Dysphagia

Dysphagia is the medical term for difficulty swallowing.  Dysphasia is usually a sign that there is a problem with your esophagus, the muscular tube that moves food and liquids from the back of your mouth to your stomach.

If dysphagia is severe, you may not be able to take in enough fluids and calories to stay healthy. In severe cases, even saliva is difficult to swallow. Complications may include aspiration pneumonia (when food or liquids are pulled into your lungs), malnutrition, dehydration, weight loss and airway blockage.

Anyone can have dysphagia, but it is more common in older adults, babies and people who have brain or nervous system conditions.

There are two types of dysphagia (diss-PHASE-yee-ah):

  • Esophageal (ah-soff-a-GEE-el) dysphagia — Caused by narrowing of the esophagus or a disruption in normal esophageal movement.
  • Orophargyneal (ora-far-rah-GEE-el) dysphagia — Caused by problems getting food from the mouth into the upper esophagus. Neurological conditions such as a stroke or Parkinson’s disease are frequently to flame. Inflammation or cancer of the mouth also can lead to this condition. 

Cause

When food and liquids have trouble moving from your mouth to your stomach, there are usually two types of problems:

  • The muscles and nerves that help move food through the throat and esophagus are not working properly. This can happen if you have had medical conditions such as a stroke, brain or spinal cord injury; certain nervous or immune system problems; or scleroderma. 
  • Something is blocking your throat or esophagus, which could happen if you have conditions such as gastroesophageal reflux disease (GERD), esophagitis, diverticula, esophageal tumors or masses outside the esophagus. 

Signs and Symptoms

Typical symptoms include:

  • Trouble swallowing
  • Coughing or choking with eating or drinking
  • Constant feeling of a lump in the throat
  • Pain with swallowing
  • Drooling
  • Recurrent pneumonia
  • Nasal sounding voice
  • Sensation of food sticking in the chest
  • Weight loss

Diagnosis

Dysphagia can be difficult to diagnose because it mimics other symptoms. That is why it is important to be seen by a skilled team of experts who are familiar with diagnosing and treating dysphagia. 

The University of Michigan Vocal Health Center team will ask you about your symptoms and medical history, and then do a thorough head and neck examination. During this process, we will also assess your vocal quality, vocal efficiency and speaking technique. 

We may need to conduct one or more tests, including:

  • X-rays
  • Laryngoscopy – This test looks at the back of your throat with a fiber-optic scope
  • Upper gastrointestinal endoscopy – During this test, also referred to as an “upper GI,” a small scope will be placed in your mouth and down your throat to look at your esophagus and perhaps your stomach and upper intestines. Sometimes, a small piece of tissue is removed for a biopsy (a test that checks for inflammation or cancer cells). 
  • Manometry
  • pH monitoring

Treatment

The treatment for dysphagia depends upon what is causing the problem. We have options such as: 

  • Endoscopic dilation – In this procedure, the esophagus is gradually stretched using special dilators or a balloon inserted through an endoscope and then inflated. Surgery or radiation therapy may be necessary to treat esophageal tumors that have narrowed the esophagus.
  • Endoscopy – A long, thin scope can be used to remove an object that is stuck in your esophagus.
  • Food and liquid changes – We may recommend foods and liquids with textures that are safer and easier for you to swallow.
  • Speech-language-voice therapy – This may involve special exercises, body positions and other techniques to improve your ability to swallow. 
  • Surgery – If you have a blockage of some sort, you may need surgery to remove it. 

Make an Appointment

Schedule an appointment by calling us at 734-936-8051.