St. Luke's Hospital
Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
Find a Physician Payment Options Locations & Directions
Follow us on: facebook twitter Mobile Email Page Email Page Print Page Print Page Increase Font Size Decrease Font Size Font Size
America's 50 Best Hospitals
Meet the Doctor
Spirit of Women
Community Health Needs Assessment
Home > Health Information

Multimedia Encyclopedia

    Print-Friendly
    Bookmarks

    Swallowing difficulty

    Dysphagia; Impaired swallowing; Choking - food; Globus hystericus

    Swallowing involves chewing food and moving it into the back of the mouth to transport it down the esophagus, the tube that moves food to the stomach.

    Difficulty with swallowing is the feeling that food or liquid is stuck in the throat or at any point before the food enters the stomach. This problem is also called dysphagia.

    Causes

    Swallowing is a complex act. Many nerves work in a fine balance to control how the muscles of the mouth, throat, and esophagus work together. Much of swallowing occurs without you being aware of what you are doing.

    A brain or nerve disorder can alter this fine balance in the muscles of the mouth and throat.

    • Damage to the brain may be caused by multiple sclerosis, Parkinson's disease, or stroke
    • Nerve damage may be due to spinal cord injuries, amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease), or myasthenia gravis

    Stress or anxiety may cause some people to feel tightness in the throat, or feel as if something is stuck in the throat. This is called globus hystericus.

    Problems that involve the esophagus often cause swallowing problems, including:

    • An abnormal ring of tissue that forms where the esophagus and stomach meet (called Schatzki's ring)
    • Abnormal spasms of the esophagus muscles
    • Cancer of the esophagus
    • Failure of the muscle ring at the bottom of the esophagus to relax (Achalasia)
    • Scarring that narrows the esophagus. This may be due to radiation, chemicals, medicines, chronic swelling, ulcers, or infection.
    • Something stuck in the esophagus, such as a piece of food.
    • Scleroderma, a disorder in which the immune system mistakenly attacks the esophagus
    • Tumors in the chest that press on the esophagus

    Symptoms

    Chest pain, the feeling of food stuck in the throat, or heaviness or pressure in the neck or upper or lower chest may be present, as well as:

    • Cough or wheezing that becomes worse
    • Coughing up food that has not been digested
    • Heartburn
    • Nausea
    • Sour taste in the mouth

    You may have problems swallowing with any eating or drinking, or only with certain types of foods or liquids. Difficulty eating very hot or cold foods, dry crackers or bread, meat, or chicken may be an early sign of swallowing problems.

    Exams and Tests

    Your doctor will order tests to identify problems, such as:

    • Something that is blocking or narrowing the esophagus
    • Problems with the muscles
    • Changes in the lining of the esophagus

    A test called upper endoscopy (EGD) is often done.

    • An endoscope is a flexible tube with a light on the end. It is inserted through the mouth and down through the esophagus to the stomach.
    • You will be given a sedative and feel no pain.

    Other tests may include:

    • Barium swallow and other swallowing tests
    • Chest x-ray
    • Esophageal pH monitoring (measures acid in the esophagus)
    • Esophageal manometry (measures pressure in the esophagus)
    • Neck x-ray

    Blood tests may be needed to identify certain disorders that can cause swallowing problems.

    Treatment

    The treatment for your swallowing problem depends on the cause.

    It is important to learn how to eat and drink safely. Not swallowing correctly may lead to choking or breathing food or liquid into your main airway. This can lead to pneumonia.

    Managing swallowing problems at home is an important step if the problem does not go away.

    • Your health care provider may suggest changes to your diet. You may also get a special liquid diet to help you stay healthy.
    • You may need to learn new chewing and swallowing techniques.

    Medicines that may be used depend on the cause, and may include:

    • Certain medicines that relax the muscles in the esophagus. These include nitrates, a type of medicine used to treat blood pressure, and dicyclomine
    • Injection of botulinum toxin
    • Medicines to treat heartburn and gastroesophageal reflux (GERD)
    • Medicines to treat an anxiety disorder, if present

    Procedures and surgeries that may be used include:

    • Using upper endoscopy, your health care provider can dilate or widen a narrowed area of your esophagus. For some people, this needs to be done again, and sometimes more than once.
    • Cancer may be treated with surgery or radiation. Achalasia or spasms of the esophagus may also respond to surgery.
    • If your symptoms are severe and you are unable to eat and drink enough, or you have problems chokingor pneumonia, you may need a feeding tube.

    When to Contact a Medical Professional

    Call your health care provider if swallowing problems do not improve after a few days, or they come and go.

    Call your doctor right away if:

    • You have a fever or shortness of breath
    • You are losing weight
    • Your swallowing problems are getting worse
    • You cough or vomit up blood
    • You have asthma that is becoming worse
    • You feel as if you are choking during or after eating or drinking

    References

    Falk GW, Katzka DA. Diseases of the esophagus. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 140.

    Kahrilas PJ, Pandolfino JE. Esophageal neuromuscular function and motility disorders. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 42.

    BACK TO TOP

          A Closer Look

            Self Care

              Tests for Swallowing difficulty

                Review Date: 11/9/2011

                Reviewed By: George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

                The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
                adam.com

                A.D.A.M. content is best viewed in IE9 or above, Fire Fox and chrome browser.


                Back  |  Top
                About Us
                Contact Us
                History
                Mission
                Locations & Directions
                Quality Reports
                Annual Reports
                Honors & Awards
                Community Health Needs
                Assessment

                Newsroom
                Services
                Brain & Spine
                Cancer
                Heart
                Maternity
                Orthopedics
                Pulmonary
                Sleep Medicine
                Urgent Care
                Women's Services
                All Services
                Patients & Visitors
                Locations & Directions
                Find a Physician
                Tour St. Luke's
                Patient & Visitor Information
                Contact Us
                Payment Options
                Financial Assistance
                Send a Card
                Mammogram Appointments
                Health Tools
                My Personal Health
                mystlukes
                Spirit of Women
                Health Information & Tools
                Clinical Trials
                Health Risk Assessments
                Employer Programs -
                Passport to Wellness

                Classes & Events
                Classes & Events
                Spirit of Women
                Donate & Volunteer
                Giving Opportunities
                Volunteer
                Physicians & Employees
                For Physicians
                Remote Access
                Medical Residency Information
                Pharmacy Residency Information
                Physician CPOE Training
                Careers
                Careers
                St. Luke's Hospital - 232 South Woods Mill Road - Chesterfield, MO 63017 Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
                Copyright © St. Luke's Hospital Website Terms and Conditions  |  Privacy Policy  |  Patient Notice of Privacy Policies PDF Sitemap St. Luke's Mobile