Understanding Dysphagia: Causes, Symptoms and Treatments

Dysphagia is the clinical term for difficulty swallowing. This can be trouble swallowing food or drinks (or both), sometimes or all the time. There are many causes, symptoms and treatments for dysphagia, and each person will experience it differently.

The swallow can be broken down into three parts:

The oral phase- sipping, biting, chewing and moving things around your mouth;
The pharyngeal phase- swallowing food and drink and passing it though your throat while protecting your airway at the same time (!!); and
The oesophageal phase- an involuntary transfer of food and drink from your throat to your stomach, and the prevention of regurgitation and reflux.

Dysphagia can occur in each of these phases or span across various ones. Often, symptoms of dysphagia can be categorised into each of these phases however almost always, each phase interacts with the next.

There are a number of ways to treat dysphagia such as modified food and drinks, and rehabilitation and equipment amongst other medical options. However, the kind of treatment suitable and available to a person is dependent on their individual presentation.

In its most severe form, dysphagia can lead to an aspiration pneumonia, choking, malnutrition, dehydration and an increased risk of morbidity and mortality.

Causes

There are many causes of dysphagia. Most importantly, a person can be born with dysphagia or they can acquire it later in life as a result of another health condition. The cause of dysphagia often dictates the symptoms, severity and stability, for example, whether it improves, stays the same or progresses over time. For more information on common health conditions that cause dysphagia see Related Conditions.

Symptoms

Symptoms of dysphagia can vary depending on the cause and severity. However, the swallow can be broken up into three parts; the oral phase, the pharyngeal phase and the oesophageal phase and a person can have symptoms in any, some or all of these parts.

Oral Phase

- Difficulty keeping food or drink from spilling out of the mouth,

- Difficulty chewing,

- Difficulty moving food or drink around the mouth,

- Having food or drink left over in the mouth after swallowing

Pharyngeal Phase

- Food or drink coming up through the nose

- Sensation of food or drink still in the throat after swallowing

- Needing to swallow multiple times to get food down

- Coughing or throat clearing after eating or drinking

- Choking

- Gurgle or gulping sounds

Oesophageal Phase

- Regurgitation of food or drink

- Sensation of hold up or slow passage through the chest.

Treatments

Treatments for dysphagia vary depending on the individual but most often symptoms are managed with a modified diet and thickened fluids. There are international standards for these known as "IDDSI" that often reduce or eliminate symptoms of dysphagia and the risk of choking. See the Diagnosis and Treatment page for more information.