Center for Digestive Diseases

UNM Hospitals Center
for Digestive Diseases

Address:
1001 Martin Luther King Ave. NE
Albuquerque, New Mexico 87106

Appointments:
(505)272-2530 or
(505)925-6000

Facsimile:
UNMH: (505)272-6839
CDD: (505)925-7849

Dysphagia (difficulty swallowing)


What is dysphagia?

Dysphagia is the sensation of difficulty swallowing.  Patients may feel that food sticks in the back of the mouth or in the chest.  Frequently patients feel food sticks at the sternal notch (the notch at the top of the breastbone).  Patients may have difficulty swallowing liquids and solids or solids alone.


What causes dysphagia?

Dysphagia may be caused by narrowing (stricture) in the esophagus (swallowing tube), tumor in the esophagus, inflammation of the esophagus, gastro-esophageal reflux disease (GERD), achalasia or neurologic problem.  Esophageal strictures may form as a result of chronic reflux of acid that causes erosions, ulcers and eventual scarring.  Allergic inflammation in the esophagus can cause a condition called eosinophilic esophagitis and this can cause narrowing (webs) and swelling.  GERD can cause disordered contraction of the esophagus and strictures.  Achalasia is a condition in which the sphincter muscle at the bottom of the esophagus does not relax properly and food therefore sticks at the bottom of the esophagus. Neurologic problems like stroke can disrupt normal coordination of the swallowing function with food sticking in the back of the mouth or the esophagus.


How is dysphagia evaluated?

Your doctor may order a barium swallow test, video swallow, upper endoscopy (EGD), esophageal manometry.  Barium swallow is a test in which a patient swallows barium contrast while x-rays are taken of the esophagus.  Narrowing of the esophagus can be detected using this test.  During a video swallow a patient swallows multiple liquids and solids containing barium while a speech pathologist and radiologist assess the transfer from the mouth into and down the esophagus. Upper endoscopy is an outpatient procedure in which your doctor uses thin, flexible tube called an endoscope, which has a camera and light to examine the lining of your esophagus, stomach and duodenum (first portion of the small intestine).


What is the treatment for dysphagia?

Dysphagia is treated according to the underlying cause. Strictures can be dilated using tapered rubber dilators or balloons during upper endoscopy.  Inflammation may be treated with swallowed steroids.  Achalasia may be treated by surgery, injection of botox (botulinum toxin) into the lower esophagus sphincter muscle or balloon dilation of the sphincter.  GERD may be treated with anitreflux medications and lifestyle changes. Dysphagia caused by neurologic problems may be treated by speech therapy training.