By Dr. Subramanian Iyer
Dysphagia is a term that may not be part of your daily vocabulary, but for those who face this challenging condition, it is a constant struggle. Dysphagia, often misunderstood, is the difficulty of swallowing, ranging from mild discomfort to the inability to swallow food or liquids. Any age group can be a victim of this. Most preterm or premature babies will experience swallowing and feeding issues.
Swallowing difficulty is not just a handicap and reason for decreased quality of experience; this can even be a reason for the death of an individual if not treated on time. Patients experiencing this condition may depend on a feeding tube until they resolve the problem. Based on their duration of alternate feeding tubes, the medical team decides on the type of feeding tubes to be used by the patient. This article delves into the symptoms, causes, risk factors, and potential treatments of dysphagia.
Symptoms to Watch For:
1. Cough: As soon as food or liquid is placed in the mouth, you may notice a cough or tendency to cough.
2. Pain while swallowing: Dysphagia can cause discomfort or pain during the act of swallowing.
3. Inability to Swallow Solid Foods or Liquids: In severe cases of dysphagia, individuals may encounter a complete inability to swallow either solid foods or liquids.
4. Sensation of food getting stuck: Many people with dysphagia describe a feeling of food getting stuck in the throat or chest, often behind the sternum (breastbone).
5. Drooling: Excess saliva production may occur due to the difficulty in managing it properly.
6. Hoarseness: Hoarseness or voice changes can result from the irritation of the throat and vocal cords.
7. Regurgitation: The regurgitation of food, especially after eating, can be a common symptom.
8. Frequent heartburn: Persistent heartburn may be associated with the condition.
9. Coughing or gagging: These can happen during attempts to swallow, leading to discomfort.
10. Weight loss: Dysphagia can contribute to weight loss as it becomes challenging to consume enough nourishment.
11. Recurrent chest infections: due to direct and indirect dysphagia, episodes of respiratory infections are noted.
Types of Dysphagia:
Dysphagia can be categorized into two main types:
Esophageal Dysphagia:
- Achalasia: Improper relaxation of the lower esophageal muscle, resulting in food regurgitation.
- Diffuse Spasm: High-pressure contractions in the esophagus that lead to difficulties after swallowing.
- Esophageal Stricture: Narrowing of the esophagus due to conditions like GERD, tumors, or scar tissue.
- Esophageal Tumors: Tumors that progressively narrow the esophagus, making swallowing increasingly difficult.
- Foreign Bodies: Objects or food that may partially block the throat or esophagus.
- Esophageal Ring: Narrowing in the lower esophagus, causing difficulties with solid foods.
- GERD (Gastroesophageal Reflux Disease): Damage from stomach acid can lead to scarring and narrowing of the esophagus.
- Eosinophilic Esophagitis: An allergic condition that results in an excess of eosinophils in the esophagus.
- Scleroderma: The formation of scar-like tissue can weaken the lower esophageal sphincter.
Oropharyngeal Dysphagia:
- Neurological Disorders: Conditions such as multiple sclerosis, muscular dystrophy, and Parkinson’s disease can weaken throat muscles.
- Neurological Damage: Sudden damage caused by a stroke or spinal cord injury can significantly affect swallowing.
- Pharyngoesophageal Diverticulum: The presence of a pouch in the throat that collects food particles, leading to swallowing difficulties.
- Cancer: Certain cancers and their treatments, including radiation therapy, can result in difficulty swallowing.
Risk Factors:
Dysphagia can have multiple risk factors ranging from neurological diseases to the process of old age.
- Congenital diseases and neurological development diseases in children
- Cancers in the head and neck region
- Cancer treatment causes structural and functional changes in the body.
- Progressive neuromuscular diseases
- Ageing: Older adults are at a higher risk of swallowing difficulties due to natural ageing and associated muscle weakness and diseases acquired.
- Certain health conditions indirectly cause dysphagia, like vitamin deficiency diseases.
Potential Health Complications:
Dysphagia can lead to severe complications, including malnutrition, unintended weight loss, dehydration, and, in extreme cases, even mortality. Aspiration pneumonia, characterized by the entry of food into the airway, can result in lung infections and has been associated with a higher incidence of hospital deaths.
Prevention and Seeking Help:
While dysphagia may not always be preventable, you can minimize the risk of occasional swallowing difficulties by adopting practices such as eating slowly and thoroughly chewing your food. If you notice any signs or symptoms of dysphagia, it is imperative to consult a deglutologist for a comprehensive evaluation and appropriate treatment. Deglutologists are specialized allied health professionals dedicated to addressing feeding and swallowing disorders and their interventions. Through proper assessment and preventive measures, complications arising from dysphagia can be mitigated effectively.
In totality, Dysphagia is a condition that should not be underestimated, and seeking medical advice is crucial for managing and treating it effectively. Understanding the symptoms and causes is the first step towards helping those who face this challenging condition.
(The author is a Professor and Chairman of Head and Neck Surgery, Oncology, Amrita Hospital, Kochi. Views expressed are personal and do not reflect the official position or policy of the FinancialExpress.com.)
