Dysphagia

Dysphagia is a condition that causes patients to have abnormal swallowing, making it difficult to swallow things or having pain when swallowing, such as when swallowing food or certain liquids, swallowing saliva, etc. Some people cannot swallow at all or may have other symptoms, such as coughing or choking while eating and drinking, feeling like there is food stuck in the throat or chest, etc.
Dysphagia can cause patients to not receive enough nutrients to nourish the body, or if it continues for a long time, it can cause weight loss and may cause complications such as chest infections.

Symptoms of dysphagia

Symptoms that indicate dysphagia include:

• Have pain when swallowing food or cannot swallow food.
• Feeling like there is food stuck in your throat or chest
• Frequent heartburn
• Excessive saliva flowing from the mouth
• Hoarse voice
• Food or stomach acid flows back into the throat.
• Coughingor choking when swallowing food
• You may need to cut your food into smaller pieces or avoid certain foods in order to be able to swallow normally.
• Unusual weight loss

However, if the patient or someone close to them has frequent problems swallowing or has symptoms similar to dysphagia, especially weight loss, food reflux, or vomiting, they should see a doctor for proper treatment. Because if not treated promptly, it may lead to serious complications, especially in cases where symptoms affect breathing and feel like food is stuck in the throat or chest, they should see a doctor immediately.

Causes of dysphagia

The causes of dysphagia or swallowing disorders are complex and sometimes the exact cause cannot be identified. However, it can occur for a number of reasons, including:

• Esophageal dysphagia, such as unrelaxed smooth muscle, esophageal spasm, esophageal stenosis, tumors or foreign objects in the esophagus, acid refluxdisease , esophagitis, scleroderma, or complications from radiation therapy, etc.
• Oropharyngeal Dysphagia, such as neurological disorders or damage to the nervous system, Zenker’s Diverticulum, or cancer, etc.

In addition, some factors may increase the risk of dysphagia, such as aging, which can cause wear and tear on the esophagus, or having certain underlying diseases, such as stroke, Parkinson’s disease, and diseases caused by neurological disorders.

Diagnosis of dysphagia

Your doctor will take a detailed history and perform a physical examination to diagnose dysphagia, and may also perform additional tests, such as:

• Swallowing test: The doctor will have the patient swallow food normally to see with the naked eye whether there are any abnormalities in the patient’s eating method or to swallow food coated with barium to help visualize the food as it passes from the mouth to the throat. This test will show the coordination of the muscles used in swallowing in the mouth, throat, and esophagus, as well as see any abnormalities such as foreign objects or lumps in the esophagus.
• Imaging tests such as computerized tomography (CT) scans, magnetic resonance imaging (MRI) scans, and barium swallows to coat the esophagus, etc.
• Esophagoscopy to help detect various inflammations such as esophageal inflammation, esophageal stricture, or tumors.
• Gastrointestinal motility testing (Manometry)
• Using a camera to observe swallowing patterns
• Nutritional assessment

Treatment of dysphagia

Treatment will depend on the type and cause of the swallowing problem, as follows:

Dysphagia due to esophageal dysphagia may be treated with various methods, including:

• Esophageal dilatation: In cases of achalasia or esophageal stenosis, your doctor may use an endoscope with a special balloon or flexible tube to help dilate your esophagus.
• Drug treatment: In cases of acid reflux, medication may be necessary to reduce stomach acid along with lifestyle changes. If the esophagus is inflamed, the doctor may prescribe corticosteroids. In cases of esophageal spasms, certain muscle relaxants may be needed.
• Surgery is used in cases of esophageal tumors, achalasia, esophageal bulging, or conditions that cannot be corrected with other treatments.

For dysphagia caused by abnormalities in the upper pharynx, your doctor may recommend treatment for speech, swallowing, and possibly other additional therapies, such as:

• Training on swallowing by having the patient position their body and head to make swallowing easier, or training on swallowing techniques specifically for patients with Alzheimer’sor Parkinson’s disease.
• Practice physical exercises, as some exercises can help with the coordination of the muscles involved in swallowing or stimulate the nerves involved in swallowing.

Dysphagia from other causes: In some patients, doctors may perform surgery if the dysphagia is caused by a blockage or narrowing of the neck, vocal cord paralysis, larger than normal bones, esophageal sac bulging out, achalasia, or cancer of the oesophagus. Patients often need speech and swallowing exercises to recover after surgery.

However, if the patient has severe dysphagia and is not getting enough food or water, the doctor may need to provide additional treatment by giving a special type of liquid diet to help maintain weight and prevent dehydration or malnutrition, including feeding through a feeding tube.

In addition, patients may initially relieve their symptoms by themselves as follows:

• Change your eating habits by eating smaller amounts more frequently, dividing or cutting food into smaller pieces, and chewing food more thoroughly and more slowly.
• Observe your diet for a variety of foods to identify which ones cause problems, then avoid them.
• Avoid drinking alcohol, smoking, and drinking caffeinated beverages, as these can make heartburn worse.

Complications of dysphagia

Dysphagia can lead to complications such as malnutrition, dehydration, and weight loss due to insufficient nutrition or water in the body; aspiration pneumonia because food can carry bacteria into the lungs; and choking because food blocks the airway, which in some cases can be fatal.

Prevention of dysphagia

Although preventing dysphagia can be difficult, people with dysphagia may be able to reduce their risk by:

• Eat more slowly and chew your food more thoroughly.
• Eat smaller bites of food or eat smaller amounts more frequently at each meal.
• Avoid foods or drinks that increase the risk, such as alcoholic beverages, caffeinated beverages, etc.
• Avoid smoking
• Observe yourself frequently. If you find any abnormalities, you should see a doctor and receive proper treatment.