Dysphagia
Tampa General Hospital’s Digestive Diseases Institute skillfully treats dysphagia (difficulty swallowing). In some cases, individuals with dysphagia even have trouble swallowing their own saliva. Dysphagia is relatively common, with the American Speech-Language Hearing Association (ASHA)* reporting that approximately one in 25 adults experiences a swallowing problem each year in the United States.
Types of Dysphagia
The act of swallowing requires the mouth, throat and esophagus to work together, and the medical community classifies dysphagia into the following types depending on which of those components is making it difficult or even impossible to swallow.
Oral Dysphagia
Your jaw, teeth, tongue and saliva play an important role in the swallowing process, since they help you chew and break down food before it enters your throat. When something in your mouth makes it difficult to swallow, it’s known as oral dysphagia.
Oropharyngeal Dysphagia/Transfer Dysphagia
Once you’re ready to swallow the food, beverage or saliva in your mouth, your tongue pushes it to the back of your throat (pharynx). Your voice box (larynx) also closes to keep anything from accidentally entering your airway (trachea) as it travels to your esophagus. When an issue affecting your throat makes it difficult for you to initiate the swallowing process, it’s referred to as either oropharyngeal dysphagia or transfer dysphagia.
Esophageal Dysphagia
After the item that you’re trying to swallow leaves your throat and enters your esophagus, your esophageal muscles contract and relax, producing a wave-like motion (peristalsis) that helps force the object down toward your stomach. If your swallowing issues result from an inability to pass food through your esophagus, it’s known as esophageal dysphagia.
Esophagogastric Dysphagia
Once your food, beverage or saliva travels through your esophagus, a band of muscle located at the bottom of your esophagus (your lower esophageal sphincter) must open so that the item can move into your stomach. If the object you’re trying to digest can’t easily make it through this passageway, it’s referred to as esophagogastric dysphagia.
Paraesophageal Dysphagia
Paraesophageal dysphagia occurs when something—for example, a nerve or tendon—rubs against or exerts pressure on the esophagus, making it difficult to swallow.
Causes and Risk Factors of Dysphagia
Dysphagia has numerous potential causes, including:
- Muscular disorders such as achalasia, cricopharyngeal spasms, esophageal spasms, muscular dystrophy, myasthenia gravis, myositis and scleroderma
- Neurological disorders such as amyotrophic lateral sclerosis (ALS), brain tumors, cerebral palsy, dementia, multiple sclerosis (MS) and Parkinson’s disease
- Neurological trauma from a stroke or a spinal cord injury
- Pain and inflammation caused by infections such as strep throat
- Physical blockages and structural issues that cause the throat or esophagus to tighten or narrow, including Barrett’s esophagus, cancerous tumors, eosinophilic esophagitis, esophageal diverticulum, esophageal rings and webs, esophageal strictures and scar tissue
Being at an advanced age can increase your risk of developing dysphagia, since older people tend to have a higher chance of experiencing many of the conditions listed above. Plus, the natural aging process causes muscle to deteriorate and become more vulnerable to injury. Individuals with gastroesophageal reflux disease (GERD) also have an increased risk of developing dysphagia because repeated exposure to stomach acid can cause scarring within the esophagus, which in turn makes the tube narrower.
Signs and Symptoms of Dysphagia
The hallmark symptom of dysphagia is difficulty swallowing, but this may be accompanied by:
- Pain
- Feeling like something is stuck in your throat or chest
- Acid reflux
- Heartburn
- Hoarseness
- Coughing
- Gagging
- Drooling
- Regurgitation
- Unexplained weight loss
If you’re regularly experiencing symptoms like these, it’s important to promptly seek treatment, since dysphagia can sometimes be a sign of a serious condition like cancer or a stroke. Failing to properly treat dysphagia can also lead to complications such as choking, dehydration, malnutrition and pneumonia.
Diagnosing Dysphagia
When you visit a doctor for the symptoms described above, they’ll likely perform a physical examination and ask you about your medical history and the issues you’ve been experiencing. Further testing for dysphagia may involve:
- Computed tomography (CT) scan
- Dynamic swallowing study
- Esophageal manometry
- Esophagoduodenoscopy
- Esophagram
- Fiberoptic endoscopic evaluation of swallowing (FEES)
- Laryngoscopy
- Magnetic resonance imaging (MRI) scan
- Upper endoscopy
- X-ray
Dysphagia Treatment
The best treatment for dysphagia will vary from one person to another depending on what’s making it difficult to swallow and how severe that difficulty is. For example, dysphagia treatment may involve:
- Implementing lifestyle changes such as eating softer foods, taking smaller bites, chewing food more thoroughly, changing your posture when eating and avoiding overly hot or cold foods and beverages
- Performing exercises that could make it easier for you to swallow
- Taking medication
- Receiving BOTOX® injections
- Undergoing surgery
- Using a feeding tube
TGH’s Approach to Treating Dysphagia
Tampa General Hospital’s Digestive Diseases Institute is a top choice for dysphagia treatment and it’s no wonder why. We operate the Joy McCann Culverhouse Center for Swallowing Disorders, a national and international referral center for the most complex swallowing disorders that’s one of only a few endowed swallowing centers in the United States. In addition, our GERD and Esophageal Surgery Center offers tertiary and quaternary esophageal care, meaning we can treat the most complex cases. Our multidisciplinary team’s commitment to always delivering the highest level of service has helped us earn recognition from U.S. News & World Report as one of the best hospitals for Gastroenterology and GI Surgery for 2023-24.
If you’re experiencing the dysphagia symptoms described above, don’t wait to get the care you need—contact Tampa General Hospital today at (800) 822-3627 and request a consultation at our Tampa, FL, treatment center. When you come in, we’ll ask you about your medical history and any issues you’ve been experiencing, perform an examination and any necessary diagnostic tests and recommend a course of treatment that’s tailored to your specific needs.