Dysphagia
Dysphagia is a medical term that refers to difficulty swallowing, affecting the throat or esophagus. Individuals with dysphagia may experience prolonged effort and discomfort while swallowing, and in severe cases, may be unable to swallow at all. This condition can manifest through various symptoms, including the sensation of food being stuck in the throat or chest, drooling, hoarseness, coughing, and regurgitation. Dysphagia can occur at any age but is more prevalent in infants and older adults, as well as in individuals with neurological disorders or other health issues.
There are two primary types of dysphagia: esophageal dysphagia, which relates to problems in the esophagus, and oropharyngeal dysphagia, which involves weakness in the throat muscles. The causes of dysphagia can range from esophageal conditions, such as gastroesophageal reflux disease and tumors, to neurological issues, like stroke or multiple sclerosis. Treatment options vary based on the underlying cause and may include muscle strengthening exercises, medications, or surgical interventions. In severe cases, patients may need to rely on liquid diets or feeding tubes to ensure proper nutrition and hydration.
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Dysphagia
Dysphagia is a medical term used to describe difficulty swallowing. It usually affects the throat or the esophagus. A person with dysphagia takes more time and puts more effort into the act of swallowing, or moving food or liquid from the mouth to the stomach. Some patients with dysphagia experience pain while swallowing. In severe cases, a person cannot swallow at all. Though dysphagia can occur at any age, it is most common in infants and older adults. Individuals with brain or nervous system problems may also be affected. Causes of this condition vary, with treatment dependent upon the cause. Persistent dysphagia can indicate a serious medical problem.
Causes and Symptoms
Individuals with dysphagia can exhibit a number of symptoms depending on the source of the issue. The primary symptom is difficulty and pain when swallowing, sometimes leaving patients unable to swallow at all. Patients have also felt like food is stuck in their throats or chests. Drooling and hoarseness can occur as well as coughing and gagging. Frequent regurgitation and heartburn often coincide due to stomach acid backup. These symptoms can inadvertently cause weight loss. Symptoms of dysphagia can lead to more severe issues if left untreated. Dysphagia can make it difficult to get the proper amount of nourishment and fluids, leading to malnutrition and dehydration. In some cases, improper functioning of the throat and esophageal muscles can cause food to enter a person’s airway, leading to respiratory problems such as pneumonia or infection.
Dysphagia falls into two categories: esophageal dysphagia and oropharyngeal dysphagia. Esophageal dysphagia affects the esophagus and is characterized by patients feeling as though food is stuck in their throats or chests after swallowing. Oropharyngeal dysphagia usually involves a weakening of the throat muscles that makes it difficult to move food from the mouth to the stomach.
The esophagus is also referred to as the food pipe or gullet. Food passes through the esophagus after being chewed and swallowed, and is then carried to the stomach. Contractions in the esophagus help the food travel down the diaphragm, which separates the abdomen from the lungs, to the stomach. Any malfunction of the esophagus can lead to difficulty swallowing. A number of esophageal conditions can cause esophageal dysphagia.
When the lower muscle of the esophagus fails to relax properly, food cannot enter the stomach and comes back up to the throat. This condition can lead to esophageal wall muscle weakening, which can worsen if not treated. The esophagus can also suffer irregular spasms that lead to poor digestion. If the esophagus somehow becomes narrowed, often due to tumors or scar tissue, large pieces of food can become trapped in the tube. When something becomes lodged in the throat or esophagus, swallowing becomes difficult if not impossible.
Certain ailments can also lead to dysphagia. Gastroesophageal reflux disease occurs when stomach acid backs up into the esophagus, damaging the tissues of the esophagus. Stomach acid backup also occurs with scleroderma, a condition in which the lower esophagus develops scar tissue and hardens. Eosinophilic esophagitis is a condition in which the esophagus becomes inflamed as a result of a food allergy or a surplus of white blood cells in the esophagus. Inflammation narrows the food pipe, making swallowing problematic. Esophageal inflammation can also be caused by radiation therapy used in cancer treatments.
Oropharyngeal dysphagia occurs when the throat muscles are weakened by certain conditions. Weak throat muscles make moving food into the esophagus difficult when swallowing. The weakness may cause choking, gagging, or coughing. Food can also go down a patient’s trachea (windpipe) or up his or her nose, leading to pneumonia.
Conditions that can lead to oropharyngeal dysphagia include neurological disorders, neurological damage, and cancer. Neurological disorders such as multiple sclerosis, muscular dystrophy, and Parkinson’s disease, which disrupt muscle function, can cause dysphagia. Brain and spinal cord injuries as well as stroke can cause neurological damage that affects a person’s ability to swallow. A throat disorder called pharyngeal diverticula can also lead to swallowing difficulties. This disorder causes small pouches that collect food particles to form in a person’s throat.
Treatment
Treatment for dysphagia depends on what is causing a person’s swallowing difficulty. With oropharyngeal dysphagia, the issue is a muscular one. Treatment must focus on strengthening the throat muscles or stimulating the nerves that activate the swallowing reflex. Speech therapists or occupational therapists can assist patients in learning how to strengthen these muscles and improve their swallowing technique to ensure effective swallowing.
For esophageal dysphagia, doctors can physically dilate the esophagus with an instrument called an endoscope, which is pushed down the esophagus with a special attachment that stretches and widens the tube. Patients with tumors or pharyngeal diverticula may benefit from surgery that unblocks the esophageal pathway. Dysphagia caused by gastroesophageal reflux disease can be treated with prescription oral medications that reduce stomach acid. Doctors encourage patient’s with stomach acid issues to avoid alcohol, tobacco, and caffeine. Medications can also ease esophageal spasms and any discomfort associated with them.
In severe cases, dysphagia can prevent a person from being able to eat or drink properly. Doctors will often recommend liquid diets to help maintain weight and hydration for these patients. Some extreme cases require a feeding tube, which bypasses the area causing swallowing difficulties.
Bibliography
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"Dysphagia." Mayo Clinic, www.mayoclinic.org/diseases-conditions/dysphagia/basics/definition/con-20033444. Accessed 8 Jan. 2016.
"Dysphagia." National Institute on Deafness and Other Communication Disorders, US Department of Health and Human Services, 6 Mar. 2017, www.nidcd.nih.gov/health/dysphagia. Accessed 21 Feb. 2018.
"Swallowing Disorders (Dysphagia) in Adults." American Speech-Language-Hearing Association, www.asha.org/public/speech/swallowing/Swallowing-Disorders-in-Adults/. Accessed 8 Jan. 2016.
"Swallowing Problems (Dysphagia)." Stanford Children's Health, www.stanfordchildrens.org/en/topic/default?id=dysphagia-90-P01991. Accessed 21 Feb. 2018.