Dysphagia: causes, symptoms and treatment

In The medical word for trouble swallowing is dysphagia. Some persons with dysphagia find drinking challenging, while others have difficulty eating specific solid or liquid foods. If we refer to its etymology, the word dysphagia comes from Greek and is divided into two words, “dys,” which means difficulty or alteration, and “tag” (phagia), which means eating or swallowing. Dysphagia refers in the medical field to the test in destroying that some patients present. Dysphagia commonly occurs when consuming certain solid foods, although some patients may also have difficulty swallowing certain liquids, and in more severe cases of this pathological condition, some people cannot swallow at all.

The cause of dysphagia is, in most cases, of neuralgic or muscular origin and can be pretty painful. This alteration of the swallowing mechanism is more common in babies and older people. Dysphagia usually appears as a symptom or sign of other diseases. Although in some cases, it may not accompany another disease and present as a pathological condition. Several underlying causes, such as a sore throat, can lead to swallowing difficulties.
If dysphagia occurs only temporarily and not more than twice, it is usually not serious, nor does it indicate any pathological condition behind the difficulty in eating certain foods. However, if this swallowing problem is persistent, it is essential to see a specialist to offer a diagnosis and possible treatment.
Many different causes can cause a swallowing disorder. The treatment of dysphagia will depend on the specific origin of the condition. In this article, we will delve into dysphagia, its causes, symptoms, and diagnosis, in addition to exposing all the reasons that can cause swallowing difficulties.

What is dysphagia?
Dysphagia is the medical term used to describe the difficulty swallowing food or liquid that some people have. Some people can’t eat food alone, while others can’t drink either solid or liquid food. While some people affected by this disease are unable to swallow at all.

The causes of dysphagia are varied. It can represent a symptom of an underlying disease or be a condition. The causes of dysphagia typically involve diseases or conditions that affect the muscles and nerves, and the state can be divided into three or two main categories, depending on the scientific literature. Esophageal dysphagia, which affects the esophagus, and oral dysphagia, which occurs in the throat. There is a third alteration, pharyngeal dysphagia. The origin of the pathology is in the pharynx and may be an underlying symptom of a neurological disease such as Parkinson’s. Most texts combine these last two and speak of oropharyngeal dysphagia.
Difficulty swallowing, the main symptom of dysphagia, is often accompanied by choking, coughing, and a sensation of something being caught in the chest or throat. Dysphagia makes it difficult for a person to eat and take in enough calories and nutrients that he needs to meet all of his daily requirements. Over time, dysphagia can cause weight loss and other serious complications that affect the body, such as malnutrition and dehydration.
The diagnosis of dysphagia includes different techniques that allow the speech therapist or swallowing specialist to determine which part is altered. This condition comprises pharmacological or surgical treatment depending on the type of dysphagia and the underlying cause.


Causes of dysphagia
Problems originating in the throat or esophagus most likely cause swallowing difficulties. Mainly, there are two types of dysphagia: oropharyngeal and esophageal dysphagia. Depending on the type of dysphagia, the disease’s origin may differ.

Oropharyngeal dysphagia
Patients with oropharyngeal dysphagia have trouble swallowing, cough when they eat and may regurgitate food through their nose. In this type of dysphagia, the food cannot reach the esophagus correctly and remains in the throat and pharynx from where it has to be expelled. When swallowing patients, they can choke and choke. They may also have a sensation of food or liquid going down the trachea or up the nose. This poor conduction of fluids can cause pneumonia.

Several conditions, including Parkinson’s disease, muscular dystrophy, and multiple sclerosis, can affect swallowing’s. Swallowing can also be affected by long-term neurological or nerve damage caused by stroke or spinal cord injury. Zenker’s diverticulum is a small pouch that forms in the throat and causes difficulty swallowing, gurgling sounds, bad breath, and frequent coughing or throat clearing. Some cancers and cancer treatments can also cause trouble swallowing.
Esophageal dysphagia
Patients with esophageal dysphagia have difficulty with the process of peristalsis that begins in the esophagus. Esophageal dysphagia makes it difficult to move food down the esophagus. Patients with esophageal dysphagia have a sensation of food sticking to or getting stuck in the esophagus. Esophageal dysphagia responds to different causes that affect the esophagus in another way.
Achalasia: In a condition known as achalasia, the esophagus muscles cannot relax and let food pass, causing food to back up into the throat. The esophagus walls may also have weakened muscles, which can worsen over time.
Diffuse spasm: After swallowing, the upper part of the esophagus may spasm uncontrollably. This condition is called diffuse spasm and affects the involuntary muscles in the lower part of the esophagus.
Esophageal stricture: Stricture refers to the loss of diameter of a channel. A narrow esophagus can trap large pieces of food.

