Swallowing Difficulty

Difficulty with swallowing is the feeling that food or liquid is stuck in the throat or at any point before the food enters the stomach. This problem is also called dysphagia (Goldman’s Cecil Medicine, 24th edition, 2011). Dysphagia is usually a sign of a problem with your throat or your esophagus. Your esophagus is that muscular tube that moves food and liquids from the back of your mouth to your stomach.

The process of swallowing

Swallowing involves several steps. You take in food inside your mouth and if it’s solid, the chewing process starts. The food or liquid is then moved into the back of the mouth. It passes through the esophagus and the esophagus moves the food to the stomach. The muscles of the mouth, throat, and esophagus that are innervated by many nerves work together in the swallowing process. Sometimes, swallowing, like the swallowing of saliva, becomes automatic, without you being aware of the process.

Is difficulty with swallowing always considered a sickness?

Swallowing difficulty can be benign. In other words, if you have dysphagia on a single episode or twice probably you do not have a medical problem. Thus swallowing difficulty can be non-problematic or just a minor problem.

When does swallowing difficulty considered a medical problem?

If you have trouble swallowing on a regular basis, you may have a serious problem that needs treatment. Swallowing difficulty can be caused by nerve disorder whereby alteration in the fine balance in the muscles of the mouth and throat is affected. Persons who had stroke and spinal cord injury may suffer from dysphagia. Other problems in the nervous system that can cause swallowing difficulty are: Parkinson’s Disease, Multiple Sclerosis, and post-polio syndrome, to name a few.

Gastroesphageal Reflux Disease (GERD) wherein stomach acid backs up regularly into your esophagus can cause swallowing difficulty. Esophagitis or inflammation of the esophagus is another. Tumors or masses that press on your esophagus may be cancerous or not cancerous. Sometimes they are just lymph nodes outside the esophagus or bone spurs on the neck vertebra that result from arthritis or degenerative changes.

Symptoms and Tests

Swallowing difficulty may be felt as chest pain, chest heaviness, feeling of pressure in the neck, cough or high pitch breathing that is similar to asthma, nausea, sour taste in the mouth, or heartburn. You may have problems in eating or drinking, or only with certain types of foods or liquids. Difficulty in eating very hot or cold foods, dry crackers or bread, meat, or chicken may be an early sign of swallowing problems. Barium swallow and other swallowing x-rays may be necessary. CAT scan can be requested. Biopsy of a mass or tumor is paramount for a definitive diagnosis.