Dysphagia

Taking a sip of water or enjoying a meal is something most of us do without a second thought. But for some, this simple act can be a source of discomfort, pain, or even fear. If you find yourself coughing or choking, or feel like food is getting stuck, you may be experiencing Dysphagia.

Dysphagia is the medical term for difficulty swallowing. It’s important to understand that this is not a disease itself, but rather a symptom of an underlying medical condition. Because swallowing is so complex, a problem can occur at any point, from your mouth to your stomach. This guide will help you understand the causes, symptoms, and treatments.

What Is Dysphagia?

Dysphagia is any problem that affects your ability to move food or liquid from your mouth to your stomach. A normal swallow is a complex, high-speed process that involves over 50 pairs of muscles and many nerves. A breakdown anywhere in this chain can cause problems.

Doctors typically divide dysphagia into two main types, based on where the problem is:

1. Oropharyngeal Dysphagia: This is a problem in the mouth or the back of the throat (the pharynx). It’s often caused by nerve or muscle issues that make it hard to start the swallow. You may cough, choke, or gag right as you try to swallow.
2. Esophageal Dysphagia: This is a problem in the esophagus (the tube that carries food from your throat to your stomach). It’s often caused by a blockage or an irritation. This type feels like food getting stuck in throat or chest, long after you’ve swallowed.

Common Causes of Dysphagia

The cause of your difficulty swallowing will determine your treatment.

Common Causes of Oropharyngeal Dysphagia (Problem in the Throat)

This type is most often related to conditions that weaken or damage the muscles and nerves involved in swallowing.

• Neurological Conditions: According to the National Institute on Deafness and Other Communication Disorders (NIDCD), conditions like stroke, Parkinson’s disease, multiple sclerosis (MS), and amyotrophic lateral sclerosis (ALS) are major causes.
• Neurological Damage: A traumatic brain or spinal cord injury.
• Aging: Natural aging can lead to a general weakening of the swallowing muscles.

Common Causes of Esophageal Dysphagia (Problem in the Esophagus)

This type is usually caused by a blockage or a problem with the esophagus itself.

• Gastroesophageal Reflux Disease (GERD): This is a very common cause. Chronic acid reflux can damage the lining of the esophagus, causing scar tissue to form. This scar tissue can narrow the esophagus, creating a “stricture.”
• Eosinophilic Esophagitis (EoE): An immune system condition where high levels of white blood cells (eosinophils) cause inflammation in the esophagus.
• Achalasia: A rare disorder where the lower esophageal sphincter (the muscle at the bottom of the esophagus) fails to relax and let food into the stomach.
• Tumors: A growth in the esophagus, whether cancerous or benign, can physically block the passage of food.

Key Symptoms of Dysphagia

Symptoms can be obvious, but sometimes they are subtle. Pay attention if you experience:

• Pain while swallowing (known as odynophagia)
• Coughing, choking, or gagging when you eat or drink
• The sensation of food getting stuck in throat or chest
• A “gurgly” or wet-sounding voice after eating or drinking
• Drooling or being unable to control saliva
• Bringing food back up (regurgitation)
• Frequent heartburn
• Unexplained weight loss
• Recurring pneumonia (which can be a sign of aspiration)

Diagnosis: How Doctors Find the Cause

Because dysphagia is a symptom, your doctor’s main goal is to find the cause. You will likely be referred to a specialist, such as a gastroenterologist (GI doctor) or an otolaryngologist (ENT).

Common diagnostic tests include:

• Patient History: Your doctor will ask you key questions, like “Does it happen with solids, liquids, or both?” and “Where do you feel the food getting stuck?”
• Barium Swallow: You’ll drink a liquid containing barium, a contrast material that coats your esophagus. This allows a radiologist to watch your swallow in real-time on an X-ray.
• Endoscopy: A doctor passes a thin, flexible tube with a camera (an endoscope) down your throat. This allows them to see the inside of your esophagus and stomach, check for blockages or inflammation, and take a tissue sample (biopsy) if needed.
• Esophageal Manometry: A small tube is passed through your nose into your esophagus to measure the muscle contractions and pressure when you swallow. This is the best test for diagnosing motility disorders like achalasia.

Risk Factors

Your risk of developing dysphagia increases with:

• Age: Older adults are at the highest risk due to natural muscle weakening and a higher prevalence of conditions like stroke and Parkinson’s.
• Neurological Conditions: Having any condition that affects the nervous system.
• Untreated GERD: Chronic acid reflux is a major, controllable risk factor for esophageal strictures.

Treatment Options for Dysphagia

The dysphagia treatment plan depends entirely on the cause.

1. For Oropharyngeal Dysphagia (Nerve/Muscle Issues)

• Swallowing Therapy: This is the primary treatment. A Speech-Language Pathologist (SLP) is an expert in swallowing. They will teach you specific exercises to strengthen your swallowing muscles and techniques to help you swallow more safely (like the “chin tuck” method).
• Dietary Modification: This is a key management strategy. An SLP may recommend:
  • Thickening liquids: Using a thickening powder to make water, juice, or soup safer to swallow.
  • Changing food texture: Eating soft, pureed, or “easy-to-chew” foods.

2. For Esophageal Dysphagia (Blockage Issues)

• Esophageal Dilation: If you have a narrowed esophagus (stricture), a doctor can stretch it during an endoscopy using a special balloon.
• Medications:
  • Proton Pump Inhibitors (PPIs): For dysphagia caused by GERD, these medications reduce stomach acid.
  • Steroids: For Eosinophilic Esophagitis (EoE), swallowing a liquid or using a “puffed” steroid inhaler can reduce inflammation.
• Surgery: If the cause is a tumor or achalasia, surgery may be required to clear the blockage or relax the esophageal muscle.

Prevention Tips

While you cannot prevent neurological causes, you can reduce your risk for some of the most common esophageal issues:

• Manage GERD: If you have heartburn, talk to your doctor. You can help manage it by eating smaller meals, avoiding trigger foods (like spicy or fatty foods), and not lying down for at least 2-3 hours after eating.
• Eat Slowly: Take small bites and chew your food thoroughly before swallowing.

When to See a Doctor

Never ignore persistent difficulty swallowing. It is your body’s signal that something is wrong.

Make an appointment with your doctor if you regularly have trouble swallowing or experience any of the key symptoms listed above.

Go to the emergency room immediately if:

• An object is completely stuck in your throat and you are having trouble breathing.
• You are unable to swallow your own saliva.

A Serious Complication: Aspiration Pneumonia

One of the biggest dangers of dysphagia is aspiration pneumonia. This is a serious lung infection that occurs when food or liquid “goes down the wrong pipe” into your lungs. According to the American Lung Association, symptoms include fever, chest pain, and a worsening cough after eating. This is why getting a proper diagnosis and treatment is so important.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.

Published on July 31, 2023 and Last Updated on October 30, 2025 by: Priyank Pandey