Dysphagia or difficulty swallowing is a serious symptom of the upper gastrointestinal tract. Dysphagia means it takes more time and effort to move food or liquid from your mouth to your stomach or refers to the sensation of food sticking or getting hung up in the base of your throat or in your chest.
Occasional difficulty swallowing food usually isn't cause for concern, and may simply happen when you eat too fast or don't chew your food well enough. But persistent or worsening difficulty swallowing food may indicate a serious medical condition requiring treatment.
When to see a doctor
Slight or occasional difficulty swallowing usually isn't cause for concern, but you should see a doctor if you regularly have difficulty swallowing or if difficulty swallowing is accompanied by weight loss, regurgitation or vomiting.
The act of swallowing food is quite complex and actually requires about 50 pairs of muscles and nerves. Several conditions can interfere with this process. Some of the causes of dysphagia include:
- Achalasia. This occurs when your lower esophageal muscle (sphincter) doesn't relax properly to let food enter your stomach. Muscles in the wall of your esophagus may be weak as well. This can cause regurgitation of food not yet mixed with stomach contents, sometimes causing you to bring food back up into your throat.
- Cancer. Certain cancers and some cancer treatments, such as radiation, can cause difficulty swallowing.
- Diffuse spasm. This condition produces multiple, high-pressure, poorly coordinated contractions of your esophagus usually after you swallow. Diffuse spasm affects the involuntary muscles in the walls of your lower esophagus.
- Esophageal stricture. Narrowing of your esophagus (stricture) can cause large pieces of food to get caught. Narrowing may result from the formation of scar tissue, often caused by gastroesophageal reflux disease (GERD), or from tumors.
- Esophageal tumors. Difficulty swallowing tends to get progressively worse when esophageal tumors are present.
- Foreign bodies. Sometimes, food, such as a large piece of meat, or another object can partially block your throat or esophagus. Older adults with dentures and people who have difficulty chewing their food properly may be more likely to have a piece of food become lodged in the throat or esophagus. Children may swallow small objects, such as pins, coins or pieces of toys, that can become stuck.
- Esophageal ring. This thin area of narrowing in the lower esophagus can intermittently cause difficulty swallowing solid foods.
- Gastroesophageal reflux disease (GERD). Damage to esophageal tissues from stomach acid backing up (refluxing) into your esophagus can lead to spasm or scarring and narrowing of your lower esophagus, making swallowing difficult.
- Eosinophilic esophagitis. This condition, which may be related to a food allergy, is caused by an overpopulation of cells called eosinophils in the esophagus, and can lead to difficulty swallowing.
- Oropharyngeal dysphagia Certain problems related to your nerves and muscles can weaken your throat muscles, making it difficult to move food from your mouth into your throat and esophagus (pharyngeal paralysis). You may choke, gag or cough when you attempt to swallow, or have the sensation of food or fluids going down your windpipe (trachea) or up your nose. This may lead to pneumonia. Causes of oropharyngeal dysphagia include:
- Neurological disorders. Certain disorders, such as post-polio syndrome, multiple sclerosis, muscular dystrophy and Parkinson's disease, may first be noticed because of oropharyngeal dysphagia.
- Neurological damage. Sudden neurological damage, such as from a stroke or brain or spinal cord injury, can cause difficulty swallowing or an inability to swallow.
- Scleroderma. This disease is characterized by the development of scar-like tissue, causing stiffening and hardening of tissues. This can weaken your lower esophageal sphincter, allowing acid to back up into your esophagus and cause frequent heartburn.
- Radiation therapy. This cancer treatment can lead to inflammation and scarring of the esophagus, which may cause difficulty swallowing.