Dysphagia The Art of Swallowing – A difficult process for many

The act of swallowing, which is the act of allowing the passage of food or drink down the throat and eventually to the stomach, is one that is often taken for granted. Most of us are able to swallow without thought or consideration. It is an act that we perform several hundred times a day without knowing. Yet for many, the act of swallowing becomes impaired at some point in their life. It takes the coordination of many different muscle and nerve groups, all having to work at exactly the right time, to allowing safe passage of food or liquid. Many times, an injury to a muscle, nerve, or the gastrointestinal tract can occur, leading to difficulties in some component of the swallowing mechanism.

Dysphagia, which is the sensation of having difficulty or abnormality in swallowing, is an extremely common problem. It is a symptom that is seen in the office of most gastroenterologists on a daily basis. A disorder of the swallowing mechanism can lead to numerous symptoms, including coughing, drooling, choking, and the sensation of food getting caught in the throat or chest. The prevalence of dysphagia is not entirely known. One study in 2007, in The Journal of the American Board of Family Medicine, asked 947 study participants if they experienced dysphagia. Over 22% of the respondents reported that they did.

Dysphagia is a symptom that warrants further investigation in order to identify the cause and initiate the appropriate therapy. It should not be regarded as a normal part of aging. It is appropriate for your physician to determine if the difficulty is in initiating a swallow (oropharyngeal) or the difficulty is in after the swallowing has occurred, often with the sensation of food getting stuck in the throat or chest (esophageal). Your physician will also ask if the dysphagia has progressed or worsened, if you are experiencing weight loss or heartburn, and if the dysphagia is to solid food, liquids or both.

There are numerous potential causes to dysphagia. Once your history is obtained, diagnostic workup can include imaging studies or an upper endoscopy. In an upper endoscopy, a camera is used to directly visualize and evaluate the upper GI tract. Biopsies can also be obtained at that time if necessary. Other testing modalities include a barium swallow study, where x-ray pictures are taken after drinking barium, and esophageal motility study, where the contractions of your esophagus can be observed to see if there are any abnormalities.

If you are experiencing any of these symptoms, it should not be ignored. It is worthwhile discussing this with your primary care physician. He or she can decide if further evaluation is necessary, order initial diagnostic testing, and make an appropriate referral if necessary.

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