Difficulty Swallowing

I’m Having Difficulty Swallowing.

Difficulty in swallowing (dysphagia) is common among all age groups, especially the elderly. Problems with swallowing which is a very complex set of functions is fairly wide ranging and can be grouped in multiple ways such as the location of the problem (oral, pharyngeal, esophageal), the nature of the problem (functional or obstructive), by chronicity (acute, subacute, or chronic), or to substance (solid, liquid, pills, or dry swallowing).  There may be associated hoarseness, cough, ear pain, and rarely drooling when one cannot even handle their own saliva.

For severe or prolonged swallowing difficulty, you should see a doctor.  An otolaryngologist can examine your throat and sometimes your esophagus to better understand the nature of the problem.  Sometimes they will be able to visualize the source of the problem; if not, tests can be ordered that will help further define what the cause is.  Treatment varies based on the diagnosis.  Common treatments include medications, swallowing rehabilitation, stretching or dilation, and sometimes surgery.

Any interruption in the swallowing process can cause difficulties. Eating slowly and chewing thoroughly can help reduce problems with swallowing. However, difficulties may be due to a range of other causes, including something as simple as poor teeth, ill fitting dentures, or a common cold. One of the most common causes of dysphagia is gastro esophageal reflux. This occurs when stomach acid moves up the esophagus to the pharynx, causing discomfort. Other causes may include: hypertension; diabetes; thyroid disease; stroke; progressive neurologic disorder; the presence of a tracheotomy tube; a paralyzed or unmoving vocal cord; a tumor in the mouth, throat, or esophagus; or surgery in the head, neck, or esophageal areas.

Some patients with swallowing disorders have difficulty feeding themselves. An occupational therapist or a speech language pathologist can aid the patient and family in feeding techniques. These techniques make the patient as independent as possible. A dietician or nutritional expert can determine the amount of food or liquid necessary to sustain an individual and whether supplements are necessary.

When swallowing cannot be adequately managed, a feeding tube may be needed, if only temporarily.