Esophageal Dysphagia

Causes

Esophageal dysphagia is caused by:

• Conditions that narrow the food pipe, such as:
  • Esophageal stricture
  • Esophageal cancer
• Conditions that cause problems with how the food pipe works, such as:
  • Inflammation—esophagitis
  • Achalasia—food or drink does not move toward the stomach
  • Damage to nerves

Risk Factors

Things that raise the risk of esophageal dysphagia are:

• Any of the problems above
• Injury or illness of nervous system such as:
  • Stroke
  • Parkinson disease
  • Multiple sclerosis
  • Huntington disease
• Gastroesophageal reflux disease (GERD)
• Cancer treatment—current or past
• Past surgery
• Premature birth
• Certain medicine

Symptoms

Symptoms of esophageal dysphagia are:

• Problems or pain with swallowing
• A feeling of food being stuck
• Food comes back up
• Drooling, coughing, choking
• Wheezing
• Hoarse voice
• Problems getting enough fluids or nutrition

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. The doctor will run tests to find the cause of swallowing problems. Tests may include:

• A test to look for problems while swallowing
• An upper gastrointestinal (GI) endoscopy—a scope to view the throat from back of mouth to the stomach
• A barium swallow—x-ray that uses a special dye to view the throat
• Tests on the muscles of the food pipe

Treatment

Treatment depends on the cause. Options may be

• Esophageal dilation—to make the food pipe wider
• Surgery—to treat GERD or remove something that is blocking the food pipe
• Diet changes such as:
  • Not eating foods that cause problems
  • Eating softer or pureed foods
  • Using a feeding tube if needed
• Speech therapy—to learn how to swallow without choking
• Medicines—to treat specific causes, relax muscles, or reduce acid

Prevention

There are no known guidelines to prevent esophageal dysphagia.