What could cause difficulty swallowing?

Swallowing should be effortless and painless, and any difficulty or discomfort with swallowing should be evaluated by your gastroenterologist. The most common cause of swallowing problems is GERD – gastroesophageal reflux disease. However, there are many other conditions which can cause swallowing to be difficult—structural abnormalities like an obstructing ring or stricture, poor movement of the esophagus, inflammation of the lining of the esophagus and, rarely, even cancer. The three most ordered tests to determine the cause of dysphagia (difficulty swallowing) is an upper endoscopy, a barium swallow and an esophageal manometry.

Dr. Leigh Vinocur, MD
Emergency Medicine Specialist

Difficulty swallowing is called dysphagia. It can occur if you eat too fast and try to swallow too much at once. Sometimes this difficulty can be attributed to aging with weakening of muscles in the esophagus that propels food down to the stomach. However, if this problem persists, it may be a sign of a more serious medical problem.

Swallowing problems that involve the mouth and throat are called oralpharyngeal dysphagia. Often it causes a gagging and choking feeling that can lead to food going down the windpipe and even cause pneumonia. There are neurological conditions that can cause this such as stroke, Parkinson’s disease, multiple sclerosis or muscular dystrophy.

Swallowing difficulty where food sticks in the esophagus, the tube that connects the throat with the stomach, gives symptoms down in the chest.  It is called esophageal dysphagia.  It can be caused by disorganized nerve signals to the sphincter—the opening to the stomach—that doesn’t relax properly and allow food to pass. This is called achalsia. These nerve signals can also cause spasms in the muscles of the esophagus. Scar tissue can form a narrowing of the esophagus called a stricture, which is usually from the acid splashing up into it when GERD is present.

Both types of dysphagia can be the result of cancers of the throat and esophagus, which causes progressive narrowing and difficulty swallowing.

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