Swallowing Disorders

Dysphagia, or difficulty swallowing, can have a significant impact on a person’s quality of life.   

WakeMed’s gastroenterologists can help patients determine what’s causing them to have problems with swallowing—whether it’s due to issues in the esophagus or neurological conditions that are impacting the way the muscles are supposed to work.

Symptoms of Swallowing Disorders

Dysphagia is more common in older adults (due to the natural progressive wear and tear on the esophagus), but can occur at any age. Symptoms include:

• Inability to swallow food
• Painful swallowing
• The feeling that food is getting stuck before it gets to the stomach
• Frequent coughing and choking
• Inability to control food and saliva in the mouth
• Regurgitation (food coming back up)
• Frequent heartburn
• Weight loss
• Recurring pneumonia 

Causes of Swallowing Disorders

Swallowing disorders usually fall into two categories:

• Esophageal dysphagia: Esophageal-related swallowing problems cause the feeling of food getting stuck in the throat, and can be caused by a number of structural issues in the esophagus.
• Oropharyngeal dysphagia: Generally caused by weakened throat muscles, this type can be related to neurological disorders as well as certain cancers. 

How Do you Diagnose Swallowing Disorders?

Occasional difficulty swallowing generally isn’t a cause for concern, but if it’s persistent, it’s time to see a doctor. Untreated, it can lead to weight loss, choking and pneumonia.

If you feel like you can’t breathe because of an obstruction, go to the nearest emergency department. 

When evaluating patients for swallowing disorders, our gastroenterologists start by taking a detailed patient history and a review of symptoms. Tests we may use to diagnose dysphagia can include:

• Endoscopic ultrasound, in which the gastroenterologist inserts a special endoscope (a thin flexible lighted tube with a camera on the tip) into the patient’s throat to look at the esophagus
• X-ray with contrast, where a patient drinks a special solution that highlights parts of the esophagus for the doctor to view
• Imaging scans, including either computed tomography (CT) or magnetic resonance imaging (MRI) scans
• Swallowing studies, which can help to pinpoint where and when the issues are happening 

How Do you Treat Swallowing Disorders?

Treatment varies depending on the type of dysphagia.

In oropharyngeal dysphagia, speech and swallowing therapy is generally the recommended treatment. Therapists can help patients with exercises to help them better coordinate their muscles, and learn how to place food and position their bodies for better swallowing.

In esophageal dysphagia, medical treatments may include:

• Medications—if the issue is related to GERD or muscle spasms, prescription medications may be able to help
• Esophageal dilation, in which the doctor stretches and expands the esophagus
• Surgery, in which a surgeon clears the esophageal path 

Eating food slowly and in small bites can also help both types of dysphagia, as well as making sure you’re sitting upright while eating and for fifteen minutes afterwards. In extreme cases, liquid diets or feeding tubes may be used.

Make an Appointment

If you or someone you care for is experiencing worrisome symptoms, we encourage you to make an appointment with one of our adult gastroenterologists, pediatric gastroenterologist or colorectal surgeons.