Dysphagia is the medical term used to refer to difficulty swallowing, a situation that is usually related to nervous system disorders, tumors, or esophageal diseases. Dysphagia implies that the process of moving food or liquids from the mouth to the stomach requires more time and effort than usual. Its prevalence in the general population is 6-9% and increases progressively with age, reaching 60% in older adults.
Dysphagia has great repercussions at the social and economic level since it affects a large number of people worldwide. In addition, it is associated with complications such as aspiration pneumonia, malnutrition, dehydration, and obstruction of the airway.
The main symptoms associated with dysphagia are:
- Pain when swallowing (odynophagia)
- Feeling that food gets stuck in the throat or chest, or behind the breastbone
- Return of food to the mouth (regurgitation)
- Thoracic pain
When determining the cause of dysphagia, it is useful to distinguish between the factors that mainly affect the pharynx (oropharyngeal dysphagia) and those that affect the esophagus and the esophagogastric junction (esophageal dysphagia). However, it is important to keep in mind that many disorders overlap and can produce both oropharyngeal and esophageal dysphagia.
There are certain conditions that can weaken the muscles of the throat, which difficult the passage of food from the mouth to the esophagus. This can cause the passage of the food bolus to the airway, which in many cases leads to the development of aspiration pneumonia.
The causes of oropharyngeal dysphagia include the following:
- Neurological disorders. Certain disorders, such as multiple sclerosis, Parkinson’s disease, dementia, and amyotrophic lateral sclerosis can cause dysphagia. Approximately 50% of patients with Parkinson’s disease have oropharyngeal dysphagia (1).
- Neurological damage. Sudden neurological damage, such as that caused by a stroke or a spinal cord injury, can affect the ability to swallow.
- Stroke is the main cause of oropharyngeal dysphagia. Stroke is the main cause of oropharyngeal dysphagia. Several studies show that approximately 55% of patients suffer from stroke oropharyngeal dysphagia, one-third of which develop aspiration pneumonia (2).
- Pharyngoesophageal diverticulum (Zenker’s diverticulum). Zenker’s diverticulum is a herniation of the esophageal mucosa through the muscles of the pharynx located on the posterior side of the junction between the esophagus and the pharynx.
- Neoplasia. Benign and malignant tumors located in the neck can make swallowing difficult. In addition, some oncological treatments, such as radiotherapy, can also cause dysphagia.
Esophageal dysphagia is characterized by the difficulty of passing food from the esophagus to the stomach. These are some of the causes of esophageal dysphagia:
- Achalasia. When the lower esophageal sphincter does not relax properly to allow food to enter the stomach, it can cause food to return to the throat. It is also possible that the esophageal muscles are weak, a condition that usually worsens with age.
- Diffuse spasm. This condition causes the esophagus to contract several times uncoordinated and with a lot of pressure, thus preventing the transport of food to the stomach.
- Esophageal stenosis. The narrowing (stenosis) of the esophagus makes it difficult to transport food to the stomach.
- Esophageal tumors. The difficulty to swallow tends to get worse progressively if there are esophageal tumors.
- Strange Bodies. Sometimes, food or other objects can obstruct, partially, the throat or esophagus. Older adults who have dentures and people who have trouble chewing food may be more likely to get a piece of food stuck in their throat or esophagus.
- Gastroesophageal reflux disease. Lesions to the esophageal tissues caused by stomach acid that recedes into the esophagus can cause spasm or scarring, as well as narrowing of the lower part of the esophagus.
- Eosinophilic esophagitis. This medical condition, which is usually related to a food allergy, causes chronic inflammation of the esophagus and prevents its proper functioning.
Dysphagia is a common symptom that is often indicative of an underlying disease that if not treated in time can lead to severe health problems. If you suffer from dysphagia it is important that you do not underestimate this symptom and consult your doctor as soon as possible. You must take proper precautions and receive proper treatment. To do this, you need a good team on your side. At Gastroenterology of Greater Orlando, we are experienced at diagnosing, treating, and preventing future issues with swallowing.. To learn more, you can visit https://dev-greaterorlandogi.pantheonsite.io