your nose/throat area so that it is does not hurt. 

 

What treatments are available for people with swallowing disorders?

Treatment depends on the cause, symptoms, and type of swallowing problem.

A speech-language pathologist may recommend:

  • specific swallowing treatment (e.g., exercises to improve muscle movement)

  • positions or strategies to help the individual swallow more effectively

  • specific food and liquid textures that are easier and safer to swallow

  • therapy can be done in a variety of settings including hospital, rehabilitation center, nursing home, assisted living, home setting, or in an out patient clinic.

 

After the evaluation, family members or caregivers can help by:

  • asking questions to understand the problem and the recommended treatment

  • assist with following treatment recommendations by doing some or all of the following:

    help with exercises

    prepare the recommended textures of food and liquid, making sure that recommendations for eating safely are followed

    keep track of how much food or liquid is consumed

    Come to therapy sessions with questions or concerns (or call your therapist)

 

What causes sudden or new swallowing disorders in adults?

Some causes of feeding and swallowing problems in adults are:

 

Damage to the nervous system, such as:

  • stroke, brain injury, spinal cord injury, Parkinson’s Disease, Multiple Sclerosis

  • Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig’s disease)

  • Muscular Dystrophy, Cerebral Palsy, Alzheimer’s Disease & other Dementias

Problems affecting the head and neck, including:

  • cancer in the mouth, throat, or esophagus

  • injury or surgery involving the head and neck

  • decayed or missing teeth, or poorly fitting dentures

Other Conditions:

  • Eosinophilic (ee-uh-sin-uh-fil-ik) Esophagitis, (EoE) is a recently recognized allergic/immune condition. A person with EoE will have inflammation or swelling of the esophagus.  This condition is becoming more common in recent years and can occur at any age.  For details about this condition, go to this link:

    https://www.aaaai.org/conditions-and-treatments/related-conditions/eosinophilic-esophagitis

  • Reflux can sometimes cause swallowing difficulties if left untreated or if not well controlled over time.  It can also lead to conditions such as Barrett’s Esophagus and Eosinophilic Esophagitis. 

 

Disclaimer:  This information is not intended to replace seeing a medical professional in person.  If you believe that you or your loved one requires medical attention or an evaluation by a therapist, you should call the appropriate professional as soon as possible.