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Digestive health centre

Swallowing problems

Problems with swallowing are also known as dysphagia.

A person with swallowing problems may not be able to swallow at all, or may experience coughing, choking, a feeling of food being stuck in the throat or bringing food back up.

Over time, swallowing problems can cause weight loss and increase the risk of chest infections.

Causes of swallowing problems include:

How do I know if I have a swallowing problem?

Normally, individuals rarely choke during a meal. Occasionally, food will stick in the oesophagus for a few seconds (especially solid foods) but will pass spontaneously or can be washed down easily with liquids. However, there are a number of symptoms that require evaluation for a possible swallowing problem, including:

  • Frequent choking on food.
  • Hesitancy in food passage for more than a few seconds.
  • Pain when swallowing.
  • Recurring pneumonia (an indication that food may be going into the lungs rather than the oesophagus).

Urgent evaluation by a doctor is required when food becomes lodged in the oesophagus for more than 15 minutes and will not pass spontaneously or with liquids.

Some people are unaware that they have swallowing problems because they compensate unconsciously by choosing foods that are easier to eat, or they eat more slowly. They are at risk of choking or having large pieces of solid food lodge in the oesophagus if they let down their guard.

How are swallowing problems diagnosed?

If you feel you have a swallowing problem, your doctor will decide which phase of swallowing needs to be tested. She will order the appropriate tests after asking questions to determine the details of your swallowing symptoms and previous medical problems, as well as performing an appropriate physical examination. Three tests are most commonly used to evaluate a swallowing problem:

  • Barium swallow and follow through. The patient swallows a barium preparation (liquid or other form that shows up under X-ray) and an X-ray machine with video recording capability is used to view its movement through the oesophagus. This is often performed under the guidance of a speech and language therapist, an expert in swallowing as well as speech.
  • Upper endoscopy: A flexible, narrow tube (endoscope) is passed into the oesophagus and projects images of the inside of the pharynx and oesophagus on a screen for evaluation.
  • Manometry: This test measures the timing and strength of oesophageal contractions and muscular valve relaxation.

Among other tests that may be necessary, according to the specific needs of the individual, are an impedance test and a pH probe test (for acid reflux).

WebMD Medical Reference

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