Swallowing problems (dysphagia)
Having difficulty swallowing is known as dysphagia. There are a number of reasons someone may have a swallowing problem. Because some of these can be serious, it is important to see your doctor if you have a swallowing problem.
What is dysphagia?
Dysphagia refers to a symptom - difficulty in swallowing. It usually occurs when there is a problem with the throat or the oesophagus, the tube through which food travels from the mouth to the stomach. However, sometimes something pressing on the oesophagus or at the back of the mouth can cause dysphagia.
Normally, muscles in the walls of the throat and oesophagus contract to push food down towards the stomach. Cells and tiny glands inside of the oesophagus also produce mucus to help food glide down the tube smoothly. At the bottom of the oesophagus, where the tube joins the stomach, there is a circular band of muscle known as a sphincter. It relaxes so that food can pass into the stomach, and it tightens to stop food and acid going up into the oesophagus. If this does not happen, it is known as reflux.
There are 3 stages to the swallowing process:
- In the oral phase, food or liquid is chewed and moved into the throat.
- In the pharyngeal phase - from the back part of the throat, which is known as the pharynx - the swallowing reflex starts squeezing food down the throat, at the same time as it closes the airway to prevent food or liquid entering it.
- In the oesophageal phase, the openings at the top and bottom of the oesophagus relax as the muscles contract to move food through towards the stomach.
We don't usually take much notice of food or liquid travelling to the stomach while we're eating or drinking unless, for example, something is especially hot. If something does go wrong, it can be difficult to swallow food or liquids. This is not the same condition as globus sensation, in which there is the sensation of a lump in the throat but there isn't a swallowing problem.
What symptoms are linked to dysphagia?
Swallowing problems can range from being mild to moderate to severe. If dysphagia is mild, you may not have trouble swallowing liquids, but solid foods may take longer to pass down or you may need to make an extra effort to swallow. In moderate cases, sometimes pieces of food can become lodged in the throat. Sometimes there is just the sensation that food has become stuck in your throat or further down the oesophagus, in your chest. In severe cases, neither liquids nor solid foods can travel down the oesophagus. There can also be:
- Pain on swallowing
- Regurgitating or bringing up food, sometimes through the nose
- Coughing or choking when eating
- Persistently drooling saliva.