Difficulty swallowing can occur with food, fluids and tablets.

Swallowing difficulty (Dysphagia)

Swallowing difficulty can occur at all ages.

The problem may arise from the throat or the oesophagus (gullet).

In children it may be due to large tonsils.

A common cause in adults is muscular tightness at the top of the gullet (globus pharyngeus).

The latter can be aggravated by acid reflux.

Some neurological conditions eg. stroke, can affect swallowing.


The commonest symptom is having a sensation that food, fluids or tablets get stuck, are slow to go down, or go down the wrong way.

Other associated symptoms can include indigestion, coughing and choking.

Difficulty swallowing can come on quickly with infections, such as tonsillitis, or more slowly with neurological conditions.


Treatment is usually aimed at the underlying cause.

Globus pharyngeus 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.

Some patients require assessment by a speech and language therapist, who can advise on consistency of food and different postures when eating.

Quite often visualisation of the throat is required in the clinic with an endoscope.

Sometimes a special Xray is requested to identify the level of the obstruction, known as a Barium Swallow.

A liquid dye is ingested and a series of X-rays taken, as the dye passes from the mouth to the stomach.

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