Dysphagia

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Dysphagia is defined as a swallowing disorder. Swallowing difficulty means the inability of a person to swallow food or drink with ease, which can result in choking, aspiration pneumonia, airway obstruction, malnutrition, dehydration, etc.   Read More

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Dysphagia

What is Dysphagia?

Dysphagia is defined as a swallowing disorder. Swallowing difficulty means the inability of a person to swallow food or drink with ease, which can result in choking, aspiration pneumonia, airway obstruction, malnutrition, dehydration, etc.  

Dysphagia
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What is dysphagia
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What are the phases of dysphagia?

Dysphagia typically falls into one of these types:

phases of dysphagia
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Esophageal Dysphagia

Esophageal dysphagia is when the person feels something is stuck in the throat. Some of the causes of this medical condition include:

  • Spasms in the lower esophagus
  • The feeling of tightness in the lower esophagus
  • Narrowing of the esophagus due to the growths or scarring
  • Foreign objects stuck in the throat
  • Narrowing of the esophagus due to GERD
  • Scar tissue formation in the esophagus as a result of post-radiation treatment

Oropharyngeal Dysphagia:

Oropharyngeal Dysphagia is caused due to disorders of nerves as well as muscles in the throat. This disorder usually weakens the muscles, thus making it very difficult for the person to eat or swallow without gagging. Some of the causes of this kind of dysphagia are:

  • Multiple sclerosis
  • Parkinson’s disease
  • Post-polio syndrome
  • Damage to nerves due to radiation therapy or surgery
  • Esophageal cancer
  • Head and neck cancer

Pharyngeal Dysphagia (Pharyngoesophageal Dysphagia):

A few of the issues caused in the throat by pharyngeal dysphagia are often due to neurological problems affecting the nerves, like Parkinson’s disease, stroke, or amyotrophic lateral sclerosis.

Causes

causes of dysphagia
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Some of the common dysphagia causes are as follows:

  • Acid reflux and GERD
  • Heartburn
  • Epiglottitis
  • Goiter
  • Esophagitis
  • Esophageal cancer
  • Stomach cancer or gastric adenocarcinoma
  • Herpes esophagitis
  • Recurrent herpes simplex labialis
  • Thyroid nodule
  • Infectious mononucleosis
  • Snake bites

What are the most common risk factors for dysphagia?

A few of the following risk factors for dysphagia are as follows:

Aging: Aging, usual wear and tear on the esophagus, and apart from that, greater risk of certain conditions like stroke and Parkinson’s disease, as well as adults who are aged are usually at higher risk of having difficulties in swallowing. However, dysphagia isn’t thought of as a typical indicator of the aging process.

Health conditions: People with a particular neurological condition or nervous system disorders are generally more prone to experience difficulty in swallowing food.

Symptoms

symptoms of dysphagia
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Some of the symptoms that are associated with dysphagia are as follows:

  • Pain while swallowing food (odynophagia)
  • Trouble in swallowing food
  • Sensation of food stuck in throat for days (sternum)
  • Drooling
  • Being very hoarse
  • Regurgitation
  • Frequent heartburn
  • Difficulty in swallowing saliva
  • Unexpected weight loss
  • Gastric acid refluxes
  • Coughing when swallowing
  • Gagging when swallowing

How is dysphagia diagnosed and treated?

The diagnosis and treatment procedures for dysphagia are as follows:

Diagnosis 

  • Physical examination– The doctor will examine the patient thoroughly during the physical examination. The doctor will look for any signs of abnormalities during the physical examination.
  • Medical and family history- The doctor will record the patient’s medical history. Patient’s history of any medications, history of any surgery, etc.
  • Barium x-ray scans- During this procedure, the patient is asked to drink barium solution that will coat the esophagus, making it easy for us to view during x-ray scans. 
  • Modified x-ray scansUpper endoscopy or esophagoduodenoscopy- During this procedure, a thin, flexible tube and a camera are inserted into the esophagus to look for abnormalities. 
  • Flexible laryngoscope- During this procedure, a scope is inserted into the nose and later into the throat and vocal cords to look for abnormalities.
  • FESS (Fibre-optic endoscopic evaluation of swallowing)- FESS is used to examine the throat as the person tries to swallow.
  • Manometry (esophageal muscle test)- During this procedure, a small tube is inserted into the esophagus and later connected to a pressure recorder to measure the muscle contractions of the esophagus when the person swallows.
  • Imaging scans- They include x-ray scans, CT scans, and MRI scans.

