When you eat food, do you have trouble swallowing it? It’s normal to have occasional trouble chewing or swallowing certain foods or drinks, especially if you’re taking big bites. If this difficulty persists, you should not ignore it. When you swallow, several muscles work together, and when there’s difficulty with this process, it’s called dysphagia, simply known as swallowing problems. This condition can cause pain or other difficulties in chewing and swallowing food. Let’s find out the causes of swallowing problems.

What is dysphagia?

Dysphagia is a medical term that refers to difficulty swallowing. It can involve problems with any stage of the swallowing process, including the mouth, throat, or esophagus. Individuals with dysphagia may find it challenging to chew, move food to the back of the mouth, or swallow, leading to various symptoms such as pain, coughing, or the sensation of food getting stuck. Dysphagia can result from various causes, including neurological conditions, muscular disorders, structural issues, or other underlying health issues.

Symptoms of dysphagia

• Difficulty in swallowing
• Chewing problems
• Pain and discomfort while eating
• Frequent choking on food
• Food coming back up (regurgitation)
• Hoarseness or voice changes
• Unintended weight loss
• Recurrent respiratory infections
• Heartburn or chest pain
• Drooling
• Fatigue

Early recognition of these symptoms can help cure the condition in its initial stages.

What causes dysphagia?

Dysphagia or difficulty swallowing, can result from various causes. Gastroenterology expert Dr Amit Miglani says, “Dysphagia can arise from issues within the mouth or throat, termed oropharyngeal or ‘high’ dysphagia, as well as complications involving the oesophagus, the tube responsible for transporting food from the mouth to the stomach. When the problem occurs in the mouth or throat, it’s categorised as oropharyngeal dysphagia, while difficulties within the oesophagus are referred to as oesophageal or ‘low’ dysphagia.”

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Here are 8 common causes of dysphagia:

1. Neurological conditions

• Parkinson’s disease: Progressive neurological disorders, including Parkinson’s, can affect the muscles and nerves responsible for swallowing, causing dysphagia.
• Dementia: People with memory loss and cognitive decline may also find it difficult to chew and swallow.
• Cerebral palsy: Dysphagia is a common complication of cerebral palsy, a developmental disorder in which one is born with this condition. With this people may find it challenging to eat.
• Stroke: “Damage to the brain regions controlling swallowing can lead to dysphagia. Stroke survivors may experience difficulty coordinating the muscles involved in swallowing,” says Dr Miglani.

2. Muscular disorders

• Myasthenia gravis: This autoimmune disorder weakens the muscles, including those involved in swallowing, leading to difficulties in moving food through the oesophagus.
• Muscular dystrophy: Genetic muscle disorders can impair the strength and coordination of the muscles used for swallowing.
• Myositis: An autoimmune disease that causes muscle weakness in your throat and oesophagus, making it difficult to swallow.

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3. Structural issues

• Tumours: Both benign and malignant tumors in the throat or oesophagus can obstruct the passage of food.
• Esophageal strictures: Narrowing of the oesophagus due to scar tissue, often a result of chronic inflammation or conditions like gastroesophageal reflux disease (GERD), can cause difficulty in swallowing.
• Eosinophilic esophagitis: An allergic reaction causing inflammation in the oesophagus, potentially leading to swallowing difficulties.

4. Medications

Some medications, particularly those that cause dry mouth or affect muscle function, may contribute to dysphagia.

5. Psychological factors

Anxiety or fear related to swallowing, known as phagophobia, can result in functional dysphagia even without apparent physical causes.

6. Infections

Conditions like thrush, strep throat (bacterial tonsils), or other infections affecting the throat can cause pain and inflammation that lead to temporary dysphagia.

7. Radiation therapy

Treatment for head and neck cancers involving radiation therapy can damage the tissues in the throat, causing swallowing problems.

8. Age-related changes

While ageing does not cause dysphagia, it is a key factor. As you age, changes in the muscles and tissues of the throat can contribute to swallowing difficulties.

How to deal with dysphagia?

Dr Miglani says treatment for dysphagia is based on its cause and severity. It may involve various approaches, such as medication, lifestyle changes, and other medical therapies. Your healthcare provider might prescribe antimicrobial drugs if infections, often caused by viruses or fungi, contribute to dysphagia. For managing GERD-related dysphagia, medications to regulate acid reflux could be recommended. Apart from this, lifestyle changes, including following a healthy diet and eating habits, such as consuming softer foods that are easier to chew or avoiding extremely hot or cold items, may also be followed to manage dysphagia.

“In cases where neurological conditions cause trouble swallowing, diverse solutions exist. These could range from botulinum toxin injections to ease muscle spasms to procedures aimed at widening the oesophagus or removing blockages. In serious cases, where adequate nutrition or hydration is challenging or there’s a risk of choking, your healthcare provider might propose a feeding tube. This tube delivers nutrients directly to the intestines or stomach, and your provider will thoroughly discuss the available options with you,” adds Dr Miglani.

Rehab may help overcome swallowing problems

Rehabilitation for swallowing difficulties can be highly beneficial. A speech-language pathologist (SLP) plays a crucial role in teaching exercises designed to strengthen the muscles involved in swallowing. Dr Miglani explains, “To ensure safer swallowing, your SLP might advise modifications in your eating and drinking habits, such as taking smaller bites and thoroughly chewing food. Additionally, adding a special thickening powder to liquids can aid in swallowing, particularly for watery beverages.”

Untreated dysphagia can pose severe health risks and can also be life-threatening. So, if you notice signs of dysphagia, consult with your doctor.