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Difficulty Swallowing? When to Seek Treatment

The ability to swallow is a biological function that most people take for granted. But when an illness or injury occurs, swallowing may no longer be an automatic process. Swallowing is regulated by the brain and requires precise muscle control. When this function is out of sync, a person may have trouble swallowing, known as dysphagia.

Occasional dysphagia, which can occur when a person eats too fast, usually is not cause for concern. But chronic dysphagia is troublesome. It is often a symptom or an outcome of a medical condition that requires treatment, says Michael Sternthal, M.D. [1], a gastroenterologist affiliated with Baptist Health South Florida.

Swallowing Issues Should not be Ignored

Failure to diagnose and treat swallowing problems can have serious health consequences, Dr. Sternthal warns. People with dysphagia are at risk for choking, dehydration, malnutrition and pneumonia, which can be triggered when food or drink enter the lungs.

Living with dysphagia not only poses a medical risk; it can negatively affect a person’s quality of life and mental health. People with swallowing difficulties often avoid social eating situations and feel isolated.

Common Causes

Dysphagia can be caused by functional abnormalities of the nerves of the brain, throat and esophagus, problems with the muscles of the throat and esophagus or a physical obstruction. The most common causes include:

‘Zenker’s Diverticulum’ can Cause Dysphagia

Dysphagia also can be caused by a Zenker’s diverticulum, a permanent bulge or pouch that forms at the junction of the hypopharynx (lower part of the throat) and esophagus. This pouch causes problems by trapping food as it is being swallowed, leading to choking, regurgitation of undigested food and aspiration. The condition is more common among older adults.

“Many cases of Zenker’s diverticulum are found incidentally during an endoscopy or imaging test prescribed to analyze a health concern, such as chronic indigestion,” Dr. Sternthal said. “Some patients with a Zenker’s have no swallowing issues and are surprised to learn of the condition. Others admit that they have been experiencing difficulty swallowing, but attributed it to the aging process.”

If a Zenker’s diverticulum is causing symptoms, endoscopic diverticulotomy is the ideal treatment, says Dr. Sternthal. “It’s a minimally invasive procedure that often is performed as an outpatient,” he said.

Treatment Depends on the Cause of Dysphagia

Diagnosing and treating dysphagia often is a collaborative effort involving gastroenterologists, otolaryngologists, radiologists, neurologists and speech and language pathologists who specialize in dysphagia. These specialists use various imaging tests to make a proper diagnosis and develop a personalized treatment plan.

Various therapies can reduce or eliminate the swallowing problem and restore a person’s ability to eat and enjoy normal foods. Treatment options include:

“Dysphagia is not always a chronic condition,” Dr. Sternthal said. “To maintain good health and quality of life, it’s important to treat dysphagia and the underlying condition causing it.”