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Dysphagia

Dysphagia

This refers to a difficulty with swallowing. Some patients start with difficulties for swallowing certain foods. They may notice that solid foods like bread or meat get “stuck” somewhere in the throat or lower down on the way to the stomach. They feel that food is not getting into the stomach. This difficulty is often compensated by drinking more water, or by replacing solid diets with semisolid or liquid diets. The difficulty with swallowing might be progressive and patients cannot swallow solids and liquids anymore. Other signs of the condition include: coughing or choking when eating or drinking, bringing food back up, or a sensation that the food is stuck in the throat or chest.

Dysphagia can be due to inflammatory, allergic or even malignant disorders. That is why, the doctor should always start the investigations with an x-ray of the oesophagus following the passage of a contrast or performing a camera examination (endoscopy). If these studies are normal, the patient is considered to have a “non-obstructive dysphagia", meaning that the difficulty for swallowing is probably related to a disorder of function of the swallow mechanism or the oesophagus. Normally, the food is swallowed and moves down to the stomach by the help of contractions of the gullet muscles that push the food downwards. If these contractions are weak or very abnormal, the patient cannot swallow properly and perceives dysphagia. The abnormal motility of the gullet can be due to inflammation, allergies or neurological conditions that impair the function of the gullet’s muscle, for example in the disease called achalasia. Tests performed in the Neurogastroenterology Diagnostic Unit can help to diagnose these conditions and thus facilitate your diagnosis and treatment.

Treatment for this condition depends on your symptoms, but can include:

  • Changing the consistency of food and drinks
  • Speech and language therapy to learn new swallowing techniques
  • Medication to improve the strength of the contractions
  • Dilatation of the valve between the oesophagus and stomach (in achalasia)