
What is Dysphagia?
Causes of Dysphagia or difficulty swallowing
Dysphagia (also known as difficulty swallowing) occurs when the muscles which control swallowing are not working normally in a coordinated manner. This is dangerous as it can result in food or water getting into the airways causing choking or lung infection known as aspiration pneumonia which can cause death. Other complications associated with dysphagia include weight loss, dehydration and depression due to inability to enjoy food or drink.
Swallowing Mechanism
Breathing and swallowing share a common area at the pharynx where muscles have to coordinate so that when we swallow, the tongue pushes back against the soft palate and closes off the nasal cavity and the epiglottis closes off the trachea so that the bolus of food travels one way down the oesophagus and into the stomach. The saliva and mucus produced by the salivary glands help the food travel down easily without getting stuck and without any pain. These muscles work together with the muscles of breathing so that breathing stops when you swallow. When you swallow, the airway is closed temporarily so that there is no risk of choking. Problems with any part of the swallowing process will cause symptoms of dysphagia.

Swallowing is a complex process and is divided into 3 phases:
- Oral preparatory phase where the food is chewed into smaller size (called a bolus) so that it can be swallowed easily with the help of your saliva. The tongue rises (while the soft palate prevents any regurgitation into the nose) and squeezes the bolus back along the roof of your mouth and into your upper pharynx.
- Pharyngeal phase is where the muscles of your pharynx contract (while the oesophageal sphincter relaxes) to allow the bolus to move down towards the oesophagus.
- Oesophageal phase is where the muscles in your oesophagus contract in sequence (known as peristalsis) to move the bolus toward your stomach. The lower oesophageal sphincter then relaxes to allow the food to get into the stomach
Symptoms of Dysphagia
- Feeling of food sticking in the throat
- Difficulty in starting to swallow
- Coughing during or after swallowing
- Drooling of saliva
- Needing to clear throat frequently
- Pain when swallowing
- Change in voice quality or a wet gurgling sound during eating or drinking
- Shortness of breath or feeling tired during meals
Common causes of dysphagia includes:
- Stroke
- Brain injury or tumours
- Nose or neck cancer
- Radiation treatment to head and neck cancers
- Parkinson’s disease
- Dementia
- Muscular dystrophies
- Dry mouth issues such as Sjogren’s syndrome
- Chronic lung diseases
See your Neurologist, ENT specialist or speech therapist if you have any swallowing issues
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If you think you may be suffering from any medical condition, you should seek immediate medical attention from your doctor or other professional healthcare providers. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website.