If your child has chronic dysphagia or dysphagia caused by a health condition, speech or occupational therapy may help. Your child will learn exercises and feeding techniques to swallow better. Your child may be able to swallow thick fluids and soft foods better than thin liquids. GERD may be treated with feeding changes or medicine. If your child is diagnosed with this condition, a particular elimination diet is often tried for treatment.
Medicines may also be tried. Children who have scarring or narrowing of the esophagus may need a test. Your child will need to be under anesthesia for this. Your child may need to have this procedure repeated. This condition can cause aspiration. This can lead to pneumonia and other serious lung problems. Children with dysphagia often have trouble eating enough.
Masses outside the esophagus, such as lymph nodes , tumors, or bone spurs on the vertebrae that press on your esophagus. What are the symptoms?
If you have dysphagia, you may: Have problems getting food or liquids to go down on the first try. Gag, choke, or cough when you swallow. Have food or liquids come back up through your throat, mouth, or nose after you swallow. Feel like foods or liquids are stuck in some part of your throat or chest.
Have pain when you swallow. Have pain or pressure in your chest or have heartburn. Lose weight because you are not getting enough food or liquid. How is dysphagia diagnosed? Your doctor may then refer you to one of the following specialists: An otolaryngologist , who treats ear, nose, and throat problems A gastroenterologist , who treats problems of the digestive system A neurologist , who treats problems of the brain, spinal cord, and nervous system A speech-language pathologist , who evaluates and treats swallowing problems To help find the cause of your dysphagia, you may need one or more tests, including: X-rays.
These provide pictures of your neck or chest. A barium swallow. This is an X-ray of the throat and esophagus. Before the X-ray, you will drink a chalky liquid called barium. Barium coats the inside of your esophagus so that it shows up better on an X-ray. This test uses a type of barium swallow that allows your swallowing to be videotaped. This test looks at the back of your throat, using either a mirror or a fiber-optic scope.
Esophagoscopy or upper gastrointestinal endoscopy. During these tests, a thin, flexible instrument called a scope is placed in your mouth and down your throat to look at your esophagus and perhaps your stomach and upper intestines. Sometimes a small piece of tissue is removed for a biopsy. A biopsy is a test that checks for inflammation or cancer cells. During this test, a small tube is placed down your esophagus.
The tube is attached to a computer that measures the pressure in your esophagus as you swallow. How is it treated?
Your treatment will depend on what is causing your dysphagia. Treatment for dysphagia includes: Exercises for your swallowing muscles. Damage to the brain may be caused by multiple sclerosis , Parkinson disease , or stroke.
Nerve damage may be due to spinal cord injuries, amyotrophic lateral sclerosis ALS or Lou Gehrig disease , or myasthenia gravis. Problems that involve the esophagus often cause swallowing problems. These may include: An abnormal ring of tissue that forms where the esophagus and stomach meet called Schatzki ring. Abnormal spasms of the esophagus muscles.
Cancer of the esophagus. Failure of the muscle bundle at the bottom of the esophagus to relax achalasia. Scarring that narrows the esophagus. This may be due to radiation, chemicals, medicines, chronic swelling, ulcers, infection, or esophageal reflux. Something stuck in the esophagus, such as a piece of food. Scleroderma , a disorder in which the immune system mistakenly attacks the esophagus. Tumors in the chest that press on the esophagus.
Plummer-Vinson syndrome, a rare disease in which webs of mucosal membrane grows across the opening of the esophagus. Other symptoms may include: Cough or wheezing that becomes worse. Coughing up food that has not been digested.
Sour taste in the mouth. Difficulty swallowing only solids may indicate a tumor or stricture suggests a physical blockage such as a stricture or a tumor. Difficulty swallowing liquids but not solids may indicate nerve damage or spasm of the esophagus. Early signs of swallowing problems may include difficulty when eating: Very hot or cold foods Dry crackers or bread Meat or chicken. Exams and Tests. Your health care provider will order tests to look for: Something that is blocking or narrowing the esophagus Problems with the muscles Changes in the lining of the esophagus A test called upper endoscopy or esophagogastroduodenoscopy EGD is often done.
Some people may be completely unable to swallow or may have trouble safely swallowing liquids, foods, or saliva. When that happens, eating becomes a challenge. Often, dysphagia makes it difficult to take in enough calories and fluids to nourish the body and can lead to additional serious medical problems.
Swallowing is a complex process. Some 50 pairs of muscles and many nerves work to receive food into the mouth, prepare it, and move it from the mouth to the stomach. This happens in three stages. During the first stage, called the oral phase, the tongue collects the food or liquid, making it ready for swallowing. The tongue and jaw move solid food around in the mouth so it can be chewed. Chewing makes solid food the right size and texture to swallow by mixing the food with saliva.
Saliva softens and moistens the food to make swallowing easier. Normally, the only solid we swallow without chewing is in the form of a pill or caplet.
Everything else that we swallow is in the form of a liquid, a puree, or a chewed solid. The second stage begins when the tongue pushes the food or liquid to the back of the mouth. This triggers a swallowing response that passes the food through the pharynx, or throat see figure.
During this phase, called the pharyngeal phase, the larynx voice box closes tightly and breathing stops to prevent food or liquid from entering the airway and lungs. The third stage begins when food or liquid enters the esophagus, the tube that carries food and liquid to the stomach. The passage through the esophagus, called the esophageal phase, usually occurs in about three seconds, depending on the texture or consistency of the food, but can take slightly longer in some cases, such as when swallowing a pill.
Dysphagia occurs when there is a problem with the neural control or the structures involved in any part of the swallowing process. Weak tongue or cheek muscles may make it hard to move food around in the mouth for chewing. A stroke or other nervous system disorder may make it difficult to start the swallowing response, a stimulus that allows food and liquids to move safely through the throat.
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