Definition

Dysphagia refers to difficulties during the swallowing process. Esophageal dysphagia occurs when swallowing problems happen in the esophagus. The esophagus is the tube that transports food from the throat to the stomach

Causes

A number of conditions can cause esophageal dysphagia, such as:

• Achalasia —affects the muscles at the bottom of the esophagus
• Scleroderma —causes thickening and stiffening of tissues, joints, and organs; can lead to problems with the esophageal muscles
• Esophageal stricture or esophageal ring—causes the esophagus to become more narrow
• Esophageal tumors
• Infectious esophagitis
• Caustic esophagitis
• Foreign bodies
• Eosinophilic esophagitis

Risk Factors

Many conditions and factors may increase your risk of esophageal dysphagia, like:

• Increased age
• Gastroesophageal reflux disease (GERD)
• Cancer
• Radiation therapy
• Respiratory or cardiovascular disorder such as stroke
• Surgery such as fundoplication
• Being born prematurely
• Taking certain medications that may affect how the esophagus works

Symptoms

Symptoms may include:

• Difficulty swallowing solids, liquids, or both
• A sensation of food being stuck in the esophagus
• Pain when swallowing
• Heartburn, regurgitation
• Coughing or choking when eating or drinking
• Drooling
• Wheezing, hoarse voice
• Weight loss, malnutrition, and dehydration due to problems with eating and drinking

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done.

Tests will be done to assess your swallowing function. These may include:

• Swallowing test to observe what happens when you swallow
• Videofluorographic swallowing study (VFSS)

Your throat may need to be viewed. This can be done with:

• Endoscopy
• Barium swallow

Your esophageal muscles may be tested. This can be done with an esophageal manometry test.

Treatment

Treatment depends on the cause, but may include:

• Esophageal dilation —Placing a tube-shaped device into the esophagus to widen the narrow part.
• Surgery
• Dietary changes—You may need to avoid eating foods that cause problems, like meat. Or you may need to eat only pureed food. In severe cases, a feeding tube may be needed to provide nutrition.
• Therapy to improve swallowing—such as learning ways to prevent choking while eating.
• Medications

Prevention

You can reduce your risk by getting early treatment for any related condition, like GERD.

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