Doctor's Notes on Dysphagia (Difficulty Swallowing)
Dysphasia is difficulty in swallowing while odynophagia means painful swallowing. Dysphagia can be as have trouble swallowing both solids and/or liquids while others may experience only difficulty swallowing solids. Signs and symptoms of dysphasia include
- coughing,
- choking,
- gagging,
- interference with breathing, and
- regurgitating foods sometimes immediately after it is swallowed.
If food lodges in the esophagus, the patient may feel pain and/or chest discomfort. If dysphasia is associated with vomiting or aspiration of food or vomitous into the lungs, aspiration pneumonia symptoms (fever, chills, and respiratory distress) may develop.
Dysphasia has many causes. Diseases of the brain affect the control of the nerves and reflexes in swallowing (for example stroke, multiple sclerosis, and many others). Diseases and conditions that affect muscle function or connective tissue can cause dysphasia; for example, muscular dystrophy, myasthenia gravis, scleroderma, and others. Diseases specific to the esophagus also cause difficulty swallowing; some esophageal diseases include achalasia (inability of the lower esophageal sphincter to open and let food pass), eosinophilic esophagitis (an inflammatory condition of the esophagus), muscle spasms, and ineffective contractions of esophageal musculature. Obstructions of the esophagus can be due to anatomical abnormalities, tumors, or scar tissue; other causes can be compression of the esophagus by structures outside it such as tumors of the chest, thoracic aortic aneurysms, and enlarged lymph nodes. Radiation, medications, or even chemical toxins may contribute to causing dysphasia by causing strictures. Congenital anatomical abnormalities may also play a role in dysphasia.
What are the treatments for dysphagia?
Treatment for dysphagia depends on the type or cause; unfortunately, there are many causes. However, there are general treatments for several types of dysphagia. For example:
- Oropharyngeal
- Referral to a speech or swallowing therapist
- Exercises to trigger swallowing
- Learn new swallowing techniques
- Esophageal
- Dilation of tight sphincter or esophageal stricture
- Surgery to remove blockage like a tumor
- Medications (depending on the cause) like antacid, smooth muscle relaxants, or corticosteroids
- Severe dysphagia
Your doctors can advise you about what treatments are the best fit for your type of dysphasia.
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REFERENCE:
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.