Dysfagia

Dysphagia is the medical term for difficulty swallowing. It can involve problems moving food or liquids from the mouth to the stomach and ranges from mild discomfort to complete inability to swallow. Symptoms commonly include sensation of food sticking in the throat or chest, coughing or choking during meals, regurgitation, drooling, unexplained weight loss, and recurrent chest infections.

Dysphagia is often classified as oropharyngeal (difficulty initiating a swallow due to problems in the mouth or throat) or esophageal (sensation of obstruction or impaired transit in the esophagus). Causes are diverse and include neurological conditions (stroke, Parkinson disease, multiple sclerosis), structural abnormalities (webs, strictures, tumors), motility disorders (achalasia, scleroderma), inflammation or infection, and side effects of medications or radiation therapy.

Evaluation typically begins with a clinical history and bedside swallowing assessment and may include fibreoptic endoscopic evaluation of swallowing (FEES), videofluoroscopic swallow study (modified barium swallow), upper endoscopy, and esophageal manometry. Tests aim to identify the level and mechanism of dysfunction and to assess risk of aspiration.

Management depends on cause and severity and can include dietary modification, swallowing therapy with a speech-language pathologist, texture alteration, medical treatment for underlying disease, endoscopic dilation, or surgical interventions. In severe cases, enteral feeding tubes may be needed. Complications include aspiration pneumonia, malnutrition, and dehydration. Dysphagia becomes more common with advancing age and warrants timely assessment to reduce risks and improve quality of life.