Dysphagia is a medical term used to describe difficulty swallowing. This condition can significantly affect a person’s quality of life. People with dysphagia may struggle to swallow food, liquids, or even saliva, causing discomfort. In severe cases the swallowing problem leads to dangerous complications such as malnutrition, dehydration, and respiratory infections.
Swallowing disorders are closely related to dental problems. Missing teeth, poorly fitting dentures, or untreated cavities interfere with proper chewing. In severe cases, dental infections and pain contribute to swallowing difficulties, emphasizing the importance of oral health.
Dysphagia is not a disease but a symptom of various underlying health conditions. In this blog, we will delve into the details of dysphagia, exploring its causes, symptoms, and treatment options.
Common Types of Dysphagia
Oropharyngeal Dysphagia
This is a type of swallowing problem that happens in the mouth and throat area. People with this condition find it hard to start swallowing because their mouth or throat muscles and nerves are not working correctly. This can make it hard to move food or liquids from the mouth down into the food pipe.
Typical symptoms:
- Coughing or gagging after eating and drinking
- Food or liquids run back into the mouth or nose
- Difficulty in initiating the swallowing process
- Feeling that food is stuck in the throat
- Frequent choking
Esophageal dysphagia
This form is when food or liquids have trouble moving down the tube that connects your throat to your stomach. This can happen if the gullet is too narrow, blocked, or if the muscles in it do not work properly. People with this condition might have difficulty swallowing food, feel pain, or even have food come back up into their mouth.
Typical symptoms:
- Feeling that food is stuck in the chest or throat
- Pain or discomfort when swallowing (odynophagia)
- Backflow of food or stomach acid
- Frequent heartburn
Other forms of dysphagia
Sometimes dysphagia is also classified according to specific causes:
- Functional: With no identifiable organic cause, it often occurs in people with mental or psychosomatic illnesses.
- Mechanical: Occurs when physical blockages, such as tumors or scar tissue, obstruct the swallowing process.
Main Causes of Dysphagia
Neurological Disorders
Neurological conditions can affect the muscles used for swallowing. They do this by interrupting communication between the brain and the throat and esophagus muscles. Some of the common neurological causes include:
- Stroke: A stroke can damage the parts of the brain that control swallowing, leading to oropharyngeal dysphagia.
- Parkinson’s Disease: This progressive disorder affects muscle control, including the muscles used in swallowing.
- Multiple Sclerosis (MS): MS can cause nerve damage that interferes with the muscles responsible for swallowing.
- Amyotrophic Lateral Sclerosis (ALS): ALS, known as Lou Gehrig’s disease, weakens and paralyzes muscles.
Muscular Disorders
Muscular diseases can cause dysphagia by weakening the muscles necessary for swallowing. Common muscular causes include:
- Myasthenia Gravis: An autoimmune disorder that leads to muscle weakness, including the muscles involved in swallowing.
- Muscular Dystrophy: A group of inherited disorders that cause muscle degeneration. This can affect the muscles of the throat and gullet.
Structural Issues
Physical blockages or abnormalities in the mouth, throat, or esophagus can also lead to dysphagia. These include:
- Gastroesophageal Reflux Disease (GERD): Inflammation and scarring in the gullet can lead to narrowing and make swallowing difficult.
- Esophageal Cancer: Tumors in the esophagus can obstruct the passage of food.
- Esophageal Stricture: A narrowing of the gullet because of scar tissue from chronic acid reflux or other injuries.
- Achalasia: Esophageal achalasia is a rare condition where the lower esophageal sphincter fails to relax, preventing food from entering the stomach.
- Zenker’s Diverticulum: A pouch that can form in the throat, trapping food and causing difficulty swallowing.
Other Issues
Eosinophilic esophagitis is an allergic condition that happens in the esophagus. Inflammation affects the esophagus, preventing it from contracting properly. This can lead to problems swallowing.
Also, as people age, the muscles involved in swallowing may weaken. The nervous system can lose some of its functionality. This can lead to difficulty swallowing, particularly in older adults, too.
White blood cells (WBCs) also play a critical role in the body’s immune system response. In the context of dysphagia, elevated WBC levels can signal an infection. Conditions like bacterial or fungal infections in the throat or esophagus can contribute to or worsen dysphagia.
Diagnosis of dysphagia
If you or someone you know is having trouble swallowing, it is essential to seek medical evaluation. Diagnosing dysphagia typically involves a combination of medical history, physical examination, and specialized tests to determine the underlying cause.
The physician will ask about the patient’s symptoms, medical history, and any medications they may be taking. They will also perform a physical examination to assess any obvious abnormalities in the mouth, throat, or esophagus.
Diagnostic Tests
- Barium Swallow Test: This imaging test involves swallowing a liquid containing barium. This liquid coats the inside of the esophagus, allowing it to be visible on X-rays. This test helps identify structural problems such as strictures or tumors.
- Endoscopy: A thin, flexible tube with a camera is inserted through the mouth into the esophagus. Dentists examine the inner lining for abnormalities such as inflammation, blockages, or growths. People also call this process endoscopic evaluation of swallowing fees.
- Manometry: This test measures the pressure and muscle contractions in the esophagus during swallowing.
- Videofluoroscopic Swallowing Study (VFSS): This test uses X-ray technology to capture real-time images of the swallowing process. Healthcare professionals often use it to evaluate oropharyngeal dysphagia.
- PH Monitoring: For patients with GERD-related dysphagia, this measures the acidity levels.
Treatment of Dysphagia
Lifestyle and Dietary Changes
For mild cases of dysphagia, simple changes to eating habits and diet can make a significant difference:
- Eat smaller, more frequent meals: Eating smaller portions can help prevent food from getting stuck.
- Choose softer foods: Pureed or soft foods are easier to swallow than hard or dry foods.
- Avoid problematic foods: Spicy, acidic, or tough foods may aggravate dysphagia symptoms.
- Stay upright while eating: Sitting up straight during meals can help food pass smoothly through the esophagus.
- Take smaller bites and chew thoroughly: Chewing food well and taking small bites can make swallowing easier.
Swallowing Therapy
A speech or swallowing therapist can help patients with dysphagia learn exercises to strengthen the muscles involved in swallowing. They may also teach techniques to improve coordination and make swallowing safer.
Speech-language pathologists (SLPs) are healthcare professionals who assess and treat swallowing disorders, including dysphagia. They evaluate swallowing, provide exercises to strengthen muscles, and develop strategies to improve safety during eating and drinking.
Medications
Depending on the cause of dysphagia, medications may be prescribed to reduce symptoms:
- Proton Pump Inhibitors (PPIs): These drugs reduce stomach acid production.
- Muscle Relaxants: In conditions like achalasia, muscle relaxants may be prescribed to help the lower esophageal sphincter relax.
Dilation or Surgery
In cases where dysphagia is caused by a structural issue, medical procedures may be necessary:
- Esophageal dilation: A doctor inserts a balloon or dilator into the esophagus and inflates it to widen the passage.
- Botox Injections: Botox injections into the lower esophageal sphincter can help relax the muscles and make swallowing easier.
- Surgical intervention: Doctors may need to remove tumors, repair abnormalities, or widen strictures in more severe cases.
Complications of Dysphagia
If left untreated, dysphagia can lead to serious complications. Food or liquids that enter the lungs instead of the stomach can cause infections like aspiration pneumonia.
Difficulty swallowing can lead to reduced food and fluid intake, causing malnutrition and dehydration. In some cases, patients need to use a feeding tube. Severe dysphagia can increase the risk of choking, which can be life-threatening.
Conclusion
Early diagnosis and treatment are crucial to prevent complications. For patients dealing with dysphagia, dental health is important. Oral hygiene plays a crucial role in preventing the buildup of bacteria that could potentially lead to infections. In some cases, misaligned teeth or poorly fitting dentures can exacerbate swallowing difficulties.
Our dental clinic in Turkey, Cosmedica Dental, offers many dental solutions. Contact our professional team for a free consultation!