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Difficulty Swallowing

Dysphagia

Having trouble swallowing, also known as dysphagia in medical terms, is a painful condition where it takes more effort to move food and drink from the mouth to the stomach. In severe cases, swallowing can become impossible.

Struggling to swallow doesn’t always signify a medical issue. It’s normal to experience occasional difficulties with swallowing, but if it persists, it could indicate a serious medical problem. This condition can affect anyone, but it’s more common among elderly people.

The National Institute of Deafness and Other Communication Disorders (NIDCD) indicated that there are 50 pairs of nerves and muscles that work together to facilitate the process of swallowing. Any issues with these nerves or muscles can cause difficulties with swallowing.

Gastroesophageal Reflux Disease (GERD)

GERD, or gastroesophageal reflux disease, is a condition characterised by acid reflux occurring at least twice a week. Acid reflux happens when the contents of the stomach flow up into the esophagus, causing a painful burning sensation in the chest. One of the symptoms of GERD is experiencing difficulty and discomfort while swallowing.

Oesophageal Cancer

When cancer cells form in the oesophagus, they begin in the inner layer and spread throughout the other layers of the oesophagus and other parts of the body. There are two main types of oesophageal cancer: one that affects the squamous cells lining the inner oesophagus and can develop along the entire oesophagus, and another that arises from gland cells that have replaced the squamous cells lining the oesophagus.

The presence of cancerous tumours in the oesophagus can cause it to narrow, making swallowing increasingly difficult as the cancer progresses. Conversely, radiation therapy employed to treat the cancer can cause inflammation and scarring of the oesophagus, leading to swallowing difficulties.

Oesophageal Strictures

Acid reflux can harm the tissues in the oesophagus and lead to a constriction in the lower oesophagus. This constriction can cause discomfort and difficulty when trying to swallow food or liquids. Individuals with an oesophageal stricture may experience a sensation of obstruction or blockage in their throat.

Achalasia

Achalasia is a rare medical condition that affects approximately 1 in 100,000 individuals, regardless of gender or age. This disease primarily affects the lower oesophageal sphincter, where the muscles fail to relax and transport food into the stomach. Consequently, people with this condition often experience difficulty swallowing and must adapt their diet by consuming liquid-based foods. In addition, weakened muscles in the lower oesophageal sphincter can also occur due to the formation of scar-like tissues. This can result in acid reflux and heartburn.

Neurological Conditions

Swallowing difficulties related to neurological conditions stem from impaired sensorimotor function during the oral and pharyngeal phases of swallowing. Neurological conditions such as stroke (the most frequent cause of neurogenic dysphagia), traumatic brain injury, cerebral palsy, Parkinson’s disease, and degenerative neurological disorders like Lou Gehrig’s disease, Huntington disease, and multiple sclerosis are known to cause dysphagia.

Eosinophilic Esophagitis

Eosinophilic Esophagitis (EoE) is an uncommon chronic condition affecting the oesophagus, where there is an accumulation of a type of white blood cell called eosinophils, leading to inflammation and damage. The exact cause of EoE is not yet known, but scientists suggest that it could be an immune system or allergic response triggered by specific foods or environmental substances, such as dust mites, pollen, and moulds. It is important to note that some individuals who believe they have GERD may actually have EoE, as the symptoms can be similar.

Zenker’s Diverticulum

Zenker’s diverticulum (ZD) is a rare condition in which a pouch or sac forms in the wall of the oesophagus, where it meets the throat, leading to the accumulation of mucous, food, and liquid instead of allowing the contents to pass through into the stomach as they normally would.

It is important to seek immediate medical attention if you encounter difficulties in breathing, sudden muscle weakness or paralysis, or if you are unable to swallow at all. In addition, if you suspect that something is obstructing your throat, leading to painful or difficult swallowing, it is recommended to consult a healthcare professional to identify the underlying cause.

In order to diagnose the cause of swallowing difficulties, a healthcare provider may conduct a thorough examination and ask about any relevant medical history. Various tests may also be performed, such as a nasoendoscopy to check the nasal passage, throat, and voice box, or an endoscopy to examine the oesophagus and take samples to identify any inflammation or tumours. Additionally, a manometry test can be used to assess the pattern and pressure of oesophagal contractions to diagnose functional causes like achalasia or diffuse spasm. Other imaging studies such as X-rays or CT scans, and barium swallow studies, may also be recommended to identify mechanical obstructions like tumours or strictures.