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Swallowing Disorders (Dysphagia)
Overview
Dysphagia is the medical term for a swallowing disorder. This can include problems with swallowing:
- Foods
- Liquids
- Pills
- Saliva
Most of the time, this is caused by a problem with the mouth and throat muscles or nerves. Swallowing problems may also be caused by a blockage in the mouth, throat, or esophagus.
Swallowing disorders include:
- Oropharyngeal dysphagia. This affects the ability to move food, liquids, pills, or saliva through the mouth or throat.
- Esophageal dysphagia. This makes it difficult to move food, liquids, or pills through the esophagus.
Symptoms
Symptoms include:
- Difficulty swallowing food, liquids, pills, or saliva
- Coughing or choking
- Drooling
- Hoarseness or gurgly voice
- Food comes back up (regurgitation)
Complications include:
- Weight loss
- Dehydration
- Choking
- Pneumonia or frequent respiratory infections
Causes and Diagnosis
Many medical conditions may affect the ability to swallow, such as a stroke, dementia, cancer, and Parkinson’s disease. It can also happen with aging, illness, major surgery, or other health problems.
To diagnose and treat swallowing disorders, your doctor will review your medical history and examine you. They may refer you to a speech pathologist or other specialist.
Tests
Depending on the results of your physical exam, we may order additional tests.
Clinical swallowing evaluation
We’ll evaluate your mouth and throat to assess your ability to eat and drink safely.
Modified barium swallow study
We’ll ask you to eat food and drink a beverage mixed with barium. While you’re eating, a radiologist takes video X-rays of your mouth and throat.
Endoscopic assessments
We insert a lighted scope with a camera into the nose and throat to observe the swallowing process. To examine the esophagus, a scope may be inserted through the mouth.
Imaging tests
Imaging studies help us examine the structures of the head, neck, brain, or chest. This helps us look for abnormalities that may be causing swallowing problems. Options include a computed tomography (CT) scan, magnetic resonance imaging (MRI), or chest X-ray.
Treatment
Swallowing therapy may help to improve your ability to eat and drink safely.
The first step is to make sure that you’re getting enough food and liquid. For more severe swallowing trouble, you may need temporary or longer-term supplemental nutrition or hydration.
We’ll work with you to create a treatment plan that may include these methods.
Different food and liquid options
Some textures of foods or liquids are safer or easier to swallow. We may recommend that you puree, mince, or chop foods and adjust the thickness of liquids to make them easier for you to swallow. For example, some people find it easier to swallow thicker liquids. We refer to the consistency of liquids as thin, slightly thick, mildly (nectar) thick, or moderately (honey) thick.
Swallowing strategies
There may be some swallowing strategies you can use to help food and liquid go down more safely, including positioning your head, neck, and body to make swallowing easier. Eating slowly and taking small bites can also help.
Exercises
We may teach you exercises to increase the coordination and strength of your swallowing muscles.
Disclaimer
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.