Definition and description
Dysphagia means difficulty with swallowing. It is a subjective sensation of something being stuck in the throat or upper chest, usually behind the breastbone. Pain may accompany the dysphagia. Swallowing difficulties may concern solids, fluids or both.
Difficulty swallowing may be due to an obstruction, or to neuro-muscular problems involving the mouth and oro-pharynx, or the oesophagus itself.
Dysphagia is considered an “alarm symptom” warranting immediate investigation, especially in older patients.
- Narrowing of the pathway following radiation, ulcers, chemical damage,
- Zenker’s diverticulum,
- Oesophageal webs,
- Foreign bodies,
- Drug side effects: some anticholinergics and antihistamines reduce salivary flow so much that swallowing is hindered, or
- Sjögren’s syndrome, an auto-immune condition.
Neuromuscular causes include:
- Oesophageal spasm,
- Parkinson’s disease, multiple sclerosis and muscular dystrophy,
- Myasthenia gravis,
- Previous infections such as polio,
- Hypertensive lower oesophageal sphincter (valve muscle),
- Nutcracker oesophagus, and
- Gastro-oesophageal reflux.