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Why You’re Having Difficulty Swallowing

More than 50 muscles work together to enable you to swallow food. Certain medical conditions may weaken the nerves or alter the structures involved in the swallowing process, making it difficult to swallow. For those unable to eat a meal, life can become quite challenging. Fortunately, there’s help.

Causes and Symptoms of Dysphagia

Dysphagia is the medical term for difficulty swallowing. It can occur for several reasons, including:

Mike Pietrantoni, speech-language pathologist at Marianjoy Rehabilitation Hospital, part of Northwestern Medicine, explains that weakness or loss of muscle coordination needed to swallow can cause aspiration: liquids or solids entering into your airway or lungs instead of your esophagus, which leads to your stomach. Aspiration can lead to medical complications, including pneumonia.

Because the causes of dysphagia vary, symptoms may present differently and can include:

  • Choking or coughing while eating
  • The feeling that food is stuck in your throat
  • Pain with swallowing (odynophagia)
  • Regurgitation (return of partially digested food from the stomach to the mouth or nose)
  • Heartburn
  • Fatigue
  • Weight loss
  • Evaluation and Treatment Options for Dysphagia

    Because there are various causes of dysphagia, there are also various treatment options. “Our treatment is highly individualized,” says Pietrantoni. “We always perform a complete assessment before making any recommendations. Our goal is to determine the underlying cause of the swallowing difficulty so we can determine how to best treat it.”

    A number of tests can help determine the cause and extent of dysphagia. These can include a videofluoroscopic swallowing study (VFSS), which is a video X-ray of the structures in your mouth and throat performed while you drink liquids and eat solid foods mixed with a small amount of barium, a substance that is visible on the X-ray. Fiberoptic endoscopic evaluation of swallowing (FEES), another swallowing assessment, involves a tiny camera at the end of a long thin tube called an endoscope. The camera and scope are used to take a close look at the structures in your throat, voice box and upper airway during swallowing.

    If you have a milder form of dysphagia, strategies as simple as eating slowly, sitting upright when eating, and taking small bites and sips may be effective to reduce risk of aspiration. In some cases, your physician or speech pathologist may recommend finely chopping or pureeing solid foods and/or thickening your liquids to make your swallowing safer. “We may also work with you to improve the coordination and strength of the muscles in your mouth, tongue and throat to improve the safety and efficiency of your swallowing,” adds Pietrantoni.

    For more severe cases, if it is unsafe for you to eat by mouth, a feeding tube may be warranted. Your provider or speech pathologist will discuss what options are best for you. “Have an honest conversation with your providers about your personal goals and what your treatment course might look like moving forward,” suggests Pietrantoni.

    “It can be frustrating if you are unable to participate in meal times like you normally would,” he continues. “Be patient with yourself during the recovery process. Everyone’s journey with dysphagia is different. Talk with your doctor and speech pathologist about what treatments and strategies will work best for you.”