Dysphagia: What's Behind Your Swallowing Difficulties?
Grace Weatherby
/ Categories: WELLNESS, 2024

Dysphagia: What's Behind Your Swallowing Difficulties?

Swallowing is a complex process that involves the coordinated action of at least 30 muscles and multiple nerves in the mouth, throat, and esophagus. When any part of this system is disrupted, it can lead to swallowing difficulties, also known as dysphagia.

More prevalent in older adults, dysphagia can prove to be a minor inconvenience for some while for others it can lead to severe complications and put their health and quality of life at risk.

Dysphagia can present a variety of symptoms, broadly categorized into two types: oropharyngeal and esophageal. The type of symptoms being experienced serve as clues to medical professionals about the potential cause of the condition.

Here’s how the symptoms of oropharyngeal and esophageal dysphagia differ:

Oropharyngeal Dysphagia:

  1. Difficulty starting to swallow: This includes trouble moving food from the mouth to the throat.
  2. Choking or coughing: Food or liquids might enter the airway instead of the esophagus, causing coughing or choking.
  3. Nasal regurgitation: Liquids or food coming back up through the nose.
  4. Gurgling voice: A wet-sounding voice after eating or drinking.
  5. Recurrent pneumonia: Due to aspiration of food or liquids into the lungs.

Esophageal Dysphagia:

  1. Feeling of food stuck in the throat or chest: A sensation that food is lodged somewhere in the esophagus.
  2. Painful swallowing: Discomfort or pain when swallowing.
  3. Regurgitation: Bringing food back up without nausea.
  4. Heartburn: A burning sensation in the chest.
  5. Unexplained weight loss: Difficulty in swallowing may lead to a reduced intake of food, resulting in weight loss.

With a clear understanding of the type of dysphagia you’re experiencing, your healthcare provider can begin to explore what’s specifically behind your condition.

COMMON CAUSES OF DYSPHAGIA

Oropharyngeal

Aging

Head and neck surgeries and injuries

Dementia

Stroke  

Parkinson’s Disease

Amyotrophic Lateral Sclerosis (ALS)

Multiple Sclerosis (MS)

Muscular Dystrophy

Thyroid Enlargement: Often the result of an iodine deficiency or Grave’s Disease

Pharyngitis and Tonsillitis: Inflammation of the throat and tonsils most often due to infection

Oral Candidiasis (Thrush): Soreness in the mouth and throat resulting from a fungal infection in the mouth

Esophageal

Aging

Esophageal Stricture: A narrowing of the esophagus, often the result of acid reflux of gastroesophageal reflux disease (GERD)

Esophageal Rings and Webs: Thin layers of tissue that form in and partially block the esophagus. These can be congenital or develop later due to chronic acid exposure from GERD.

Esophageal Tumors: Benign or malignant growths in the esophagus. Risk factors include smoking, heavy alcohol use, and family history.

Diffuse Esophageal Spasm: Irregular spasm contractions of the esophagus brought on by damage to the nerves that coordinate the muscles of the esophagus

Scleroderma: Hardening and tightening of the skin and connective tissues that restricts the esophagus, resulting from an autoimmune disease

Eosinophilic Esophagitis: An allergic inflammatory condition often related to food allergies and environmental allergens

 

Understanding the type of dysphagia you are experiencing and the underlying cause is crucial for effective treatment and management.

Beyond assessing your symptoms, diagnosis often involves a clinical examination and imaging studies. Based on the findings, treatment may include:

  • Swallowing therapy: Exercises to strengthen the muscles involved in swallowing
  • Lifestyle changes: Modifying eating habits and using safe swallowing strategies
  • Dietary modifications: Changing the texture of foods and liquids to make swallowing easier and/or reducing acid intake.  
  • Medications: To manage underlying conditions like infections or inflammation.
  • Surgery: In cases where structural abnormalities need to be corrected.
  • Dilation: Stretching narrowed areas of the esophagus.

If you or someone you know experiences persistent difficulty swallowing, contact your doctor. Addressing any issue early can significantly improve outcomes and help you return to living your life fully sooner.

