OVERVIEW

What is esophageal dysphagia?

Strictly speaking, dysphagia is not a disease but a symptom, which is one of the clinical manifestations of certain conditions. Dysphagia refers to the obstruction of food during its passage from the mouth to the stomach, often causing patients to feel as if food is stuck in the "chest" or even experience pain behind the sternum.
From the mouth to the stomach, food passes through three parts: the mouth (oral cavity), the throat (pharynx), and the esophagus. Esophageal dysphagia specifically refers to obstruction occurring in the esophagus.
Esophageal obstruction by foreign bodies or esophageal diseases can both lead to esophageal dysphagia, which can be diagnosed through medical history, clinical symptoms, and barium swallow imaging. Treatment usually requires identifying the underlying cause and addressing it accordingly. Most cases of esophageal dysphagia have a good prognosis, but if it is caused by esophageal cancer, the prognosis is poor.

Is esophageal dysphagia common?

Esophageal dysphagia is quite common in gastroenterology. Most cases are due to esophageal obstruction by foreign bodies, with an annual incidence rate of approximately 13 per 100,000 people.

SYMPTOMS

What are the manifestations of esophageal dysphagia?

It manifests as a choking sensation a few seconds after swallowing food, which may be accompanied by pain during swallowing. Patients can clearly feel food stuck in the chest area or above the stomach.

CAUSES

What causes esophageal dysphagia?

The most common cause of esophageal dysphagia is foreign body obstruction, occurring in approximately 25 per 100,000 people annually.
Other conditions that may lead to esophageal dysphagia include esophageal strictures, esophageal tumors, esophagitis, achalasia, diffuse esophageal spasm, gastroesophageal reflux disease, and scleroderma.

Is esophageal dysphagia hereditary?

Whether it is hereditary depends on the underlying cause. Certain autoimmune diseases, such as scleroderma, may have genetic components.

Is esophageal dysphagia contagious?

No.

DIAGNOSIS

How should esophageal dysphagia be diagnosed?

It can be determined based on medical history, clinical symptoms, and esophageal-related examinations.

What tests are needed for esophageal dysphagia?

• Gastroscopy: A special endoscope is used to observe esophageal lesions. This examination may cause slight discomfort but is non-invasive.

• Barium swallow: Also known as a barium meal, it involves swallowing a special white liquid (barium) followed by imaging to reveal structural issues in the esophagus.

• Esophageal manometry: A pressure-sensing tube is inserted into the stomach and gradually withdrawn to measure pressure at different points in the esophagus. It may cause discomfort but is non-invasive.

Which diseases can esophageal dysphagia be easily confused with? How to differentiate them?

Esophageal dysphagia needs to be distinguished from oropharyngeal dysphagia. The key difference is that oropharyngeal dysphagia causes a sensation of obstruction at the very beginning of swallowing, while esophageal dysphagia leads to obstruction a few seconds after swallowing.

TREATMENT

Which department should I visit for esophageal dysphagia?

Gastroenterology.

Is it necessary to see a doctor for esophageal dysphagia?

Yes.

How is esophageal dysphagia treated?

Treatment varies depending on the cause:

• For achalasia, treatments may include endoscopic balloon dilation, peroral endoscopic myotomy (POEM), botulinum toxin injections, or calcium channel blockers (e.g., nifedipine) to relax the lower esophageal sphincter;

• For esophageal tumors, surgical resection or chemoradiotherapy may be required;

• For infectious esophagitis, appropriate antibiotics are selected based on the condition;

• For GERD or peptic esophageal strictures, H2 blockers (e.g., diphenhydramine) or proton pump inhibitors (PPIs, e.g., omeprazole) may be used, along with balloon dilation therapy;

• For systemic conditions like scleroderma, in addition to PPIs, systemic medications (e.g., glucocorticoids, methotrexate) may be required.

Can esophageal dysphagia be cured?

If the underlying cause is curable—such as esophageal foreign bodies, GERD, or infectious esophagitis—esophageal dysphagia can also be cured. However, if the cause is esophageal cancer, a cure is unlikely unless the tumor is surgically removed.

DIET & LIFESTYLE

What should be paid attention to in the diet for esophageal dysphagia?

Cut food into smaller pieces and chew thoroughly before swallowing. Try foods with different textures. If thin liquids are difficult to swallow, switch to thicker liquid foods. Avoid alcohol, tobacco, and caffeine.

What should patients with esophageal dysphagia pay attention to in daily life?

Closely monitor the patient while eating. If choking or gagging occurs, handle it immediately or seek medical attention as soon as possible.

Does esophageal dysphagia affect fertility?

No.

Can patients with esophageal dysphagia take flights, engage in strenuous exercise, or travel to high-altitude areas?

Yes.

PREVENTION

Can esophageal dysphagia be prevented? How to prevent it?

Whether it can be prevented depends on the underlying cause. For example, in cases of food-induced foreign body obstruction, paying attention to chewing food thoroughly, eating slowly, and avoiding laughing or playing while eating can help reduce the occurrence of esophageal dysphagia to some extent.