by Scholten A
(Difficulty Swallowing [Esophagus])

Definition

Esophageal dysphagia is a problem that happens with swallowing. It feels like food is stuck in the food pipe (esophagus). The esophagus is the tube that connects the throat to the stomach.

Treatment can improve swallowing.

Esophagus and Stomach
IMAGE
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Causes

Esophageal dysphagia is caused by:

  • Conditions that narrow the food pipe, such as:
  • Conditions that cause problems with how the food pipe works, such as:
    • Inflammation—esophagitis
    • Achalasia—food or drink does not move toward the stomach
    • Damage to nerves

Risk Factors

Things that raise the risk of esophageal dysphagia are:

Symptoms

Symptoms of esophageal dysphagia are:

  • Problems or pain with swallowing
  • A feeling of food being stuck
  • Food comes back up
  • Drooling, coughing, choking
  • Wheezing
  • Hoarse voice
  • Problems getting enough fluids or nutrition

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. The doctor will run tests to find the cause of swallowing problems. Tests may include:

  • A test to look for problems while swallowing
  • An upper GI endoscopy—a scope to view the throat from back of mouth to the stomach
  • A barium swallow—x-ray that uses a special dye to view the throat
  • Tests on the muscles of the food pipe

Treatment

Treatment depends on the cause. Options may be

  • Esophageal dilation —to make the food pipe wider
  • Surgery—to treat GERD or remove something that is blocking the food pipe
  • Diet changes such as:
    • Not eating foods that cause problems
    • Eating softer or pureed foods
    • Using a feeding tube if needed
  • Speech therapy—to learn how to swallow without choking
  • Medicines—to treat specific causes, relax muscles, or reduce acid

Prevention

There are no known guidelines to prevent esophageal dysphagia.

RESOURCES

American Speech-Language-Hearing Association  https://www.asha.org 

Dysphagia Research Society  https://dysphagiaresearch.site-ym.com 

CANADIAN RESOURCES

Heart and Stroke Foundation of Canada  https://www.heartandstroke.ca 

Ontario Association of Speech-Language Pathologists and Audiologist  https://www.osla.on.ca 

References

Chilukuri P, Odufalu F, et al. Dysphagia. Mo Med. 2018;115(3):206-210.

Dysphagia. Cedars-Sinai website. Available at: https://www.cedars-sinai.org/health-library/diseases-and-conditions/d/dyphagia.html. Accessed July 30, 2021.

Dysphagia. EBSCO DynaMed website. Available at: https://www.dynamed.com/approach-to/esophageal-dysphagia. Accessed July 30, 2021.

Dysphagia. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/gastrointestinal-disorders/esophageal-and-swallowing-disorders/dysphagia. Accessed July 30, 2021.

Swallowing disorders in adults. American-Speech-Language-Hearing Association website. Available at: https://www.asha.org/public/speech/swallowing/Swallowing-Disorders-in-Adults. Accessed July 30, 2021.

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