Common GI Symptoms
Common GI Symptoms > Dysphagia – Difficulty in Swallowing
Dysphagia – Difficulty in Swallowing
What is Dysphagia?
Dysphagia refers to the feeling of difficulty swallowing food or water. If you are having dysphagia, you should consult a doctor.
There are many possible causes of dysphagia, including problems in the mouth, oesophagus (food pipe), and stomach. It can also be caused by nerve/brain problems such as stroke or Parkinson’s disease.
To find out what is the underlying cause, a doctor will need to ask you detailed questions, perform a physical examination, and order various tests.
What are some of the common causes of dysphagia?
Oesophageal cancer
As cancer grows, it starts to block the passage of food/water during swallowing. Dysphagia is usually the earliest warning symptom of oesophageal cancer. If detected early, it may be cured through surgery to remove cancer.
Strictures/Scarring – Non-cancerous
These areas of narrowing can be caused by previous damage to the oesophagus by acid reflux, injury from swallowing chemicals such as bleach/detergent, certain medicines.
Achalasia
When we swall ow food, there are nerves and muscles which contract to push this food down into the stomach. Achalasia is a condition in which these nerves are affected, impairing the action of swallowing.
Neurological problems
Patients with conditions such as stroke or Parkinson’s disease may experience difficulty swallowing their food and water. This can result in them choking and coughing when trying to drink water.
What are some tests your doctor may order?
Endoscopy
An endoscope is a thin, flexible tube with a tiny video camera at the tip. The endoscope is controlled by the doctor and goes through the mouth, down the food pipe, and into the stomach. The video allows the doctor to look for any abnormalities within the digestive tract. It is also possible to take small samples (biopsy) using the endoscope. During the procedure, mild sedative medicine will be given for comfort.
Barium Swallow
This involves first drinking a special liquid which contains barium. This liquid then coats the lining of the food pipe and stomach. After which, an X-ray picture is taken. The barium allows the outline of the oesophagus and stomach to be seen clearer than in a normal plain X-ray.
CT Scan (computed tomography)
This is a high-resolution scan in which a series of X-rays are taken. This gives a 3D view of the internal organs in the body.
Oesophageal Manometry
This is done by passing a thin, flexible tube down the oesophagus. Along the tube are numerous pressure sensors. This test is most useful for diagnosing conditions affecting the nerve and muscles of swallowing (eg: Achalasia).
Videofluoroscopic Swallowing Study (VFSS)
It involves drinking a solution containing barium. At the same time, live X-ray video is taken to examine the movement of barium down the mouth into the oesophagus. This test is useful to diagnose neurological problems of swallowing (eg. stroke patients).