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Dysphagia - Phases, Causes, Diagnosis, and Treatment

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Dysphagia is difficulty in swallowing. Read the article to know more about dysphagia.

Written by

Dr. P. Saranya

Medically reviewed by

Dr. Jagdish Singh

Published At November 25, 2022
Reviewed AtJune 27, 2023


Dysphagia is the term used to describe swallowing difficulties. People with dysphagia have difficulties in swallowing certain foods or liquids, while others cannot swallow. Dysphagia can be painful. Dysphagia can occur at any age, but it is more common in older adults and patients affected by stroke.

What Are the Phases of Swallowing?

The three phases of swallowing are:

  • Oral.

  • Pharyngeal.

  • Esophageal.

In the oral phase, food or liquid is contained in the mouth by the tongue and palate. The food is chewed in the mouth, and the saliva softens and moistens the food making it easier to swallow.

The second phase begins when the brain decides to swallow. The food is pushed from the oral cavity into the pharynx. A muscular valve located at the bottom of the pharynx opens, allowing the food to enter the esophagus, and the other muscles close the airway to prevent food entry.

In the esophageal phase, as the esophagus contracts, a muscular valve that is present at the end of the esophagus opens, and food is propelled into the stomach. Difficulty in swallowing may occur in any of these stages.

What Are the Symptoms Associated With Dysphagia?

Signs and symptoms associated with dysphagia include:

  • Pain while swallowing.

  • Inability to swallow.

  • A sensation of food getting stuck.

  • Coughing or gagging when swallowing.

  • Food or stomach acid regurgitates into the throat.

  • Drooling.

  • Hoarseness of voice.

  • Frequent heartburn.

What Are the Causes of Dysphagia?

Swallowing is a complex process that involves many muscles and nerves. Any condition that weakens or damages the muscles and nerves that are involved in swallowing can cause dysphagia.

  • Nervous System Disorders: Certain conditions that affect the brain and nervous systems, like Parkinson's disease and multiple sclerosis, can lead to difficulty swallowing.

  • Muscle Disorders: Disorders of the esophagus, like achalasia, scleroderma, and esophageal spasms, can cause dysphagia.

  • Esophageal Narrowing: Narrowing or blockage of the esophagus in esophageal cancer or a swollen thyroid gland can cause difficulty in swallowing.

  • Acid Reflux: Gastroesophageal reflux disease can form scar tissue in the esophagus, which makes swallowing difficult.

  • Tonsillitis: Tonsillitis is the inflammation of the tonsil, which makes swallowing painful.

  • Stroke: Brain cells die due to a lack of oxygen when there is a reduced blood supply. If the brain cells that control swallowing is disturbed, dysphagia occurs.

  • Radiation: People who receive radiation therapy to the head and neck area can have difficulties swallowing.

  • Xerostomia: This condition is the dry mouth in which there is not enough saliva which might cause difficulty in swallowing.

What Are the Risk Factors for Dysphagia?

The following factors can increase the risk of dysphagia:

  • Aging: As you age, there is normal wear and tear of the esophagus, and older adults are at higher risk of swallowing difficulties.

  • Health Conditions: People with neurological disorders are more likely to have dysphagia.

How Is Dysphagia Diagnosed?

The doctor asks about the history of swallowing difficulties and does a physical examination.

The following tests are done to rule out dysphagia:

  • Barium Swallow: The patient is given a special liquid containing barium which coats the esophagus when swallowed. X-rays are taken when the patient is swallowing the liquid, which shows muscular activity, the shape of the esophagus, and blockage or narrowing of the esophagus.

  • Barium Meal: The patient is asked to swallow barium-coated foods of different consistencies. Images are taken when the food travels from the mouth to the throat. This study helps in evaluating the coordination of the muscles of the mouth and throat during swallowing.

  • Endoscopy: A thin, long, flexible tube is inserted through the mouth into the esophagus to look for inflammation, narrowing, or tumor. Endoscopy is also used to take tissue samples for examination in the laboratory.

  • Esophageal Manometry: This test measures the pressure of the muscles of the esophagus during swallowing.

  • Computed Tomography (CT) Scan: This imaging method uses a series of x-ray views to create cross-sectional images of the esophagus.

  • Magnetic Resonance Imaging (MRI): This technique uses a magnetic field to create detailed images.

  • pH Test: This pH test helps determine if acid reflux is the underlying cause of dysphagia.

How Is Dysphagia Treated?

Treatment typically depends on the underlying cause and severity of the condition. The treatment methods include:

  • Antibiotics are given to treat tonsillitis.

  • Drugs to control acid reflux are given.

  • Botulinum toxin injections are given to relieve muscle spasms.

  • Surgery is done to enlarge the esophagus. For widening the esophagus, a small balloon may be inserted and then inflated.

  • If dysphagia is caused due to a tumor, surgery is done to remove the tumor.

  • If the patient is not getting a sufficient amount of nutrients, the doctor may suggest a feeding tube. This device delivers food directly into the stomach.

