Trouble Swallowing (Dysphagia or Aphagia)

Dysphagia is the medical term for trouble swallowing. Sufferers are sometimes unaware of their problem. Some signs and symptoms of dysphagia include difficulty starting a swallow, difficulty controlling food or saliva in the mouth, coughing, choking, unexplained weight loss, gurgly or wet voice after swallowing or the sensation that food is becoming stuck or held up before it passes into the stomach or is regurgitated. Untreated dysphagia may develop into aphagia in which one refuses to swallow.

A common cause of dysphagia is spasm of the esophageal sphincters due to gastroesophageal reflux.  Tumors and strictures of the esophagus can also cause swallowing problems. If dysphagia is severe enough, aspiration into the airway can occur causing aspiration pneumonia which can be life threatening.

A complete evaluation of the upper and lower aerodigestive tract is necessary to properly diagnose the cause of dysphagia. This evaluation may include x-ray studies such as a barium swallow or endoscopy of both the upper and lower aerodigestive tracts. In some cases, evaluation of the esophagus can be done in the office using a new technique known as transnasal esophagoscopy (TNE). This procedure is done with topical anesthesia and requires no sedation.

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