Problems with swallowing may affect quality of life and health
The ability to swallow normally is not only vital for adequate nutrition, but also to prevent food and liquids from entering the lungs
The inability to swallow properly is a symptom of many conditions. Swallowing difficulty can occur at all ages and the problem may arise from the mouth, throat or the oesophagus (gullet).
A common cause of swallowing disorders in adults is muscular tightness at the top of the gullet (called “globus pharyngeus”). This can be caused by stress and aggravated by acid reflux. Some neurological conditions eg. stroke, multiple sclerosis can also affect swallowing.
The commonest symptoms of a swallowing disorder are the sensation that food, liquids or tablets get stuck, are slow to go down, or cause choking and coughing.
Difficulty swallowing can come on quickly with throat infections, such as tonsillitis, or more slowly with neurological conditions.
Treatment is usually aimed at the underlying cause. For example, globus pharyngeus (the feeling of a lump or tightness in the throat when no actual lump exists) usually settles with time and reassurance. If acid reflux is implicated, treatment with antacids often helps.
If the patient is unable to swallow at all, then intravenous fluids may be required in hospital.
Some patients require assessment by a speech and language therapist, who can advise on the correct consistency of food and different postures when eating.
Visualisation of the throat with an endoscope is required in the clinic. Sometimes a special Xray is requested to identify the site of the blockage, known as a barium swallow. This where a liquid dye is ingested and a series of X-rays taken, as the dye passes from the mouth to the stomach.