The following measures can reduce the risk of dysphagia:

  • Eat small bites of food and chew thoroughly.

  • Sit upright while eating.

  • Tilt the head slightly to help in swallowing.

  • Sit or stand upright 15 to 20 minutes after eating a meal.

  • Exercises are taught by speech therapists to strengthen the swallowing muscles.

  • Do not talk while keeping food in the mouth.

  • If food or liquid gets stuck in the throat, cough gently or clear the throat and swallow again without taking a breath.

  • Eat more soft foods.

  • Try to avoid foods that are tough to chew and swallow.

  • If thin liquids are causing cough, make them thick using a liquid thickener.

  • Limit alcohol and caffeine because they can cause dry mouth, which makes swallowing difficult.

What Are the Complications of Dysphagia?

  • Malnutrition: Dysphagia can result in reduced intake of nutrients and fluids, which can result in dehydration, malnutrition, and weight loss.

  • Aspiration Pneumonia: Food or liquid entering the airways during difficult swallowing can cause aspiration pneumonia.

  • Choking: When food gets stuck in the throat, it can lead to choking.


Difficulty in swallowing does not always indicate a medical problem. Sometimes it may be temporary and resolve on its own. Sometimes proper diagnosis and understanding of the cause can help in successful treatment.

Frequently Asked Questions


What Is the Primary Cause of Dysphagia?

Many muscles and nerves are involved in the complex act of swallowing. Dysphagia can be caused by any condition that makes the muscles and nerves used to swallow weak, hurt, or narrow the back of the throat or esophagus.


What Are Dysphagia’s Four Stages?

Dysphagia's four stages are as follows.
- Oral propulsive.
- Oral preparatory.
- Esophageal.
- Pharyngeal.


Is Dysphagia Curable?

Although treatment is available for many dysphagia cases, a cure is not always available. Dysphagia treatment options include new swallowing strategies that can be learned through speech and language therapy. Changing the consistency of liquids and food so that they are less dangerous to swallow.


Which Two Kinds of Dysphagia Are There?

Two primary types of dysphagia are listed below.
First, oropharyngeal dysphagia affects the mouth or throat.
Second, oesophageal dysphagia affects the tube that carries food from the mouth to the stomach.


What Is the Best Approach to Dysphagia Treatment?

Different swallowing exercises are beneficial for dysphagic individuals. In addition, Dysphagia symptoms can be alleviated by participating in condition-specific exercises that help strengthen and coordinate the muscles involved in swallowing. However, people frequently require assistance and direction from a medical professional to complete these exercises.


Which Treatment for Dysphagia Is Most Effective?

Endoscopic dilatation is frequently used to treat obstruction-induced dysphagia. If the esophagus is scarred, people can also stretch it. During an endoscopy examination of the esophagus, endoscopic dilatation will be performed.


How Serious Is Dysphagia?

Dysphagia can be uncomfortable. Occasionally, swallowing is difficult. Occasionally having trouble swallowing, like eating too quickly or not chewing your food well enough, is usually nothing to worry about. However, persistent dysphagia can be a serious medical problem that needs to be treated.


Can Dysphagia Result in Cancer?

Dysphagia has both harmless and threatening causes. An imminent report was directed on 220 patients utilizing endoscopy, biopsies, and barium swallow. It was observed that threats are a significant reason for dysphagia in the elderly.


Does Dysphagia Pose a Threat?

Because dysphagia can be life-threatening and last a long time, providing the right support is important.


End-Stage Dysphagia: What Is It?

Dysphagia is a poor indicator of a patient's prognosis when nearing death. However, the inability to swallow may be a crucial symptom for many patients with a life-limiting illness that prompts them to consider hospice or end-of-life care.


How Long Can Dysphagia Keep You Alive?

The survival rate is approximately six months shorter with a feeding tube than without one in patients with significant dysphagia and dementia.


What Is Immediate Relief Available for Dysphagia?

To treat esophageal dysphagia, the gastroenterologist may prescribe corticosteroids, antacids, proton-pump inhibitors (PPIs), muscle relaxants, and other medications to help people swallow.


How Is Dysphagia Diagnosed?

The ability to swallow is assessed through videofluoroscopy. It happens in the X-ray department and shows people their swallowing moving in real-time. People will be asked to swallow various liquids with varying consistency, including a non-toxic liquid called barium, visible on X-rays.


Which Vitamin Helps Dysphagia?

Although prompt vitamin B12 supplementation has been shown to reverse neurological symptoms, the degree of recovery varies depending on the severity and duration of symptoms before treatment. For example, some patients' neurogenic dysphagia was completely reversed after three months of B12 supplementation.


Does Drinking Water Help Dysphagia?

Maintain hydration because dysphagia can make it easy for elderly people to dehydrate. They might drink nothing if they cannot drink regular water.
Dr. Jagdish Singh
Dr. Jagdish Singh

Medical Gastroenterology


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