Medical Professionals
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I’m Having Difficulty Swallowing – What Does This Mean and What Can I Do About It? How do I treat my problem swallowing? Written by
Teresa Menadier, MD Gastroenterologists of Ocean County
W
e take our ability to swallow for granted. It may seem like an easy, natural bodily function, but there are a lot of muscles and tissues coordinating together at just the right moment to move what we eat from our mouth to our stomach. Difficulty swallowing (referred to as “dysphagia”) is the inability to swallow solid food and/or liquid with ease. Some describe this as a sensation of food getting stuck in their throat or chest after swallowing. Others may feel chest pressure, chest tightening, or have choking or coughing after swallowing.
Treatment depends on the underlying cause. Sometimes we can stretch the esophagus if it is narrowed. Medication that reduces acid or that can relax the muscles of the esophagus can also be used. Occasionally, we can inject a muscle relaxant such as Botox into the bottom part of the esophagus. A less common condition, called achalasia, may benefit from surgery. Occasionally, a swallowing specialist can provide exercises to strengthen your swallowing muscles, train you to improve the way you swallow and teach you how to adjust the consistency of what you are eating and drinking so it goes down more easily. All in all, difficulty swallowing is an important symptom to discuss with your gastroenterologist.
Call to schedule your appointment at Gastroenterologists of Ocean County.
Omar Tamini, MD
What can cause problems swallowing?
Not chewing thoroughly, for example, in someone who might be missing teeth or has trouble using dentures is one cause. A prior stroke can produce weakness in the muscles at the top of the esophagus. Longstanding acid reflux (GERD or “heartburn”) can cause inflammation in the esophagus. A narrowing or scarring of the esophagus after many years of untreated acid reflux can create a roadblock, called a stricture, that will prevent passage of food or drink. Food allergens can also cause inflammation of the esophagus and lead to narrowing. Diseases that affect the muscles and nerves of the esophagus, such as scleroderma and achalasia, respectively, can affect the way the esophagus moves and can disrupt proper emptying of food into the stomach. In some people, the esophagus is overactive and squeezes too hard, which can be painful. Infections of the esophagus can also cause pain and difficulty swallowing. The most worrisome cause of swallowing difficulty is a cancer in the esophagus.
Jill Collier, MD Edgar Bigornia, MD Kenneth Glazier, MD Jai Mirchandani, MD Teresa Menadier, MD
• Colonoscopy and colon polyp removal • Colon cancer detection and screening • Rectal bleeding evaluation • Ulcer pain evaluation and treatment • Swallowing disorders
• Endoscopic treatment of hemorrhoids • Capsule Endoscopy • Breath testing • Esophageal and anorectal manometry
How do I figure out what is causing my swallowing difficulty? The first step in our investigation is usually an upper endoscopy (referred to as an EGD), a low-risk exam under anesthesia that allows us to examine the esophagus and stomach and to take biopsies if necessary. A second test we can do is called a pH test. This is a test you go home with that records acid exposure in the esophagus. A third test, called a barium esophagram, involves drinking a substance that lights up under X-ray. A radiologist takes pictures and videos under X-ray to see how things travel from your mouth to your stomach. Finally, we can perform a test called esophageal manometry. This requires a catheter to be placed into your esophagus for a 30 to 40-minute exam. We will measure the pressures and activity of the esophagus muscles as you swallow small sips of water.
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A Division of Allied Digestive Health
January/February 2019 March/April 2018