Symptoms A-Z

Top 10 Difficulty Swallowing (Dysphagia) Causes & Treatments

Understand your trouble swallowing symptoms, 7 causes & treatment options for your trouble swallowing.

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Trouble Swallowing Symptoms

Trouble swallowing, or dysphagia, is the inability to swallow foods and liquids with ease. Dysphagia can affect both men and women and may occur at any age [1].

Common accompanying symptoms of dysphagia or trouble swallowing

If you're experiencing dysphagia or trouble swallowing, it's also likely to experience:

Sometimes people experience occasional dysphagia when eating too fast or not chewing food properly; however, sometimes dysphagia can become chronic and persistent [5]. People with chronic trouble swallowing often have to cut their food into smaller pieces or avoid certain foods due to their difficulties in swallowing [7].

Symptoms associated with chronic dysphagia

If you're experiencing chronic dysphagia, you may also experience:

Chronic dysphagia often signals serious underlying conditions, so it is important to seek medical care promptly in order to get a diagnosis and appropriate trouble swallowing treatment [7].

Trouble Swallowing Causes

An intricate system of multiple pairs of muscles and nerves work together to control swallowing. Anything that causes irritation, injury, compression, or damage to these components can result in difficulty swallowing. The causes of dysphagia can be categorized as either oropharyngeal or esophageal [1-3].

Oropharyngeal

The oropharynx is a section of the mouth and neck. It reaches from the back of the oral cavity to the hyoid bone (the horseshoe-shaped bone located in the middle of the neck, halfway between the chin and the thyroid cartilage) [4]. Conditions that weaken the throat muscles of the oropharynx result in trouble swallowing, because then your body cannot move food from your mouth into the throat and esophagus. People with oropharyngeal swallowing problems often choke or gag when trying to swallow. These types of conditions can be categorized as having a neurological or obstructive cause.

  • Neurological: Disorders such as multiple sclerosis, strokes, and spinal cord injury cause damage and dysfunction of the nerves that facilitate swallowing and can result in oropharyngeal difficulty.
  • Obstructive: Obstruction in the oropharynx can happen due to cancers of the neck or from the development of pouches just above the esophagus. These pouches are called diverticula and tend to collect food particles, which results in difficulty swallowing, bad breath, and coughing [5].

Esophageal

The esophagus is the long muscular tube that connects the throat to the stomach. The upper esophagus is composed of a sphincter a bundle of muscles that are important for control of eating and protecting the airway. The lower esophagus also has a sphincter that closes and contracts to prevent acid and stomach contents from going back into the esophagus. Conditions that cause esophageal difficulties in swallowing can be categorized as muscular or structural [5].

  • Muscular: When the sphincters of the esophagus do not properly relax or contract, food is often regurgitated back into the throat after swallowing. The muscles can also spasm, resulting in multiple, uncoordinated contractions of the esophagus that make swallowing painful.
  • Structural: The esophagus can become narrowed due to a variety of conditions. This causes difficulty swallowing because food gets trapped or cannot move past the narrowing or blockage into the stomach. Gastroesophageal reflux disorder (GERD) often causes narrowing and scarring of the esophagus due to the stomach acid that regurgitates into the esophagus.

7 Possible Trouble Swallowing Conditions

The list below shows results from the use of our quiz by Buoy users who experienced trouble swallowing. This list does not constitute medical advice and may not accurately represent what you have.

Acid reflux disease (gerd)

GERD (gastroesophageal reflux disease) in infants refers to the passage of stomach contents into the throat causing troublesome symptoms, such as feeding intolerance, inadequate oral intake of calories and/or poor weight gain. Vomiting or visible regurgitation ...

Stroke or tia (transient ischemic attack)

Transient ischemic attack, or TIA, is sometimes called a "mini stroke" or a "warning stroke." Any stroke means that blood flow somewhere in the brain has been blocked by a clot.

Risk factors include smoking, obesity, and cardiovascular disease, though anyone can experience a TIA.

Symptoms are "transient," meaning they come and go within minutes because the clot dissolves or moves on its own. Stroke symptoms include weakness, numbness, and paralysis on one side of the face and/or body; slurred speech; abnormal vision; and sudden, severe headache.

A TIA does not cause permanent damage because it is over quickly. However, the patient must get treatment because a TIA is a warning that a more damaging stroke is likely to occur. Take the patient to the emergency room or call 9-1-1.

Diagnosis is made through patient history; physical examination; CT scan or MRI; and electrocardiogram.

Treatment includes anticoagulant medication to prevent further clots. Surgery to clear some of the arteries may also be recommended.

