Difficulty Swallowing

If you’re having difficulty swallowing and your doctor or specialist couldn’t determine a reason why, you might want to read about eosinophilic esophagitis. Especially if you have a past history of allergies or hay fever. This disorder has just come to light in recent years and many medical specialists only recently became aware of it.

Most people take the ability to effectively swallow food and drink as a given, never worrying about a day when they may have trouble swallowing and never wondering what might cause such an occurrence. Yet, for those who have experienced difficulty swallowing while eating or drinking the function of ingesting food and drink making sustenance available for the ongoing support of the body becomes of the utmost importance.

Normal Swallowing

Normal swallowing is a product of the effective functioning of the tongue, epiglottis, and esophagus. First, the tongue moves food from the mouth into the throat. Second, the epiglottis covers the larynx and protects the airway from inadvertently receiving any food or drink. Finally, the muscles lining the esophagus, a long tube connecting the mouth and stomach, contract squeezing the food through the passageway and into the digestive system. When this is happening properly each step takes just milliseconds and swallowing is an instinctive reaction requiring little thought or effort.

Difficulty Swallowing (Dysphagia)

Sometimes people have trouble swallowing, known as dysphagia. Difficulty swallowing can occur in people of all ages at various levels of severity. Some may experience this issue only once or twice in a lifetime, while other have infrequent random episodes, and some live with the discomfort of swallowing troubles in every moment. The feelings individuals perceive when having trouble swallowing may be reported as different sensations, from an experience akin to choking, to a less frightening feeling of a tightening or lump in the throat. Some may not recognize the symptoms they experience as trouble swallowing at all.

Symptoms of Dysphagia

  • Feeling that you are unable to swallow food or drink. This commonly is described as an inability to control the muscles of the throat and occurs more frequently with solid food than with liquids.
  • Need to swallow multiple times to ingest food or drink.
  • Constant coughing, especially when eating, possibly accompanied by gagging or choking reflex.
  • Re-appearance of just-swallowed food or drink into the throat, mouth, or nasal passages.
  • Pain while swallowing. This may be experienced in the area of the esophagus or in the chest near the breastbone.
  • Heartburn.
  • Perception of a lump, often described as a large heavy ball, in the throat or chest.
  • Feeling of food being stuck in the throat.
  • Decreased appetite, with or without decreased enjoyment of eating.
  • Unexplained weight loss.

Causes

There are numerous issues that can cause a person to have difficulty swallowing and all of the potential causes fall into two types of systemic malfunctions: (1) structural changes or blockages in the esophagus and throat, or (2) problems with the muscles and/or nerves of the area. Blockages are a common cause of trouble swallowing, yet the blockage itself may be the result of many different issues including Esophagitis (including Eosinophilic Esophagitis), Gastrointestinal Reflux Disease (GERD), diverticula, tumors (both within the esophagus and protruding from nearby structures), esophageal webs, or impacted food which has lodged into some segment of the esophagus.

Esophagitis is a blanket term referring to an inflammation of the esophageal tissues. A common cause of esophagitis resulting in difficulty swallowing is the build-up of eosinophil cells as part of an allergic reaction. Gastrointestinal Reflux Disease (GERD) is a chronic condition in which the stomach acids escape into the esophagus causing ulcers and subsequent scar tissue. These structural changes reduce the available passageway in the esophagus.

Diverticula are small pockets that can develop in tissues throughout the body. When present in the esophagus they can capture food causing a feeling of discomfort and in worse cases an infection may develop. Tumors can grow within the esophageal tissues or just outside the esophagus in nearby tissue and bone. Protrusions or excessive pressure in the esophagus can then result in trouble swallowing.

Esophageal webs are structural issues resulting in thin pieces of web-like tissue along the lining of the esophagus narrowing the passage and resulting in obstruction.

Muscle and nerve damage causing trouble swallowing may be the result of an inflammatory disorder of the immune system, a brain or spinal cord injury, a muscle spasm in the esophagus, a disease resulting in weakened muscular systems and malfunctioning nervous systems such as muscular dystrophy or Lou Gehrig’s Disease, or a stroke.

Inflammatory disorders of the immune system, such as dermatomyositis, can result in decreased control over the muscles.

Brain and spinal cord injuries can damage the nervous system reducing the ability to interpret signals from the esophagus and causing difficulty swallowing. Muscle spasms in the esophagus can cause a consistent constriction of the esophageal walls prohibiting the passage of food and drink.

Effective swallowing is essential for a healthy comfortable life. Difficulty swallowing can occur to people of all ages and the issue may be a one time glitch of the system or an ongoing medical concern that requires treatment. If difficulty swallowing has caused breathing concerns, limited food intake, or lasted for longer than a week individuals should seek medical attention.

For more detailed information check out the list of topics about eosinophilic esophagitis.

You can also ask questions and communicate with others about the disorder by becoming a member of the free Eosinophilic Esophagitis Forum.