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Dysphagia is difficulty eating because of disruption in the swallowing process. In severe cases, even saliva is difficult to swallow, and you may not be able to take in enough fluids and calories to stay healthy. Complications may include aspiration pneumonia (food or liquids are pulled into your lungs), malnutrition, dehydration, weight loss and airway blockage.

Causes of Dysphagia

Some causes of dysphagia include:

  • Muscle disorders, like dermatomyositis or myotonic dystrophy
  • Obstructive lesions in the throat or esophagus, such as tumors
  • Vitamin B12 deficiency
  • Neurological disorders
  • Scleroderma
  • Narrowing of the esophagus after infection or irritation (like yeast or central nervous system infections)
  • Cancer treatments, including scarring or other injury to the swallowing muscles from chemotherapy and radiation for cancer
  • Birth defects, such as cleft palate
  • Reflux
  • Diabetes
  • Alcoholism
  • Thyroid disorders
  • Medications

Narrowing of the Esophagus


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Are You at Risk?

Risk factors for dysphagia include:

  • Diabetes
  • History of polio
  • Previous treatment for head and neck cancer
  • Progressive neurological disorder or muscle disorder
  • Gastroesophageal reflux disease
  • Head trauma

Symptoms of Dysphagia

Symptoms include:

  • Trouble swallowing
  • Constant feeling of a lump in the throat
  • Pain with swallowing
  • Drooling
  • Coughing or choking with eating or drinking
  • Recurrent pneumonia
  • Nasal sounding voice
  • Sensation of food sticking in the chest
  • Weight loss

Diagnosing Dysphagia

Your doctor will ask about your symptoms and medical history, and perform a physical exam. He or she will also watch you chew and swallow.

Tests may include:

  • Nasopharyngoscopy — uses a scope to view the throat
  • Blood tests — check for infection and thyroid function
  • Esophagram with barium swallow — X-ray test of the esophagus
  • Endoscopy — a thin, lighted tube in the throat examines the esophagus
  • Videoradiographic studies — X-rays during which swallowing is filmed on video
  • Ultrasound — sound waves examine structures inside the body
  • Manometry — tests the amount of pressure generated in various parts of the esophagus
  • pH studies — tests the degree of acidity in the esophagus
  • CT scan — a type of X-ray that uses computers to make pictures of the neck and chest
  • Chest X-ray — to check for pneumonia

Treatment for Dysphagia

Treatment of an underlying condition may help improve your swallowing problems. A speech-language pathologist can also teach you:

  • Techniques to help you swallow more easily
  • Exercises that strengthen the muscles needed for swallowing

Diet Changes

In severe cases, you may need to use high-nutrition liquid drinks. If you have trouble swallowing thin liquids, you may need powders to thicken liquids so they are easier to swallow.

Nonsurgical Treatments

Nonsurgical treatments include:
  • Progressive dilatation — instruments slowly stretch the esophagus
  • Biofeedback
  • Nasogastric feeding tube


In severe cases, surgery may be needed to:

  • Release an overly tight muscle
  • Remove a stricture or web that is blocking the esophagus
  • Place a stent (a tiny tube) to hold the esophagus open
  • Place a feeding tube through the abdominal wall


Speak with your doctor to get a referral. If you don't have a primary care doctor, we can help you find one. Call us at 434.243.3675.


Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.

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