Difficulty Swallowing (Dysphagia)

Difficulty with swallowing, also called dysphagia, is the feeling that food, drink, or medication gets stuck in the throat or at any point before the food enters the stomach. The difficulty may occur with eating or drinking, and can involve liquids, pills, or food. The dysphagia problem can be in the mouth, head, and neck, or in the esophagus.

Swallowing problems in the esophagus can include:

  • An abnormal ring of scar tissue that forms where the esophagus and stomach meet (this is called a Schatzki ring)
  • Abnormal spasms of the esophagus muscles
  • Growth, mass, or cancer of the esophagus
  • Failure of the lower esophageal sphincter, or LES, to relax (this is called achalasia)
  • Scarring that narrows the esophagus due to radiation, chemicals, medicines, chronic inflammation, ulcers, or infection
  • Something stuck in the esophagus, such as a piece of food
  • Scleroderma, which is a disorder in which the immune system mistakenly attacks the esophagus
  • External compression from organs or tumors in the chest that press on the esophagus

Symptoms of dysphagia can include:

  • Chest pain
  • The feeling of having food stuck in the throat
  • Heaviness or pressure in the neck or upper or lower chest
  • Coughing or wheezing that becomes worse
  • Coughing up food that has not been digested
  • Heartburn
  • Nausea
  • Sour taste in the mouth

If esophageal dysphagia goes untreated, it could lead to a number of complications, including:

  • Food or pill impaction, when food and medication get stuck in the esophagus
  • Esophageal perforation or rupture
  • Delayed diagnosis of masses
  • Aspiration, or inhaling, of contents refluxed up from the blocked esophagus

Medications that may be prescribed depending on the cause of dysphagia may include:

  • Medicines that relax the muscles in the esophagus, including nitrates, calcium channel blockers, and others
  • Injection of botulinum toxin
  • Medicines to treat heartburn and gastroesophageal reflux disease (GERD)

In some cases, providers may recommend a procedure to treat dysphagia. Procedures used to treat dysphagia include:

  • Upper GI endoscopy with dilation, which can be used to dilate, stretch, or widen a narrowed area of the esophagus
  • Radiation therapy, which may be used if cancer is causing the problem
  • Surgery, which may be used if the problem is caused by achalasia or spasms of the esophagus, as well as for removal of a mass or cancer