Difficulty in swallowing (dysphagia) is common among all age groups, especially the elderly. The term dysphagia refers to the feeling of difficulty passing food or liquid from the mouth to the stomach. This may be caused by many factors, most of which are temporary and not threatening. Difficulties in swallowing rarely represent a more serious disease, such as a tumor or a progressive neurological disorder. When the difficulty does not clear up by itself in a short period of time, you should see an otolaryngologist—head and neck surgeon at Arkansas Otolaryngology Center in Little Rock.
What are the symptoms of swallowing disorders? Symptoms of swallowing disorders may include:
A feeling that food or liquid is sticking in the throat
Discomfort in the throat or chest (when gastro esophageal reflux is present)
A sensation of a foreign body or “lump” in the throat
Weight loss and inadequate nutrition due to prolonged or more significant problems with swallowing
Coughing or choking caused by bits of food, liquid, or saliva not passing easily during swallowing, and being sucked into the lungs
How are swallowing disorders diagnosed? When dysphagia is persistent and the cause is not apparent, the otolaryngologist—head and neck surgeon will discuss the history of your problem and examine your mouth and throat. This may be done with the aid of mirrors. Sometimes a small tube (flexible laryngoscope) is placed through the nose and the patient is then given food to eat while the scope is in place in the throat. These procedures provide visualization of the back of the tongue, throat, and larynx (voice box). These procedures are called FEES (Fiber optic Endoscopic Evaluation of Swallowing) or FEESST (Flexible Endoscopic Evaluation of Swallowing with Sensory Testing). If necessary, an examination of the esophagus, named TransNasal Esophagoscopy (TNE), may be carried out by the otolaryngologist. If you experience difficulty swallowing, it is important to seek treatment to avoid malnutrition and dehydration.
How are swallowing disorders treated? Many of these disorders can be treated with medication. Drugs that slow stomach acid production, muscle relaxants, and antacids are a few of the many medicines available. Treatment is tailored to the particular cause of the swallowing disorder.
Gastro esophageal reflux can often be treated by changing eating and living habits in these ways:
Eat a bland diet with smaller, more frequent meals.
Eliminate tobacco, alcohol and caffeine.
Reduce weight and stress.
Avoid food within three hours of bedtime.
Elevate the head of the bed at night.
If these don’t help, antacids between meals and at bedtime may provide relief.
Many swallowing disorders may be helped by direct swallowing therapy. A speech pathologist can provide special exercises for coordinating the swallowing muscles or stimulating the nerves that trigger the swallow reflex. Patients may also be taught simple ways to place food in the mouth or position the body and head to help the swallow occur successfully.
Some patients with swallowing disorders have difficulty feeding themselves. An occupational therapist or a speech-language pathologist can aid the patient and family in feeding techniques. These techniques make the patient as independent as possible. A dietician or nutritional expert can determine the amount of food or liquid necessary to sustain an individual and whether supplements are necessary.
What causes swallowing disorders? Any interruption in the swallowing process can cause difficulties. Eating slowly and chewing thoroughly can help reduce problems with swallowing. However, difficulties may be due to a range of other causes, including something as simple as poor teeth, ill fitting dentures, or a common cold. One of the most common causes of dysphagia is gastro esophageal reflux. This occurs when stomach acid moves up the esophagus to the pharynx, causing discomfort. Other causes may include: hypertension; diabetes; thyroid disease; stroke; progressive neurologic disorder; the presence of a tracheotomy tube; a paralyzed or unmoving vocal cord; a tumor in the mouth, throat, or esophagus; or surgery in the head, neck, or esophageal areas.
If you have a persistent problem swallowing, see an otolaryngologist—head and neck surgeon. Sometimes, the issues of swallowing may be attributed to something more complex, so seeing a specialist is important to get the correct diagnosis. Contact Arkansas Otolaryngology Center to schedule an appointment and evaluation.