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Jan 20, 2019 Dr Zulfikar Bux, Features / Columnists
By Dr Zulfikar Bux
Assistant Professor of Emergency Medicine
While difficulty swallowing is not a frequent complaint, it can indicate seriousness and is sometimes ignored by patients when it initially presents itself.
The Medical term for difficulty swallowing is Dysphagia. People who have dysphagia have trouble swallowing solid foods, liquids, or saliva. They may not be able to swallow at all. Dysphagia can make it hard to take in enough calories and fluids to keep your body working properly.
Today we will highlight some important facts about dysphagia to help you understand how serious it can be.
WHAT ARE THE SYMPTOMS OF DYSPHAGIA?
If you have dysphagia, you may have some of the following symptoms:
• Pain while swallowing
• Choking
• Feeling like something is stuck in your throat or chest
• Being hoarse
• Coughing up food
• Gagging or coughing when swallowing
• Bad breath
• Drooling
• Weight loss
• Frequent heartburn
• Dehydration
WHO’S AT RISK OF SUFFERING FROM DYSPHAGIA?
Dysphagia can happen at any age, but it is more common in older people. Many different things can cause dysphagia:
• Poor eating habits. Eating too fast or taking large bites can cause dysphagia. So can eating while lying down or not drinking enough water while eating. You may also experience dysphagia if you can’t chew properly because of painful or missing teeth or dentures.
• Nerve and muscle disorders. People who have had a stroke, or people who have Parkinson’s disease, multiple sclerosis, muscular dystrophy, or myasthenia gravis may have problems swallowing. These disorders can stop the nerves and muscles in your esophagus from working right. The esophagus is the tube that takes food from your mouth to your stomach. This can cause food to move slowly or even get stuck in the esophagus.
• Problems with the esophagus itself. For example, conditions like acid reflux can damage the esophagus and cause scar tissue to form. The scar tissue may narrow the opening of the esophagus and may result in dysphagia.
• Other disorders. Certain cancers, an enlarged thyroid, or an enlarged heart may put pressure on the esophagus and cause dysphagia.
HOW IS DYSPHAGIA DIAGNOSED?
When you visit the doctor, he/she will question and examine you. This will help him/her to get an idea of what may be causing your dysphagia and what tests to order. Your doctor may order a test called a barium swallow. During this test, you will drink a liquid that contains a small amount of barium. Then the doctor can watch it travel through your body on an X-ray machine. This test can show whether something is blocking your esophagus, or if another problem is causing your dysphagia.
You may also need an endoscopy. For this test, the doctor will look into your esophagus. He or she will look inside the esophagus, stomach, and the first part of the small intestine. The doctor may take a small sample of tissue (called a biopsy) to rule out cancer or other possible causes of your dysphagia. You will probably be given a sedative medicine. This should make you more relaxed and comfortable during the test. Your throat will also be numbed, so you shouldn’t feel pain when the tube is inserted.
ARE THERE TREATMENT OPTIONS FOR DYSPHAGIA?
Treatment for your dysphagia will depend on what is causing it.
If poor eating habits are the cause, you may be taught how to improve your ability to swallow. This could include chewing carefully or drinking more water while eating. Or you may need to change positions while swallowing. This could be as simple as turning your head at a different angle. Your doctor may also work with you to find foods that are easier for you to swallow. You might need to do exercises to strengthen your swallowing muscles, such as your tongue and your esophagus.
Sometimes, medicine or other treatments may be used to treat the cause of dysphagia. For example, if your dysphagia is caused by heartburn, your doctor might suggest taking an antacid or acid reducer before every meal. If you have a muscle problem causing dysphasia, a medicine called botulinum toxin may be used to relax throat muscles. This will make swallowing easier.
Sometimes dysphagia is caused by a tumour or something else blocking the esophagus. You may need surgery to treat these problems. For some people, surgery won’t help. They would need a feeding tube in the stomach to make sure they are getting the foods and fluids they need. Dysphagia can be an indicator of badness. If you are having difficulties swallowing, do not ignore it, get help!
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