Swallowing Problems

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KEY POINTS

• Swallowing problems can make it hard for you to have food move from your mouth to your stomach.
• If you have mild swallowing problems, it may help if you take small bites, sit up, and don’t talk when you eat.
• Treatment depends on the cause and severity. It may include eating soft foods, surgery, or a placement of a feeding tube.

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What are swallowing problems?

Swallowing problems are usually a problem with your throat or esophagus that keeps you from being able to move food or fluids from your mouth to your stomach. The esophagus is the tube that carries food from your throat to your stomach.

The medical term for swallowing problems is dysphagia.

What is the cause?

Swallowing moves food and liquids from the mouth into the stomach. There are several steps in this process. The tongue moves food and drink to the back of the mouth and into the throat. The food and drink need to go into the esophagus and not into your windpipe. A flap in your throat protects your voice box and windpipe from the food or drink as it moves into the esophagus. The muscles in your esophagus then push the food into your stomach.

Many different things can cause swallowing problems. For example:

• Diseases that affect the muscles or nerves needed for swallowing
• A stroke that has affected part of your brain
• Injury of your mouth, head, or neck
• Blockage of the esophagus caused by:
  • Getting a bone or large piece of food stuck in your throat
  • Swelling or irritation from stomach acid, infection, or an allergic reaction
  • Tumors
• Some medicines

What are the symptoms?

Symptoms may include:

• Throat or chest pain when you swallow
• Coughing or choking during or after swallowing
• A feeling that food is stuck in your throat
• Clearing your throat often
• Hoarseness or a change in your voice
• Food or drink coming out of your nose when you swallow
• Losing weight because you are not able to eat enough to stay healthy

How are they diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:

• Endoscopy, which uses a slim, flexible, lighted tube passed through your mouth to look at your throat and esophagus
• Barium swallow, which is an X-ray taken of the esophagus and stomach after barium is swallowed. Barium is a liquid that helps your intestines show up well on the X-ray. The barium may be added to different types of food to see how well you can swallow soft or hard foods.
• Esophageal manometry, which uses a thin, pressure-sensitive tube passed through your nose, down the esophagus, and into your stomach to check the muscles in your esophagus

You may be referred to an ear nose and throat specialist for tests or treatment.

How are they treated?

The treatment of a swallowing problem depends on its cause and how severe it is. For example, if you have an infection, your provider may prescribe an antibiotic. If you have too much stomach acid, medicine to reduce acid levels may take care of your swallowing problem.

Your provider may suggest that you change your diet, such as eating soft foods or thickening the liquids you drink. You may be referred to a speech therapist. Therapy may include exercises for your mouth, tongue, or the muscles you use to swallow.

If a tumor, cancer, or an injury cause swallowing problems, you may need surgery.

If you are not getting all of the nutrients you need, you may need to have a feeding tube placed into your stomach.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider.

Ask your provider:

• How and when you will get your test results
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent swallowing problems?

Not all causes of swallowing problems can be prevented. It may help if you:

• Take small bites and chew well before you try to swallow your food.
• Avoid talking at the same time you are chewing food or drinking.
• Sit up when you are eating. Don’t lie down for at least an hour after eating. It’s best to not eat for 2 to 3 hours before you go to bed.
• Keep household liquids, such as bleach, away from young children. The chemicals can burn the throat and cause swallowing problems.
• Use safety equipment to help prevent injuries.