Dysphagia is the medical term for a swallowing disorder. This may include any kind of difficulty swallowing: pain, inability to swallow, sensation of sticking, or frequent coughing, as well as reflux and gastroesophageal reflux disease (GERD). Dysphagia is classified into two main types: oropharyngeal (\-ˌfar-ən-ˈjē-əl, -fə-ˈrin-j(ē-)əl\) – meaning, related to the mouth and pharynx, or esophageal (\i-ˌsäf-ə-ˈjē-əl\) – meaning, related to the feeding tube or esophagus. SLPs deal with oropharyngeal dysphagia and screen for esophageal dysphagia. Depending on the suspected or known cause of the dysphagia, a patient suffering from dysphagia may also be seen by an otolaryngologist (ear, nose and throat specialist), a neurologist, a gastroenterologist or another kind of medical specialist.
To understand dysphagia of the mouth and throat, it helps to understand the basics of swallowing. Swallowing is an automated process for most people—like breathing, we don’t really think about it. But if you can’t breathe, or you can’t swallow, you quickly realize how critical these functions are. When we are eating, a signal is sent from the brain to trigger the coordination of some 50 pairs of muscles and nerves to move food around in the mouth and prepare it for swallowing. Problems with swallowing generally occur later in life, and may be linked to:
- Progressive neurological disorders, such as from multiple sclerosis, amyotrophic lateral sclerosis, Parkinson’s disease.
- Sudden neurological damage, such as from a stroke or brain and/or spinal cord injury.
- Cancer or cancer treatment, for example surgery and/or radiation for head and neck cancer.
- Other issues
Dysphagia can also occur in children, usually as a result of nervous system disorders (i.e. cerebral palsy) or cleft lip/palate.
Complications of dysphagia include malnutrition and dehydration as well as respiratory problems. Food or liquid can enter the airway (aspiration), which can lead to upper respiratory tract infections and/or pneumonia. Dysphagia can present from a mild problem (ex difficulty chewing solids) to more severe problems (ex food or liquid penetrating into the lungs causing aspiration). Difficulties with swallowing can also lead to anxieties and/or depression.