Treating a full spectrum of dysphagia.
Swallowing, a seemingly simple act, is a complex process involving numerous muscles and nerves. When this process is disrupted, it can lead to a condition known as dysphagia, or difficulty swallowing. Swallowing disorders can range from mild discomfort to severe issues that impact nutrition, hydration, and overall quality of life. At St. Luke's University Health Network, our team of experts specialize in diagnosing and treating a full spectrum of swallowing disorders, helping patients regain comfort and confidence in eating and drinking.
Understanding swallowing disorders
Dysphagia is the medical term for difficulty swallowing. It can involve problems with moving food or liquid from the mouth to the stomach. This can manifest as difficulty swallowing or a sensation of food sticking in the throat or chest after swallowing (esophageal dysphagia). Swallowing disorders can affect people of all ages, though they are more common in older adults and individuals with certain medical conditions.
Symptoms of swallowing disorders
Symptoms of dysphagia can vary depending on the cause and location of the problem. Common signs and symptoms include:
- Pain while swallowing
- Inability to swallow
- Sensation of food getting stuck in the throat or chest
- Drooling
- Hoarseness
- Regurgitation of food
- Frequent heartburn
- Sour taste in the mouth
- Coughing or gagging when swallowing
- Choking
- Unexpected weight loss
- Recurrent pneumonia or respiratory infections
Causes of swallowing disorders
Swallowing disorders (dysphagia) can stem from problems affecting either the mouth and throat or the esophagus. Oropharyngeal (mouth and throat) causes often involve neurological disorders or damage—such as stroke, Parkinson’s disease, multiple sclerosis, ALS, or spinal cord injury—that weaken swallowing muscles or disrupt nerve coordination. Esophageal dysphagia may result from muscle or motility disorders such as achalasia or esophageal spasms, structural narrowing from strictures, tumors, or foreign bodies, and inflammatory conditions including GERD or eosinophilic esophagitis. Less common causes include connective tissue diseases like scleroderma and scarring from radiation therapy, all of which can interfere with the normal passage of food from the throat to the stomach.
Treatment and surgical options for swallowing disorders
Treatment for swallowing disorders at St. Luke’s is highly individualized and guided by a multidisciplinary team that addresses the specific cause and severity of each patient’s condition. Care often begins with non‑surgical approaches such as speech‑language pathology therapy to strengthen swallowing muscles, improve coordination, and recommend safe dietary modifications, along with medications to manage underlying issues like GERD or esophageal muscle spasms. Additional treatments may include Botox injections to relax tight esophageal muscles or dilation procedures to widen narrowed areas of the esophagus. When conservative therapies are not sufficient, surgical options—such as myotomy for achalasia, fundoplication for severe reflux, removal of obstructions, or esophagectomy in complex or cancer‑related cases—may be recommended to restore safer, more effective swallowing.
Frequently asked questions about swallowing disorders
Dysphagia refers to difficulty swallowing, while odynophagia refers to pain during swallowing. While they can occur together, they are distinct symptoms with different underlying causes.
Untreated dysphagia can lead to serious complications, including malnutrition, dehydration, weight loss, aspiration pneumonia (when food or liquid enters the lungs), and a significant decrease in quality of life due to fear of eating and social isolation.
The duration of swallowing therapy varies greatly depending on the cause and severity of the dysphagia, as well as the individual's response to treatment. Some individuals may see improvement in a few weeks, while others may require several months or ongoing therapy.
Many cases of dysphagia can be significantly improved with appropriate treatment, and some can be completely cured, especially when the underlying cause is treatable (e.g., GERD, strictures). For chronic or progressive conditions, the goal of treatment is often to manage symptoms, prevent complications, and improve swallowing safety and efficiency.
Lifestyle changes that can help manage swallowing disorders include eating smaller, more frequent meals, chewing food thoroughly, sitting upright during and after meals, avoiding distractions while eating, and modifying food and liquid consistencies as recommended by a speech-language pathologist.
