Difficulty swallowing is a common problem. I have had countless patients with this… and also two family members with this in the past few months.
Swallowing is a complex process. Breathing must be coordinated with swallowing. Food is chewed (and mixed with saliva) and forms into a bolus such that with the initiating of swallowing the food passes the upper esophageal sphincter and into the esophagus. While in the esophagus peristalsis occurs to get this bolus of food through the relaxed lower esophageal sphincter and into the stomach.
Many things can hinder the swallowing process.
- Neurological conditions: Parkinsons, stroke, dementia
- Neuromuscular conditions: ALS (Lou Gehrig’s), myasthenia gravis, multiple sclerosis
- Structural issues: head and neck cancers, radiation, thyroid enlargement
- Oral causes: poor dentition or dentures, dry mouth
- Reflux (this is the most common!)
What is the work up for difficulty swallowing? First, see your physician. You need a good physical exam with a head and neck exam, observation of a swallow, abdominal inspection and palpation, cranial nerve exam, and discussion of nutritional status and fitness.
From there daily reflux medication may be prescribed, or a swallowing study may be ordered, or a referral to a GI physician for esophagogastroduodenoscopy (EGD).
In the meanwhile, diet modifications is helpful. Eat mindfully. Avoid foods that cause problems. Chew carefully. Cut food into smaller pieces. Drink liquids during the meal. Eat upright. Chin-tuck with swallowing.
I hope this helps.