Rarity: Common

Top Symptoms: dizziness, leg numbness, arm numbness, new headache, stiff neck

Symptoms that never occur with stroke or tia (transient ischemic attack): bilateral weakness

Urgency: Emergency medical service

Low calcium level

Hypocalcemia is a condition where there is not enough calcium in the blood. Calcium is a mineral contained in the blood, which helps the heart and other muscles function properly, and is needed to maintain strong teeth and bones.

Rarity: Rare

Top Symptoms: fatigue, shortness of breath, irritability, general numbness, tingling foot

Urgency: Primary care doctor

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Osteoma of skull and facial bones

An osteoma is a benign (non-cancerous) outgrowth of bone, usually in the skull and facial bones. They are slow growing and usually cause no symptoms. Osteomas are noticed once they begin causing problems with breathing, vision, or hearing.

Rarity: Rare

Top Symptoms: new headache, vision changes, steady headache, trouble swallowing, sinus pain

Urgency: Primary care doctor

Achalasia

Achalasia is a disorder of the esophagus, the tube that carries food from the mouth to the stomach. This condition affects the ability of the esophagus to move food into the stomach.

Rarity: Ultra rare

Top Symptoms: pain below the ribs, regurgitation, unintentional weight loss, heartburn, deep chest pain, behind the breast bone

Urgency: Primary care doctor

Brain tumor or mass

In medical terms, "mass" and "tumor" mean the same thing: the unexplained, out-of-place growth of tissue anywhere in the body, including the brain.

The cause of any sort of brain tumor is unknown. Some originate in the brain, while others spread from cancers growing in other parts of the body.

Symptoms may include increasing headaches; nausea and vomiting; blurred or double vision; loss of sensation in an arm or leg; loss of balance; confusion; speech difficulties; or seizures.

If symptoms persist, it is important to see a medical provider so that any treatment can begin as soon as possible.

Diagnosis is made through neurological examination, CT scan, and/or MRI.

If the mass or tumor is found to be benign, that means it is not cancer and not harmful. It may or may not be treated.

If it is malignant, that means it is cancer and must be treated. This will involve some combination of surgery, radiation therapy, and chemotherapy, followed by specialized therapy to help with recovery.

Rarity: Rare

Top Symptoms: fatigue, headache, nausea, loss of appetite, irritability

Symptoms that always occur with brain tumor or mass: focal neurological symptoms

Urgency: In-person visit

Barrett's esophagus

Barrett esophagus is a condition in which the tissue lining the esophagus changes. These changes occur after longstanding gastro-esophageal reflux. Symptoms of gastro-esophageal reflux can be regurgitation, heartburn. Barretts esophagus is associated with a risk of developing malignant esophageal disease.

Rarity: Common

Top Symptoms: nausea, regurgitation, heartburn, sore throat, dry cough

Urgency: Primary care doctor

Trouble Swallowing Treatments and Relief

When to see a doctor for dysphagia

There are different treatments for trouble swallowing, depending on whether the cause is oropharyngeal or esophageal. It is important to see your physician promptly in order to get the proper diagnosis and care.

Treatment for oropharyngeal causes of dysphagia

Since oropharyngeal dysphagia is a problem with how your throat muscles move, your physician may refer you for swallowing therapy where you can learn different exercises and techniques to better coordinate your swallowing and stimulate the nerves that trigger swallowing [8].

Treatments for esophageal causes of dysphagia

Treatments for esophageal causes often involve widening and expanding the esophagus.

  • Dilation: This is a special procedure that uses a scope with a special balloon attached to stretch and expand the width of the esophagus.
  • Surgery: Obstructive causes such as cancerous tumors, diverticulum and other outgrowths can be removed with surgery.
  • Medications: Difficulty swallowing associated with GERD is often treated with prescription oral medications that help reduce stomach acid.

At-home treatments for dysphagia

In addition to the treatment above try the following lifestyle changes to further help alleviate your trouble swallowing symptoms:

  • Modify eating habits. Eat smaller, more frequent meals. Chew food slowly and thoroughly. Cut food into smaller pieces if necessary.
  • Avoid foods that cause you trouble
  • Avoid alcohol, tobacco and caffeine: These factors can make heartburn and GERD worse [9].

FAQs About Trouble Swallowing

Here are some frequently asked questions about trouble swallowing.

Can anxiety cause difficulty in swallowing?

Generally, no. Anxiety does not cause difficulty swallowing. It can, however, cause dry mouth which can cause difficulty chewing and swallowing particularly dry foods like crackers. Other common causes of difficulty swallowing are a common cold or sore throat and allergies [10].

Why do I feel like I have a lump in my throat?

A lump in the throat is a condition that commonly accompanies anxiety and is known as globus sensation. Globus sensation does not have a known cause, though some theorize that it may be because of increased muscle tension. It is not known to be connected to any actual negative physical consequences [11].

