Ear, Nose & Throat

What Is Dysphagia, or Difficulty Swallowing?

If swallowing has become difficult, you could have dysphagia — and you may need to seek treatment so you can swallow without pain.

Julie Lynn Marks
By Medically Reviewed by 
Reviewed:
Medically Reviewed
black african american woman drinking water touching her throat
Difficulty swallowing, or dysphagia, is a symptom of various diseases.Getty Images; Canva
Swallowing seems like such a simple act that many of us take it for granted — until we develop a swallowing problem, and daily tasks like speaking and eating become a major challenge. Dysphagia is the medical term used to describe trouble swallowing, and it's a problematic symptom that needs treatment — maybe even speech therapy — to correct.

Dysphagia is a common symptom, particularly in older adults. Studies show that between 10 and 33 percent of older adults are affected by dysphagia.

 But it's not only a factor of age, as anyone can experience trouble swallowing.

Types of Dysphagia, or Difficulty Swallowing

There are two main types of dysphagia, each categorized by the part of the body that is affected. The two types have different symptoms.

Esophageal Dysphagia

With esophageal dysphagia, the esophagus (the tube that connects the throat to the stomach, allowing food to travel into the stomach) is damaged in some way and swallowing is affected. Symptoms of esophageal dysphagia include:

  • Signs of malnutrition and dehydration
  • Weight loss
  • Lack of interest in food
  • Pain in the chest when you swallow
  • Coughing in the night that wakes you up
  • Vomiting up food after you swallow it
  • A sensation of food getting stuck in the chest in the area of the breastbone

Oropharyngeal Dysphagia

Oropharyngeal dysphagia is a swallowing problem that originates from an issue or abnormality affecting the throat or mouth. Symptoms of oropharyngeal dysphagia include:

  • Signs of malnutrition and dehydration
  • Lack of interest in food
  • Weight loss
  • Frequent cough or choking during swallowing
  • Clearing the throat often
  • Swallowing frequently
  • Taking a long time to chew food
  • Moving the head or neck in a strange motion while swallowing
  • Painful swallowing
  • Problems breathing while eating
  • Getting food stuck in the throat often
  • Drooling
  • Expelling liquids out of the nose

Conditions That Cause or Contribute to Dysphagia

Eosinophilic esophagitis (EoE) is one condition that can cause dysphagia. With EoE, there’s an overpopulation of certain cells called eosinophils in the esophagus.

 This buildup of eosinophils can cause damage, narrowing, and inflammation of the esophagus, which may lead to swallowing problems or food impaction (where food gets stuck in the esophagus). Researchers believe that the disease is related to food allergies.

Certain neurological conditions, like amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease), multiple sclerosis, polio, and Parkinson's disease may also lead to swallowing difficulties. While dysphagia symptoms may occur at any time, they typically surface during the later stages of these diseases.

People with Alzheimer's disease or other forms of dementia may also experience trouble swallowing. They may get tired easily or forget how to chew their food.

Some research has shown that dysphagia occurs in about 75 percent of patients with Alzheimer’s.

Other common causes of dysphagia include:

  • Diseases that affect the muscles
  • Congenital abnormalities that affect sucking or swallowing
  • A tumor in the throat or on the tongue
  • A stroke
  • Damage to the esophagus (from radiation or ingesting toxic substances)
  • GERD (gastroesophageal reflux disease) or persistent heartburn
  • Cancer of the head or neck
  • An infection
  • Food allergies
  • Diseases that affect the vascular system, like lupus or scleroderma

Complications of Dysphagia or Chronic Trouble Swallowing

Choking can happen when food gets stuck in the throat. A person can die if the food item completely blocks their airway, and medical interventions, such as the Heimlich maneuver, aren’t successful.

Dysphagia can keep people from wanting to, or being able to, eat and swallow — resulting in nutritional deficiencies, weakness, too much weight loss, and dehydration. The esophagus may also weaken and form a "trap" that allows food to become stuck in it, expanding and keeping food and liquid from reaching the stomach.

Another serious complication, called aspiration pneumonia, can occur when a person aspirates — or takes food into the lungs because of trouble swallowing. The food can become lodged in the lungs, where bacteria may grow and cause an infection.

Treatment and Therapy Options for Dysphagia Depend on the Root Cause

Treatment will depend on the cause of the dysphagia and which part of the body is affected.

Medications

Medications may be prescribed to treat an underlying condition that is responsible for dysphagia.

Therapy

Many people need therapy to strengthen their muscles and improve swallowing. Exercises can boost coordination and build tone in the muscles of the face to manage dysphagia. Finding easier ways to eat (like turning the head a certain way or altering food and drink) may also help. Speech therapy often focuses on techniques to facilitate swallowing, and it can teach people with dysphagia how to continue to eat and swallow despite any physical limitations.

In the most severe cases, a feeding tube is necessary to ensure nourishment when a person can no longer chew and swallow independently.

Surgery

Surgery may be required to fix abnormalities of the throat or esophagus to make difficult swallowing a little easier.

Diet for Dysphagia

Some people with dysphagia find that dietary changes improve their symptoms. They may have to eat foods that are soft and moist, or carefully dice, mince, mash, or puree foods that aren’t.

Thickening agents can minimize swallowing issues for people who have trouble with thin liquids.

Getting rid of distractions during mealtime and eating when you’re most alert can also help.

Individuals with food allergies or EoE may try an elimination diet, which involves removing suspected food triggers and gradually reintroducing them to try to figure out what’s causing negative reactions.

Finding Help for Dysphagia

If you have trouble swallowing, you should talk to your doctor. Dysphagia is often a complex condition to treat. Swallowing is an intricate process that involves many muscles and nerves in the body.

To help with your swallowing issues, you may need to see one or more of the following specialists:

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