What can cause a swallowing problem?
Q: I recently began having a problem swallowing foods. What could this be? It is really starting to bother me.
A: Swallowing difficulty (doctors call it dysphagia) can happen for a variety of reasons. It is not always caused by a serious medical problem, but it is always a problem that needs to be sorted out.
Dysphagia is an urgent problem if you are losing weight or if you are coughing or choking after eating. If that’s the case, call your doctor immediately.
Sometimes swallowing difficulty can be a side effect of a medicine. Several medications (particularly those used to treat psychiatric symptoms) can interfere with your mouth and throat muscle coordination.
Some medicines also cause significant dryness of the mouth, which can contribute to swallowing difficulty.
This symptom could also come from inflammation or scarring (also called a stricture) in the esophagus. These problems usually come from acid reflux or from pills that are causing irritation in the esophagus.
A stroke, Parkinson’s disease or other less common neurologic illnesses that affect the function of muscles or nerves can also cause swallowing problems.
Sometimes a feeling of a lump in the throat can interfere with swallowing. This can happen if you have acid reflux, but it may also be a symptom of anxiety. (It’s possible for a lump to be caused by cancer, but that’s very unlikely without other symptoms.)
You should schedule a visit with your doctor so that all of these possibilities can be considered. Tests that your healthcare provider might recommend include:
—A video swallowing study. This test uses an X-ray technique called fluoroscopy to videotape your swallowing while you consume samples of foods or drink.
—Esophagogastroduodenoscopy (EGD). EGD allows your doctor to view the esophagus, stomach and duodenum (the first part of the small intestine). For the test, a camera on a flexible, narrow cord is inserted down your throat.
—Barium swallow. For this X-ray test, you swallow a liquid that shows up on X-rays, so your doctor can view your esophagus.
—Laryngoscopy. This test allows your doctor to see your larynx. For the test, a camera on a flexible, narrow rod is inserted into your nose or mouth.
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