Do You Have Trouble Swallowing? You’re Not Alone

More than 20 percent of adults over the age of 50 report trouble swallowing. They can experience scary choking scenarios, frustration eating, and even difficulty breathing. The cause can relate to any of 30-plus ailments.

trouble swallowing

Trouble swallowing? It could be due to any of dozens of reasons.

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If you have trouble swallowing, you have dysphagia. If that trouble swallowing is associated with pain, it’s called odynophagia. These are big words for an annoying—and potentially dangerous—disorder that most of us call “trouble swallowing.”

According to the National Foundation of Swallowing Disorders, the number of those who have trouble swallowing may be as high as 22 percent of people over 50 years old. “Several studies conclude that between 300,000 and 600,000 individuals in the United States are affected by neurogenic dysphagia each year. Plus, 10 million Americans are evaluated each year for swallowing difficulties.”

So, if you’re having trouble swallowing, at least you know you’re not alone.

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These Diseases Can Involve Trouble Swallowing

Trouble swallowing is mostly found in older adults, children, and people with neurological conditions (nervous-system disorders), like Parkinson’s disease. It can become serious quickly because trouble swallowing can result in choking, reduced air intake, and a greatly decreased ability to eat.

According to Verywell.com, “In Parkinson’s disease, dysphagia may occur from a delayed swallow response, as well as a symptom called tongue pumping, in which a person’s tongue moves back and forth repetitively preventing food from leaving the mouth.”

DISORDERS AND CONDITIONS THAT CAUSE SWALLOWING TROUBLE

  • Allergic reaction
  • Anxiety and stress
  • Birth defects in the swallowing mechanism
  • Cancer (head, neck, stomach, esophagus)
  • Cancer treatments
  • Cerebral palsy
  • Dementia
  • Dermatomyositis
  • Dry throat
  • Epiglottitis
  • Esophageal narrowing
  • Esophageal inflammation or infection
  • Esophageal polyps or masses
  • Esophageal spasms
  • Gastroesophageal reflux disease (GERD)
  • Goiter
  • Herpes esophagitis
  • Immune system disorders
  • Injuries (head, brain, neurologic, neck, throat, chest, spinal cord)
  • Multiple sclerosis
  • Muscular dystrophy
  • Myopathy
  • Nerve damage
  • Parkinson’s disease
  • Polymyositis
  • Recurrent herpes simplex labialis
  • Scleroderma
  • Stroke
  • Swollen tonsils
  • Swollen tongue
  • Thyroid nodule
  • Venom from a snake bite

Disorders and diseases that can cause trouble swallowing include everything from allergic reactions, dry throat, and swollen tonsils to scleroderma, Parkinson’s disease, and esophageal (and other types of) cancer. See sidebar for a more complete list.

Symptoms That Present with Dysphagia

A person who is having trouble swallowing is usually aware of the problem. It can be painful, and it can be scary, especially if it involves choking or difficulty breathing.

If the person is a child or an elderly adult with dementia, he or she may not be able to express what is happening to them. So if you’re a caretaker, it may be wise to learn the symptoms that present when someone has trouble swallowing. They include:

  • Choking while eating
  • Chronic sore throat
  • Coughing while eating or right after
  • Dehydration
  • Difficulty chewing
  • Drooling, leaking food
  • Feeling like there’s a lump in the throat or chest
  • Gagging while eating
  • Gurgling sounding voice during or after eating
  • Heartburn
  • Malnutrition
  • Pain in the throat or chest
  • Painful swallowing
  • Recurring pneumonia or chest congestion after eating
  • Refusing to eat
  • Regurgitation
  • Voice change (usually to hoarse)
  • Weight loss

Dysphagia Diagnosis

Although you may end up in the care of a specialist (ear, nose, and throat doctor or gastroenterologist), start with your primary-care physician. Your physician will do a thorough examination, including a medical and lifestyle history, asking you questions about your diet, heartburn, acid reflux, and whether you have trouble swallowing liquids or just food. He or she will, of course, look in your mouth and down your throat, as far as possible.

Diagnostic tests will likely be order and may include:

  • Barium swallow and x-ray to check for abnormalities in the esophagus.
  • Endoscopy, which is when a thin tube with a camera attached is eased down your throat so the doctor can view the esophagus.
  • Fluoroscopy, which is often done by a speech pathologist, to look for problems in the swallowing process (see sidebar).

Treatment for Trouble Swallowing

It’s no surprise that treatment you have trouble swallowing will depend greatly upon the cause. That’s why those somewhat invasive diagnostic tests are so important. If only diagnosing trouble swallowing was as simple as a blood test!

Among the treatments that might be used for trouble swallowing:

  • Dilation of the esophagus. A device is sent down your throat to widen narrow areas.
  • Medicines. These are especially helpful if your trouble swallowing is diagnosed as heartburn, GERD, esophagitis, or an infection.
  • Exercise. You’ll learn to strengthen your swallowing muscles through special exercises.
  • Surgery. To remove a tumor, mass, or diverticula that might be causing trouble swallowing.

What You Can Do: Dietary Changes

SOURCES & RESOURCES

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The American Cancer Society (ACS) lists helpful ways to ease your trouble swallowing, including:

  • Dunk breads in milk to soften.
  • Eat slowly.
  • Eat smaller meals more frequently.
  • Go for soft, high-calorie foods, like cream-based soups, pudding, ice cream, yogurt, and milkshakes.
  • Mash foods. If using a blender, add liquids to dry foods before blending.
  • Sit upright to eat and drink and stay that way for a few minutes after meals.
  • Take small bites and swallow each bite before taking another.
  • Try thicker liquids, such as pureed fruit or adding thickeners to liquids.
  • Use a straw for liquids and soft foods.

When you have trouble swallowing, the experts that ACS say, it is wise to avoid foods that might aggravate the condition, including acidic foods (citrus fruits and drinks), alcohol, spicy foods and drinks, and hard foods (pretzels, crackers, nuts, chips).

It is possible that some people may always have trouble swallowing. For these patients, doctors may recommend a feeding tube to bypass the swallowing process but still provide adequate nourishment.

WHAT YOU SHOULD KNOW

The American Academy of Otolaryngology—Head and Neck Surgery describes the mechanism of swallowing, whether it’s to eat food, drink liquids, or just swallowing normal saliva and mucus:

  • Stage 1—Oral preparation: Chewing and manipulating the food or liquid in preparation for swallowing.
  • Stage 2—Oral stage: The tongue sends the food/liquid to the back of the mouth.
  • Stage 3—Pharyngeal stage: The food passes through the pharynx, which is the region of throat that connects the mouth to the esophagus (swallowing tube).
  • Stage 4—Esophageal stage: When the food/liquid passes through the esophagus to the stomach.

Only stages 1 and 2 have an element of voluntary control.

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