Esophageal tumors: Esophageal tumors can cause the esophagus to narrow, making swallowing progressively more difficult. Scar tissue and tumors can also cause narrowing of the esophagus.
Foreign body stuck: Food or other objects can also get stuck in the throat or esophagus. It is a problem that can occur in older adults who wear dentures or in people who have difficulty chewing food.
Esophageal ring: A narrow area at the bottom of the esophagus that can cause problems swallowing solid food.
Acid reflux: Damage to the esophagus tissue caused by acid reflux can lead to narrowing and scarring of the esophagus’s lower part.

Eosinophilic esophagitis: This condition is thought to be related to a food allergy caused by an excess of cells called eosinophils in the lower part of the esophagus.
Scleroderma: When the tissue of the esophagus is injured, scars develop that replace the original tissue; the faults cause the organ to lose some of its functionality. In this case, the sphincter stops working correctly, and the acid can leak back into the esophagus, causing a series of damages and heartburn.
Radiation therapy: Radiation therapy kills cancer cells and can cause scarring and inflammation of the esophagus, leading to other problems and difficulty swallowing.

Often patients with dysphagia are unaware of the condition, simply thinking that this difficulty swallowing may be due to inflammation or something less serious. In these mild cases, dysphagia goes unnoticed, but without treatment, the chance of aspiration pneumonia (a lung infection that can be brought on by breathing in saliva or food particles) increases. Not being diagnosed with dysphagia can also cause malnutrition and dehydration.
Symptoms of dysphagia include choking on food, difficulty swallowing, and the feeling that food is stuck in the mouth, throat, or chest (behind the breastbone). When swallowing, a person may cough or gag. I might also drool. Food or stomach acid may back up into the esophagus and throat. The dysphagia patient frequently presents with heartburn as the flow returns again and again. In some conditions, patients may present with hoarseness, unexplained weight loss, and recurrent pneumonia. Some patients may feel that they cannot control their saliva.

The treatment of dysphagia will depend on the underlying cause of the condition.
esophageal dysphagia
Treatment of esophageal dysphagia includes dilation of the esophagus, pharmacological treatment, diet, and surgery.
Dilation of the esophagus: In the case of tightness of the sphincter muscles (achalasia) or narrowing (stricture), esophageal dysphagia can be treated with dilation of the esophagus, a balloon fed through an endoscope to expand the esophagus, or stretching the esophagus with multiple flexible tubes
Drug treatment: Reflux can be treated with prescription medications taken by mouth to reduce stomach acid. Pharmacological treatment may have to be followed for an extended period. The esophageal spasm can be relaxed with muscle relaxants, and corticosteroids can be used for eosinophilic esophagitis.
Diet: Diet can also help in certain conditions. Depending on the cause of the difficulty swallowing, the doctor may include a particular diet as a treatment. In the case of eosinophilic esophagitis, it can be included in the diet as part of the treatment.

Surgery: Some esophagus diseases (tumors, achalasia, pharyngoesophageal diverticulum) require surgery to open the esophageal tract.

Oropharyngeal dysphagia
To treat oropharyngeal dysphagia, you can go to a speech therapist or a specialist in swallowing pathology. Swallowing exercises can help, on the one hand, the muscles involved in the swallowing process, and, on the other hand, they can stimulate the nerves that trigger the swallow reflex that is working incorrectly.
Some techniques can be learned to make swallowing better. Ways to get food to the mouth more efficiently or how to position the body and head to aid swallowing can be discovered. If dysphagia is caused by problems that affect the nervous system and nerves, such as Parkinson’s or Alzheimer’s disease, exercises and new techniques to help to swallow may be effective.