 

Kate O'Neill, MS, CCC-SLP, is a speech-language pathologist at SVMC Outpatient Rehabilitation, part of Southwestern Vermont Medical Center.

Print
964

Theme picker


 

 

 

Introducing Dr. Amy Freeth

Amy E. Freeth, MD, resumed endocrinology services at SVMC in March 2020. The practice, known as SVMC Endocrinology, is a part of Southwestern Vermont Medical Center (SVMC) and Southwestern Vermont Health Care (SVHC). It replaces the Bennington Osteoporosis Center, where Dr. David Gorson had provided similar services to the community until his retirement in 2019.

How do you describe endocrinology to people who don’t know what it is? The endocrine system is made up of glands that make hormones. These hormones are chemical messengers that travel via the bloodstream to communicate with the cells and organs of the body. Hormones are important for growth, development, mood, metabolism, and reproduction. These glands include the pituitary, thyroid, parathyroid, pancreas, adrenal, testes, and ovaries.

Endocrinology is a practice of medicine that specializes in disorders of these systems. Disorders most commonly are related to underactive or overactive function of these glands and require replacement of the hormone or specific treatments such as medications, ablation, or surgery.

Since hormones function in feedback loops and are part of a larger complex functional system that exists in flow with the human body, replacement hormones or treatment of endocrine disorders can be challenging and involve changes to our lifestyles that support the optimal functioning of the body.

What diagnoses are most common among the patients you treat?  Pituitary tumors, hypothyroidism, hyperthyroidism, thyroid nodules, thyroid cancer, hyperparathyroidism, osteoporosis, diabetes, adrenal insufficiency, Cushing’s disease, primary hyperaldosteronism, pheochromocytoma, obesity, and polycystic ovarian syndrome.

What sorts of treatments do you offer? I offer comprehensive consultation and management of endocrine disorders. I also interpret testing and make treatment plans for endocrine disorders. I also provide interpretation of bone density reports and perform fine needle aspiration biopsies in collaboration with Radiology Associates of Bennington. Technology is increasingly becoming more important in the management of diabetes. Technology includes glucose meters, insulin pumps, and continuous glucose monitoring (sensors). I work with certified diabetes educators to create a team approach to diabetes management. As we develop this new department, we are looking for innovative ways to help people regain and optimize their health. I have training in nutrition counseling and health coaching to help people find their path to good health.

Why is it important for patients who need an endocrinologist see them regularly? Your endocrinologist is part of your health team and has experience and a deep understanding of what is happening within your body to help assess, guide, and co-manage your disorder. There is testing that may need to be done to make sure you are living with optimal hormonal balance. Allowing hormones to run too low or too high can have lasting adverse effects on the body leading to other disease or imbalances.

How do you help protect patients who need to come into the office from infections, like COVID-19? At this time, I am seeing patients via telemedicine and phone visits. This week we are starting to see a portion of our patients in the clinic. Patients can register on the phone and wait in their car until the room is ready. Patients will be screened for fever and should wear a mask. Staff will wear proper protective equipment and follow guidelines for handwashing and cleaning of the rooms.

Since many patients who will likely want to come to the endocrinology clinic will be members of high-risk populations (diabetes, hypertension, obesity, and the elderly), patients will have a choice of the type of visit they have.

Dr. Freeth sees patients 8 a.m. – 5 p.m. Tuesday - Thursday in Suite 307 of the Medical Office Building located at 140 Hospital Drive in Bennington. For an appointment, call 802-447-4555. The schedule will expand to additional days as needed.

Theme picker


Theme picker


Theme picker


Our Services

PARTNERSHIP IS POWERFUL MEDICINE

A commitment to excellence and a patient-centered approach sets Southwestern Vermont Health Care apart.

 Cancer Care
 Orthopedics
 Emergency
 Maternity
 Primary Care
 ExpressCare
 Cardiology
 Rehab & Residential Care
View All Services

Theme picker

Theme picker

Theme picker

Theme picker

Theme picker