Dysphagia is the medical term for difficulty swallowing. People with this symptom have difficulty swallowing liquids, solids, or both. Some also experience pain, or odynophagia, at the same time.

Although some people often regard dysphagia as a symptom, doctors sometimes use the term to describe a condition in its own right.

There is a wide range of potential causes of dysphagia. If it only happens once or twice, there is probably no serious underlying problem, but if it occurs regularly, a person should contact a doctor.

This article discusses the various causes, symptoms, diagnosis, and potential treatments of dysphagia.

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Dysphagia is difficulty swallowing. It occurs due to a problem with any of the muscles or nerves that control swallowing, making it more difficult to swallow food or drink.

There are several types of dysphagia:

  • oral dysphagia (high dysphagia), which occurs due to a problem in the mouth
  • pharyngeal dysphagia, which occurs due to a problem in the throat
  • esophageal dysphagia (low dysphagia), which occurs due to a problem in the esophagus, or food pipe.

It is worth noting that pain when swallowing (odynophagia) is different from dysphagia, but it is possible to have both at the same time. A globus sensation is when a person feels as though there is something stuck in the throat.

There are many possible causes of dysphagia, including:

Dry mouth

A dry mouth, or xerostomia, can make it harder to swallow. Potential causesTrusted Source of dry mouth include:

Inflammation or infection

Swelling of the mouth, throat, or esophagus can cause dysphagia. This may occur due to infections, allergic reactions, or irritation from other causes.

Eosinophilic esophagitis is a rare and chronic form of inflammation that may occur due to allergies or an immune reaction.

Gastroesophageal reflux disease

Esophagitis, or inflammation of the esophagus, can also occur due to gastroesophageal reflux disease (GERD). This causes frequent acid reflux, which is when stomach acid moves back upward into the esophagus.

GERD can also cause narrowing of the esophagus, or strictures, which can obstruct swallowing.

Physical differences or obstructions

Physical differences in the size or structure of the mouth, throat, or esophagus can lead to problems swallowing. Examples includeTrusted Source:

  • large tonsils
  • cleft lip or palate, which occurs when bones in the head do not fuse properly, leaving a gap
  • esophageal webs, which are thin membranes of tissue that partially or fully block the esophagus
  • Zenker’s diverticulum, which is a pouch that can form in the throat

Tumors, which may be cancerous or noncancerous, can also obstruct swallowing.

Brain injury or stroke

Any condition that damages the part of the brain responsible for controlling swallowing can potentially leadTrusted Source to dysphagia.

A stroke can cause dysphagia if reduced blood flow affects these cells, either due to a blood clot, plaques, or a bleed. However, most people with dysphagia due to a stroke regain the ability to swallow in 1 to 2 weeksTrusted Source.

Neurodegenerative conditions

These conditions cause a gradual and progressive deterioration in nerve and brain function. Examples include:

Other autoimmune diseases

Autoimmune conditions occur when the immune system mistakenly attacks healthy tissues, resulting in symptoms. Autoimmune diseases that can affect swallowing include:

  • multiple sclerosis (MS), which involves damage to the myelin surrounding nerves
  • myasthenia gravis, which damages the junction between nerves and muscles
  • systemic lupus, which can affect many parts of the body
  • scleroderma, which is a group of rare diseases that cause the skin and connective tissues to harden or tighten

Symptoms of dysphagia can includeTrusted Source:

  • having to try to swallow repeatedly
  • a delay in swallowing
  • coughing or gagging when swallowing
  • a feeling of something being “stuck” in the throat or chest
  • food or stomach acid backing up into the throat
  • a sore throat
  • unpleasant breath

Depending on the cause, some people may also have difficulty controlling saliva and closing their mouth and may take longer to eat meals.

Some people have dysphagia and are unaware of it. In these situations, it may remain undiagnosed and a person may not receive treatment.

The risk factors for dysphagia includeTrusted Source:

  • older age
  • staying in hospital
  • being in intensive care, particularly if a person requires intubation

Potential complications of dysphagia can includeTrusted Source:

  • Infections: Aspiration pneumonia can occur if a person swallows something that goes down the “wrong way,” allowing food or drink to enter the lungs. This can lead to infection.
  • Malnutrition: If a person cannot swallow properly, they may not consume enough nutrients or calories. This is especially pertinent when people are not aware of their dysphagia and not receiving treatment.
  • Dehydration: If an individual cannot drink properly, they may not be taking in sufficient fluids, leading to dehydration.
  • Isolation or embarrassment: Some people may experience embarrassment because of dysphagia and avoid social activities involving food or drink.

Sometimes, an inability to swallow may lead to food becoming impacted, which raises the risk of a perforation, or hole, in the esophagus. This can cause sepsis and can be fatal.

To diagnose dysphagia, a doctor may start by asking about symptoms, how long a person has had them, and whether they affect the swallowing of liquids, solids, or both.

To determine the type of dysphagia and underlying cause, they may recommend a person undergoes:

  • a swallow study, which involves testing different consistencies of food and liquid
  • a barium swallow test, which involves swallowing a fluid that then shows up on an X-ray
  • an endoscopy, which allows doctors to see inside the throat and esophagus
  • manometry, which measures pressure changes due to muscle contractions
  • a biopsy, which involves taking a small sample of tissue to test in a laboratory

A healthcare professional may refer someone to a specialist, such as a speech-language pathologist, to identify the specific problem.

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 includeTrusted Source:

  • swallowing rehabiliation, which involves learning swallowing techniques and strengthening muscles with a speech-language therapist
  • dietary changes, such as blending foods or eating more liquid foods, which may make them easier to swallow
  • stimulation of the tongue or soft palate with temperature, massage, or electricity, which may help people with neurological conditions
  • dental work, such as fitting dentures, if this could help with chewing and swallowing
  • mental health support, if dysphagia is affecting a person’s emotional well-being, or anxiety may be contributing to it

Doctors will also aim to treat the underlying cause, if they identify one. This may involve:

  • taking medications to manage chronic conditions and reduce their symptoms
  • adjusting a person’s existing medications if they are causing dysphagia
  • having surgery to address structural problems, such as dilation of a narrow esophagus or the removal of an obstruction
  • having cancer treatments, such as chemotherapy or radiation therapy

If a person does not respond to treatment, they may need to use a feeding tube in order to avoid malnutrition or dehydration. A feeding tube delivers nutrition, hydration, and medication directly to a person’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.

Dysphagia, or difficulty swallowing, can occur for many reasons, from dry mouth and medication side effects to autoimmune diseases and cancer.

People with dysphagia may find they have to repeatedly try to swallow, that their swallowing is delayed, or they experience other symptoms, such as coughing or a globus sensation.

Although difficulty swallowing is more common in older adults, it is not a typical part of aging. Anyone who has persistent dysphagia should speak with a doctor as soon as they can.