SYMPTOMS

What is dysphagia?

Dysphagia, also known as difficulty swallowing, refers to the sensation of effort or obstruction when swallowing food or drinking water, making it difficult or impossible to swallow. Commonly described as "choking easily while eating" or "food sticking in the esophagus," it typically manifests as difficulty swallowing, a feeling of obstruction as food passes through the mouth or throat, prolonged swallowing time, and in severe cases, the inability to swallow food or water.

What are the types of dysphagia, and what are their symptoms?

Based on the location of occurrence, it can be classified into: oropharyngeal dysphagia and esophageal dysphagia.

• Oropharyngeal dysphagia: Difficulty initiating swallowing, with a sensation of food stuck in the neck. It is often accompanied by difficulty starting the swallow, nasal speech, coughing, bad breath, dysarthria, double vision, and recurrent aspiration pneumonia.

• Esophageal dysphagia: Often related to digestive system disorders, common accompanying symptoms include reflux, painful swallowing, choking, hoarseness, retrosternal pain or burning sensation. Compared to oropharyngeal dysphagia, patients feel food stuck in the chest or between the neck and chest.

TREATMENT

How to treat dysphagia?

The treatment for dysphagia depends mainly on the underlying cause. Common approaches include:

• Adjusting nutrition and diet, such as switching to soft or liquid foods, and combining food with liquids;

• For dysphagia caused by neurological conditions like stroke, improving swallowing posture and undergoing specific swallowing exercises can help;

• Acid-suppressing medications like proton pump inhibitors (e.g., omeprazole, lansoprazole) are often used for dysphagia due to acid reflux disease;

• Patients with esophageal strictures may require dilation, stent placement, or surgery.

Specific treatment should be based on the cause and guided by a doctor.

What should dysphagia patients pay attention to in their diet?

For patients with dysphagia, especially those undergoing rehabilitation, dietary precautions are crucial.

• Avoid hard fresh fruits, nut-filled bread, raw vegetables, etc., as these foods are difficult to swallow and may hinder rehabilitation progress;

• Making food visually appealing and aromatic can stimulate appetite;

• Keep water or other drinks within reach during meals to aid swallowing;

• Ensure a quiet eating environment.

DIAGNOSIS

When should people with dysphagia see a doctor?

Most cases of dysphagia do not resolve on their own and require appropriate treatment, especially when eating is severely affected, significant weight loss occurs, or severe reflux or vomiting is present. Dysphagia caused by neurological conditions often occurs after the underlying disease and can be reported to a doctor during follow-up visits. If severe breathing difficulty occurs or a food bolus becomes stuck in the throat or esophagus due to narrowing, immediate emergency treatment is necessary to avoid life-threatening risks.

Which department should be consulted for dysphagia?

The choice of department for dysphagia depends on its underlying cause, which can generally be determined based on medical history and accompanying symptoms.

• If dysphagia is progressively worsening and accompanied by significant weight loss or emaciation, it may indicate esophageal malignancy, requiring consultation with the gastroenterology department.

• If the patient has a history of cerebrovascular disease or experiences paralysis or numbness in other body parts, neurological disorders are likely, necessitating a visit to the neurology department for treatment of the primary condition.

• If a neck mass is present along with choking while drinking or hoarseness, thyroid enlargement may be suspected, requiring an ENT (ear, nose, and throat) consultation.

• If there is a history of depression, hysteria, or other abnormal psychiatric symptoms, dysphagia may be psychogenic, and treatment at a specialized mental health center or psychiatry department is recommended.

POTENTIAL DISEASES

What could be the causes of dysphagia?

Diseases causing dysphagia can generally be classified into two categories: mechanical and motility-related:

• Mechanical dysphagia: Any condition that narrows the diameter of the esophagus may lead to dysphagia. This includes both intrinsic esophageal strictures and external compression from enlarged adjacent organs. Common causes include inflammation of the throat or esophagus, esophageal tumors, thyroid enlargement, and mediastinal tumors.

• Motility-related dysphagia: Normal swallowing relies on coordinated neuromuscular activity. Dysfunction in the nerves or muscles controlling swallowing results in motility-related dysphagia, such as in cerebrovascular accidents (stroke), myasthenia gravis, Parkinson’s disease, achalasia, and dermatomyositis.

In addition to the above, psychiatric conditions like hysteria, anxiety disorders, and depression may also frequently cause dysphagia.