Can your thyroid cause you to have trouble swallowing?

Yes, a significant increase in the size of your thyroid, called a goiter, can cause difficulty swallowing. The thyroid sits along the front of the neck and enlargement is often caused by insufficient iodine in the diet. Because of the position of the thyroid, it can cause difficulty swallowing when enlarged [12].

Why do I have difficulty swallowing and breathing when lying down?

There are two common causes of difficulty breathing while lying down. The first is related to your weight. For overweight individuals, it can be difficult to draw breath because of the amount of body mass the chest has to lift when lying flat [13]. Additionally, body mass around the neck can lead to obstructive sleep apnea, which causes increased resistance to flowing air while sleeping [14]. Additionally, if you have fluid backup into your lungs because of congestive heart failure (CHF), this can cause difficulty breathing while lying down (orthopnea). Orthopnea can be alleviated by numerous pillows to elevate the upper body or sitting in a chair [15].

When I have a sore throat why do I have difficulty swallowing?

A sore throat often causes difficulty swallowing because of either the swelling or the pain. The swelling from a sore throat can cause a narrowing of the pharynx and make it harder to fit hard or large food items past the esophagus. At the same time, a severe sore throat can be painful enough to make it less desirable to swallow or make the process feel more difficult [16].

Questions Your Doctor May Ask About Trouble Swallowing

To diagnose this condition, your doctor would likely ask the following questions:

  • Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
  • Did you swallow something that could have caused your symptoms?
  • Have you ever been diagnosed with an ulcer?
  • Any fever today or during the last week?

The above questions are also covered by our A.I. Health Assistant.

If you've answered yes to one or more of these questions

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Trouble Swallowing Symptom Checker Statistics

People who have experienced trouble swallowing have also experienced:

  • 7% Pain With Swallowing
  • 5% Sore Throat
  • 3% Regurgitation

People who have experienced trouble swallowing were most often matched with:

  • 50% Stroke Or Tia (Transient Ischemic Attack)
  • 28% Low Calcium Level
  • 21% Acid Reflux Disease (Gerd)

Source: Aggregated and anonymized results from visits to the Buoy AI health assistant (check it out by clicking on “Take Quiz”).

Trouble Swallowing Symptom Checker

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References

  1. Husney A, Thompson EG, Kahrilas PJ, eds. Difficulty swallowing (dysphagia). Michigan Medicine: C.S. Mott Childrens Hospital. Updated March 7, 2018. MottChildren Link
  2. Dysphagia (difficulty swallowing). University of Michigan: Michigan Medicine. UofM Health Link
  3. Dysphagia (difficulty swallowing). Yale Medicine. Yale Medicine Link
  4. Stierman K. Surgical approaches of the oropharynx. The University of Texas Medical Branch. Published January 13, 1999. UTMB Link
  5. Esophageal diverticula. UW Medicine. UW Medicine Link
  6. Signs and symptoms of esophageal cancer. American Cancer Society. Updated June, 14, 2017. ACA Link
  7. Dysphagia. FamillyDoctor.org. Updated August 28, 2018. FamillyDoctor.org. Link
  8. Shaker R. Oropharyngeal dysphagia. Gastroenterol Hepatol (N Y). 2006;2(9):633-4. NCBI Link
  9. Altman K. Difficulty swallowing can indicate more serious problem. Baylor College of Medicine. Published June 29, 2016. BCM Link
  10. Taubert M, Davies EM, Back I. Dry mouth. BMJ. 2007;334(7592):534. NCBI Link
  11. Jones D, Prowse S. Globus pharyngeus: An update for general practice. Br J Gen Pract. 2015;65(639):554-5. NCBI Link
  12. Hamdan AL, Jabbour J, Al Zaghal Z, Azar ST. Goiter and laryngopharyngeal reflux. ISRN Endocrinol. 2012;2012:208958. NCBI Link
  13. Heart & vascular institute. Johns Hopkins Medicine. Hopkins Medicine Link
  14. Romero-Corral A, Caples SM, Lopez-Jimenez F, Somers VK. Interactions between obesity and obstructive sleep apnea: Implications for treatment. Chest. 2010;137(3):711-9. NCBI Link
  15. Nava S, Larovere MT, Fanfulla F, Navalesi P, Delmastro M, Mortara A. Orthopnea and inspiratory effort in chronic heart failure patients. Respir Med. 2003;97(6):647-653. NCBI Link
  16. Larrabee R. Sore throat, viral. Penn Medicine: Lancaster General Health. Lancaster General Health Link

Disclaimer: The article does not replace an evaluation by a physician. Information on this page is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes.