What is Dysphagia?

Dysphagia is the difficulty in swallowing. It results from a problem involving any of the muscles or nerves that control the act of swallowing, making it harder to drink or swallow food.

There are many different types of dysphagia, several of which are categorized as follows:

• Oral dysphagia (high dysphagia), by disorder in the mouth
• Pharyngeal dysphagia, a disorder in the throat
• Esophageal dysphagia (low dysphagia), caused by an esophagus or food pipe malfunction
• Note that there is a different condition known as odynophagia, which refers to the pain that accompanies swallowing. These conditions may or may not happen together. There is also a different sensation referred to as a Globus, in which the patient thinks something is caught in their throat.

What are the symptoms of dysphagia?

The following symptoms may be associated with dysphagia:

• Discomfort when swallowing.
• Being unable to swallow.
• Having the sensation that food is lodged behind the breastbone, in the chest, or in the neck.
• Drooling.
• A hoarse voice.
• Reproduction of food is known as regurgitation.
• Heartburn that occurs frequently.
• Backflow of food or stomach acid into the throat.
• Reduction of weight.
• When swallowing, coughing, or choking.

What causes dysphagia?

Swallowing is quite complex as it involves many muscles and nerves. Dysphagia can be brought on by any illness that weakens or destroys these muscles and nerves or narrows the esophagus or back of the neck.

In general, dysphagia can be classified into one of the following groups:

Esophageal dysphagia

Esophageal dysphagia is when food sticks or gets caught at the base of the throat or in the chest after swallowing starts. Some reasons for esophageal dysphagia are as follows:

• Achalasia: Achalasia is an illness that creates difficulty in swallowing. Damaged nerves or muscles make squeezing food and liquid into the stomach tough for the esophagus. Achalasia often worsens with time.
• Esophageal spasm: This condition results in high-pressure, poorly coordinated contractions of the esophagus, typically after swallowing. Esophageal spasm invades the involuntary muscles in the walls of the lower esophagus.
• A narrowed esophagus: A constricted esophagus, often known as a stricture, might catch big food particles. Narrowing may result from tumors or scar tissue, which are frequently brought on by gastroesophageal reflux disease (GERD).
• Esophageal tumors: If a tumor is present in the esophagus, the feeling of swallowing difficulty tends to be worse at first and worsen with time. The tumor can continue to slowly strangle the esophagus.
• Foreign bodies: At times, food or another object may lodge partially in the throat or esophagus. Older adults with dentures and trouble chewing may be especially prone to having some food caught in the throat or esophagus.
• Esophageal ring: A thin area of narrowing in the lower esophagus can sometimes cause trouble swallowing solid foods.
• GERD: Stomach acid refluxing into the esophagus can damage the tissues in the esophagus, resulting in spasms, scarring, and narrowing of the lower esophagus.
• Eosinophilic esophagitis: Eosinophilic esophagitis is an immune system disease. It occurs when white blood cells, known as eosinophils, accumulate in the esophagus.
• Scleroderma: Scleroderma leads to the formation of scar-like tissue, which causes tissues to become stiff and hard. This can compromise the lower esophageal sphincter. Acid flows back into the esophagus, causing frequent heartburn.
• Radiation therapy: This cancer treatment can cause inflammation and scarring of the esophagus.

Oropharyngeal dysphagia

Certain conditions may weaken the throat muscles, making pushing food from the mouth into the throat and then down into the esophagus difficult. Someone might choke or gag attempting to swallow, or food or fluids can go down the windpipe, known as the trachea, or up the nose. This can cause pneumonia.

Causes of oropharyngeal dysphagia include:

• Neurological disorders: Some conditions, including multiple sclerosis, muscular dystrophy and Parkinson's disease — cause dysphagia.
• Neurological damage: Sudden neurological damage, including a stroke or brain and/or spinal cord injury, impacts the individual's ability to swallow.
• Pharyngoesophageal diverticulum, also called Zenker diverticulum: It is a small pouch, also called a diverticulum, that forms and collects food particles in the throat, often right above the esophagus. This leads to difficulty swallowing, gurgling sounds, bad breath, and repeated throat clearing or coughing.
• Cancer: Some cancer types and therapies, such as radiation, may cause difficulty swallowing.

What increases the risk of developing dysphagia?

Aging does not cause dysphagia, but it is a major risk factor. Muscle deteriorates as we age, making us more susceptible to injury. As one age, the likelihood of acquiring numerous neurological disorders linked to dysphagia rises.

How is dysphagia diagnosed?

A clinician may begin diagnosing dysphagia by inquiring about symptoms, duration of symptoms, and if swallowing liquids, solids, or both is affected.

They might advise someone to have the following tests to identify the kind of dysphagia and its underlying cause:

• A swallow study, which tests various food and liquid consistencies
• An endoscopy enables medical professionals to view inside the throat and esophagus. A barium swallow test entails swallowing a fluid that is subsequently visible on an X-ray.
• Manometry, which gauges pressure changes brought on by muscular contractions
• A biopsy, which entails removing a small sample of tissue for laboratory analysis

A medical practitioner could recommend an expert, like a speech-language pathologist, to determine the specific problem.

How is dysphagia treated?

Treatment for dysphagia depends on the type and cause of the condition and may involve a range of strategies to improve symptoms and quality of life. These may include:

• Swallowing rehabilitation, education on how to swallow, along with muscle exercises with a speech-language therapist, diet modification,
• Blending foods and eating more liquefied foods makes them easier to swallow and can be carried out by stimulating temperature.
• Massage or electricity on the tongue or on the soft palate in cases involving neurological conditions can be used to fit dentures so that the difficulty in chewing is minimized, which eventually promotes swallowing.
• Mental health support, if dysphagia is impacting a person's mental health or anxiety, may be causing it.

Doctors will also work to treat the underlying cause if they find one. This may include:

• Medications to control chronic conditions and their symptoms
• Changing a person's current medications if they are contributing to dysphagia
• Surgery to correct structural problems, such as dilation of a narrow esophagus or removal of an obstruction
• Having chemotherapy or radiation treatments for cancer

If a patient is not responding to treatment, then they might need a feeding tube to prevent malnutrition or dehydration. A feeding tube is used to feed and hydrate the body and administer medications into a patient's stomach or intestines.

A person may have a nasal tube, which goes through the nose and into the stomach, or a gastrostomy, which goes directly into the stomach through a small incision in the skin.

What are the complications of not treating dysphagia?

If left untreated, dysphagia can cause major health problems and even death. Among the risks are:

• Dehydration.
• Malnourishment.
• Choking.
• Aspiration pneumonia and silent aspiration.
• Survivors of stroke are more vulnerable to silent aspiration.

Silent aspiration occurs when food and liquid go into your lungs, but you don't cough, choke, or exhibit any other symptoms of a problem with swallowing. The foreign substance can cause pneumonia.

When to call the doctor about dysphagia?

Schedule an appointment with your doctor as soon as you feel that dysphagia isn't a one-time thing. Repeated dysphagia is bound to result from an underlying cause that may be diagnosed and managed by your doctor.
 
If you believe something has become stuck in your throat and you are experiencing difficulty breathing, you should go to the emergency department. Other symptoms of an emergency include sudden muscle weakness, paralysis, and difficulty swallowing. Seek immediate assistance.

Why Choose Tender Palm Super-Speciality Hospital for Dysphagia Treatment in Lucknow, India?

Tender Palm Super-Speciality Hospital offers advanced Dysphagia treatment in Lucknow, India, at an affordable cost. We have a team of experienced neurologists and speech-language pathologists who provide accurate diagnosis and both non-surgical and surgical treatment options including swallowing therapy, dietary modification, and endoscopic intervention procedures. Our Neurology and Speech Rehabilitation team has decades of experience in successfully treating Dysphagia in Lucknow, India.

To seek an Expert Consultation for Dysphagia Treatment in Lucknow, India:

Call us at +91-9076972161
Email at care@tenderpalm.com

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