During the treatment:

  • Treatment for oropharyngeal dysphagia usually includes certain learning exercises to help coordinate the swallowing muscles and restimulate the nerves.
  • Special swallowing techniques are also taught to help compensate for oropharyngeal dysphagia.
  • The doctor might use a special balloon attached to expand the width of the esophagus for tight esophageal dysphagia.
  • The esophageal tumor might require surgery and medications to clear out the path of the esophagus.
  • Laparoscopic Heller Myotomy, Peroral Endoscopic Myotomy (POEM), Esophageal dilation, and stent placement of few of the surgical treatment procedures that the doctor suggests for dysphagia

Prognosis, Post-treatment, and Recovery:

  • Post-treatment medications will be prescribed either in a liquid form or will be advised to crush pills and have them.
  • The doctor will recommend follow-up if the patient has undergone a surgical procedure.
  • Recovery usually takes a month post-surgery for the patient to recover and return to normal life in case of severe dysphagia. 

What are the most common complications associated with dysphagia?

A few of the causes that arise due to difficulty in swallowing are:

  • Malnutrition, weight loss, and dehydration: The medical condition can make it difficult for the person to take in adequate nourishment and also fluids
  • Aspiration pneumonia: Food or liquid that is entering the airway, especially when the patient tries to swallow, can cause aspiration pneumonia since the food can introduce bacteria to the lungs
  • Choking: Choking can normally occur when the food gets stuck in the throat. However, if food completely blocks the airway, death can occur.

FAQ

What is the dysphagia diet plan?

Pureed pieces of bread, smooth puddings, and well-moistened mashed potatoes are the best diet for dysphagia.

What are dysphagia home treatment swallowing exercises?

Shaker Exercise, Hyoid Lift Maneuver, and Supraglottic Swallow are the best dysphagia home treatment swallowing exercises.

What is dysphagia lusoria?

Dysphagia lusoria is an abnormal medical condition that is characterized by difficulty in swallowing that is caused by an aberrant subclavian artery in the right.

What is the difference between odynophagia vs. dysphagia?

Dysphagia is generally the abnormal transit of solids or liquids, while on the other hand, odynophagia is pain that is caused during swallowing.

Why does it feel like something is stuck in my throat?

The muscle spasms caused due to GERD can make a person feel like something is stuck in their throat.

What are aspiration symptoms?

Feels like something is stuck in the throat and chest; the throat hurts when swallowing and causes difficulty swallowing saliva.

Can dysphagia be prevented?

Although dysphagia (swallowing difficulty) can’t be prevented, we can still reduce the risk of the occasional difficulty swallowing by chewing and eating food slowly, changing in eating habits, limiting alcohol and caffeine consumption, and eating more soft food than hard food.

What are the conditions that can cause swallowing difficulty?

The conditions that can cause swallowing difficulty are listed below:
a)       Muscle disorders
b)       Nervous system and brain disorders
c)       Scarring from acid refluxes
d)       Infection 
e)       Esophageal narrowing and blockages.

What kind of rehabilitation help with dysphagia?

Rehabilitation can help people suffering from dysphagia to a great extent. A few of them are listed below:
a)       Clearing the throat frequently
b)       Sitting upright while eating
c)       Changing our way of eating food and drinking
d)       Follow the exercises taught by the doctor to strengthen the swallowing muscles.