In this article, we will discuss the various causes of dysphagia along with symptoms, diagnosis, and potential treatments. Dysphagia can be caused by a difficulty anywhere in the swallowing process. There are three general types of dysphagia:. Oral dysphagia high dysphagia — the problem is in the mouth, sometimes caused by tongue weakness after a stroke , difficulty chewing food, or problems transporting food from the mouth.
Pharyngeal dysphagia — the problem is in the throat. Esophageal dysphagia low dysphagia — the problem is in the esophagus. This is usually because of a blockage or irritation. Often, a surgical procedure is required.
It is worth noting that pain when swallowing odynophagia is different from dysphagia, but it is possible to have both at the same time. And, globus is the sensation of something being stuck in the throat. Possible causes of dysphagia include:. Amyotrophic lateral sclerosis — an incurable form of progressive neurodegeneration; over time, the nerves in the spine and brain progressively lose function. Achalasia — lower esophageal muscle does not relax enough to allow food into the stomach.
Stroke — brain cells die due to lack of oxygen because blood flow is reduced. If the brain cells that control swallowing are affected, it can cause dysphagia. Esophageal ring — a small portion of the esophagus narrows, preventing solid foods from passing through sometimes. Eosinophilic esophagitis — severely elevated levels of eosinophils a type of white blood cell in the esophagus. These eosinophils grow in an uncontrolled way and attack the gastrointestinal system, leading to vomiting and difficulty with swallowing food.
Multiple sclerosis — the central nervous system is attacked by the immune system, destroying myelin, which normally protects the nerves. Myasthenia gravis Goldflam disease — the muscles under voluntary control become easily tired and weak because there is a problem with how the nerves stimulate the contraction of muscles. Successful management requires multidisciplinary collaboration, accurate diagnostic workup and effective therapeutic strategies.
Treatments for dysphagia include occupational therapist or speech and language therapy to learn new swallowing techniques, using texture modified foods and thickened fluids, changing the consistency of food and liquids to make them safer to swallow and in sometimes other forms of feeding — such as tube feeding through the nose or stomach [ 10 , 12 ]. Treatment to rehabilitate swallowing function and compensation techniques are common pathways for managing some cases of dysphagia [ 10 , 11 ].
Surgery is used in patients who have some changes such as a tumor or diverticula blocking the pharynx or esophagus or patients who have a problem that affects the lower esophageal muscle. Dilation is used to expand any narrow areas of the esophagus [ 13 , 14 ]. If dysphagia is related to GERD or esophagitis, medicines may help prevent stomach acid from entering the esophagus. Infections in pharynx, larynx and esophagus are often treated with antibiotic medicines. Botox injection of cricopharyngeus muscle and esophagus is used to treat dysphagia in patients with underlying muscle spasm and hypertonicity [ 15 , 16 ].
The most common complications of dysphagia are pulmonary complications, dehydration and malnutrition. Other possible complications, such as social isolation, mental and emotional health issues or intellectual and body development deficit in children with dysphagia, have not been studied thoroughly.
The main pulmonary complications are aspiration pneumonia, toxic aspiration syndromes and pulmonary fibrosis [ 17 ]. Dysphagia is the medical term for the symptom of difficulty in swallowing. It is a common symptom in a wide group of patients. Patients with untreated dysphagia are at high risk of aspiration and malnutrition.
Thorough examination is important, and successful management requires multidisciplinary collaboration, accurate diagnostic workup and effective therapeutic strategies. The incidence and nature of dysphagia in these conditions is largely unknown. What are the stages of dysphagia? They include: Oral phase — sucking, chewing, and moving food or liquid into the throat.
Pharyngeal phase — starting the swallow and squeezing food down the throat. Esophageal phase — opening and closing the esophagus, or the tube that goes from the mouth to the stomach. How do I strengthen my swallowing muscles? As example, you may be asked to: Inhale and hold your breath very tightly. Pretend to gargle while holding your tongue back as far as possible.
Pretend to yawn while holding your tongue back as far as possible. Do a dry swallow, squeezing all of your swallowing muscles as tightly as you can. What is the difference between Odynophagia and dysphagia? Dysphagia and odynophagia are common disorders encountered by primary care physicians. Dysphagia is not a benign process and may cause dehydration, aspiration, nutritional deficiencies, or airway obstruction.
What causes weak swallowing muscles? Some neurological causes of dysphagia include: a stroke. What are the warning signs of esophageal cancer? Esophageal Cancer: Symptoms and Signs Difficulty and pain with swallowing, particularly when eating meat, bread, or raw vegetables.
Causes The following are some common causes of oropharyngeal dysphagia:. Diagnosis To diagnose the underlying cause of the dysphagia, a physician may perform any of the following tests:. Treatment Treatment for dysphagia mainly depends on the type or the underlying cause. For oropharyngeal dysphagia, a speech therapist may teach a patient exercises to coordinate the swallowing muscles or teach swallowing techniques.
Treatment for esophageal dysphagia may include esophageal dilation, surgery to remove esophageal tumor or diverticulum, or medication. Severe dysphagia may require the insertion of a feeding tube Coding and sequencing for dysphagia are dependent on the physician documentation in the medical record and application of the Official Coding Guidelines for inpatient care.
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