Difficulty Swallowing

Key Points:

• Some people find that they have a hard time swallowing. Doctors call this “dysphagia”, which means difficulty swallowing.

• When we say “difficulty swallowing”, we mean someone has trouble moving food or liquid from their mouth, through their esophagus, and into their stomach. It could also mean the feeling that food isn’t moving through the esophagus (even if it really is).

• Some people have trouble getting food out of their mouth and into their esophagus. This is called “oropharyngeal dysphagia”, meaning difficulty transferring liquid or food out of the mouth and into the esophagus.

• Some people can move food or liquid into their esophagus without a problem, but then have trouble moving the material down their esophagus and into their stomach. This is called “esophageal dysphagia”, meaning difficulty transiting the food down the esophagus.

Key points:

• Normally you should be able to swallow food or liquids on the first try without difficulty.

• It is unusual to have gagging, choking, or coughing when trying to swallow; these symptoms could mean that food or liquid is going down the wrong pipe, into your airway.

• Some people with dysphagia report that food or liquid feels stuck in the throat or chest.

• Sometimes food or liquid can come back up through the throat, mouth, or nose after swallowing.

• When difficulty swallowing becomes more severe, it can cause drooling because of inability to swallow saliva.

• Pain or pressure can occur when food gets stuck in the throat or chest.

• If dysphagia leads to reduced eating, then weight loss may occur.

If you plan to see a doctor for swallowing problems, then it will be important to describe the symptoms you are experiencing. The “My History” function of MyGiHealth asks more about dysphagia and can help you describe how you swallow in “doctor talk” should you plan to see a healthcare provider.

Normally when food or liquid is swallowed, it moves easily from the mouth to the upper esophagus. The esophagus then contracts from top to bottom smoothly moving food down the esophagus and into the stomach.

For more information how swallowing normally works on mouth and esophagus, please explore the difficulty swallowing educational videos.

Sometimes the normal process of swallowing can get interrupted. Here are some reasons why:

• A blockage like scarring, inflammation or a growth can get in the way of food moving through.

• The esophagus contracts in a way that doesn’t move food from the mouth to the stomach properly.

• The upper or lower esophageal sphincters don’t relax in a normal way to let food through.

Sometimes people feel like food or liquid gets stuck in their throat, but a doctor can find no cause for this feeling. The medical term for this is called “globus”, which refers to an unusual feeling of fullness in the throat without a clear explanation. Patients with globus almost never have a serious cause. Usually their symptoms don’t get any worse or may even go away. But it’s still a good idea to check with a doctor if the feeling does not go away.

Here are two main types of swallowing difficulties:

Oropharyngeal dysphagia: This includes problems that affect the ability to move food from the mouth to the upper esophagus.

Esophageal dysphagia: This includes problems that cause food to get stuck while passing through the esophagus and into the stomach.

If you are having difficulty swallowing, then the most important thing to do is see a doctor. A doctor will help you better understand the cause of the problem and help you choose the best treatment.

Sometimes eating differently can help. Here are some ideas.

• Avoid alcohol and caffeine.

• Experiment with different textured foods. Find out what's easier or harder for you to swallow (such as thin liquids or sticky foods).

• Avoid very hot or very cold foods.

• Eat soft or pureed foods to make it easier to swallow.

• Eat several small meals throughout the day, instead of 3 larger meals.

• Cut food into small pieces before eating.

• Eat slowly. Take time to chew food well.

• Sit upright when eating. Stay sitting up at least 30 minutes after a meal.

• Try special cups and spoons designed to make swallowing easier.

• Avoid using straws to drink.

• Drink after eating each mouthful of solid food to help wash it down.

To learn more about difficulty swallowing, please visit these websites:

• The American College of Gastroenterology

• The International Foundation for Functional Gastrointestinal Disorders

• National Institutes of Health