Difficulty swallowing (dysphagia)

Finding it hard to swallow can make eating and drinking uncomfortable or leave you worried about food getting stuck. Some people notice problems only with certain foods, while others find liquids difficult to swallow too.

Difficulty swallowing is known as dysphagia. There are many possible causes, so it’s important to find out what’s behind your symptoms. At Complete Health Australia, our gastroenterology specialists can investigate swallowing problems and recommend treatment based on the cause.

What is dysphagia?

Dysphagia is the medical term for difficulty swallowing. It can affect the process of moving food or drink from your mouth, through your throat and into your oesophagus, which is the tube that carries food to your stomach.

For some people, swallowing may feel slow or uncomfortable. You might feel as though food is sticking in your throat or chest. Others may cough or choke while eating and drinking.

Dysphagia can develop gradually or begin suddenly. It isn’t a condition in itself, but a symptom that can have a number of underlying causes. Persistent or worsening swallowing problems should always be assessed.

Dysphagia symptoms

Swallowing difficulties can feel different depending on where the problem occurs and what’s causing it.

Symptoms may include:

• Feeling that food is stuck in your throat or chest
• Coughing or choking when eating or drinking
• Taking longer than usual to finish a meal
• Pain or discomfort when swallowing
• Food or liquid coming back up after swallowing
• Having to chew food for longer or take smaller mouthfuls
• Avoiding certain foods because they’re difficult to swallow
• Unexplained weight loss

Some people may also develop repeated chest infections if food or drink enters the airway instead of the oesophagus. This is known as aspiration.

Seek medical advice if swallowing is becoming more difficult, you’re losing weight without trying or food regularly feels as though it’s getting stuck.

Call triple zero (000) if you suddenly develop difficulty swallowing alongside signs of a stroke, such as facial weakness, weakness in an arm or difficulty speaking. You should also seek urgent help if food is completely stuck and you can’t swallow your saliva.

What causes dysphagia?

Dysphagia can develop when there’s a problem with the muscles or nerves involved in swallowing. It can also happen when the oesophagus becomes inflamed or narrowed.

Acid reflux can irritate the lining of the oesophagus. Over time, inflammation may sometimes lead to narrowing, known as an oesophageal stricture.

Other conditions affecting the oesophagus include eosinophilic oesophagitis, where the immune system causes inflammation in the oesophagus, and oesophageal rings or webs, which are thin areas of tissue that can make part of the oesophagus narrower.

Some people have a problem with the way the muscles of the oesophagus move food towards the stomach. These are called oesophageal motility disorders. One example is achalasia, where the muscles don’t move food normally, and the muscle at the lower end of the oesophagus doesn’t relax as it should.

Swallowing problems can also be related to conditions affecting the brain or nerves, including a stroke or Parkinson’s disease. Less commonly, increasing difficulty swallowing can be a symptom of a growth in the throat or oesophagus.

Diagnosing dysphagia

Understanding when your symptoms happen can give your specialist important clues about the cause. They may ask if you have difficulty with solid foods, liquids or both, and if your swallowing has changed over time.

Depending on your symptoms, tests may include:

• Gastroscopy – a thin, flexible camera is used to examine your oesophagus and stomach and take tissue samples if needed
• Barium swallow – X-rays are taken while you swallow a special liquid that shows up clearly on the images, helping your specialist see how it moves through your throat and oesophagus
• Oesophageal manometry – a test that uses a thin tube to measure how well the muscles in your oesophagus contract and work together
• Swallowing assessment – looks at how safely and effectively you swallow, often with support from a speech pathologist

Your specialist will recommend the investigations most useful for understanding your particular symptoms.

Dysphagia treatment

Treatment depends on what’s making swallowing difficult.

If acid reflux has caused inflammation, medicines that reduce stomach acid may help the oesophagus heal. Treatment for eosinophilic oesophagitis may include medicines to reduce inflammation or changes to your diet.

If part of the oesophagus has become narrowed, your specialist may recommend oesophageal dilatation. During this procedure, the narrowed area is carefully stretched to make swallowing easier.

Oesophageal motility disorders need treatment tailored to the condition involved. This may include medication, a procedure carried out using a flexible instrument passed into the digestive tract (an endoscopic procedure), or surgery.

If the swallowing problem involves the mouth or throat, a speech pathologist may recommend swallowing techniques or exercises. Changes to the texture of food and drinks may also make swallowing safer for some people.

Discover expert gastroenterology care with Complete Health Australia

Difficulty swallowing can affect what you eat and how comfortable you feel at mealtimes. Getting the right diagnosis can help identify what’s causing the problem and which treatment may help.

Complete Health Australia brings together gastroenterology expertise in oesophageal conditions with access to investigations such as gastroscopy. Our specialists can assess persistent swallowing problems and provide care based on the underlying cause.

Book an appointment