What is dysphagia, what are the symptoms and how is the treatment done

Dysphagia can be described as difficulty swallowing, which is generally referred to as oropharyngeal dysphagia, or as the sensation of having food trapped between the mouth and stomach, which is generally referred to as esophageal dysphagia.

It is very important to identify the type of dysphagia present, in order to carry out the most appropriate treatment, and, in some cases, both types of dysphagia may appear simultaneously.

Generally, treatment consists of performing exercises, learning swallowing techniques, administering medications and, in some cases, performing surgery.

Types of dysphagia and symptoms

Symptoms may vary depending on the type of dysphagia:

1. Oropharyngeal dysphagia

Also called high dysphagia due to its location, oropharyngeal dysphagia is characterized by the difficulty to start swallowing, with symptoms such as difficulty in swallowing, nasal regurgitation, coughing or reduced cough reflex, nasal speech, choking and bad breath.

In more severe cases, there is a risk of dehydration, malnutrition and aspiration of saliva, secretions and / or food to the lung.

2. Esophageal dysphagia

Esophageal dysphagia, also called low dysphagia, occurs in the distal esophagus and is characterized by a sensation of food trapped in the esophagus. Dysphagia that occurs with both ingestion of solids and liquids is associated with disorders of esophageal motility, and may also be associated with chest pain. Dysphagia that occurs only for solids can be a sign of mechanical obstruction.

Possible causes

Oropharyngeal dysphagia can occur due to the occurrence of a stroke, traumatic brain injury, degenerative diseases such as Parkinson's and Alzheimer's, neuromuscular diseases, such as amyotrophic lateral sclerosis, myasthenia, multiple sclerosis, brain tumors and cerebral palsy, oral cavity and laryngeal tumors, medication, prolonged orotracheal intubation, tracheostomy and radiotherapy, for example.

The most common causes of esophageal dysphagia are mucosal diseases, with narrowing of the esophageal lumen due to inflammation, fibrosis or neoplasia, mediastinal diseases, with obstruction of the esophagus and neuromuscular diseases that affect esophageal smooth muscle and its innervation, interrupting peristalsis and / or relaxation of the esophageal sphincter.

How the treatment is done

The treatment for oropharyngeal dysphagia is limited, as the neuromuscular and neurological disorders that produce it, can hardly be corrected by clinical or surgical treatment. Generally, changes in the diet are provided, with softer foods, thick fluids, in positions that facilitate swallowing. Therapeutic techniques can also be adopted to help swallowing, such as strengthening exercises and thermal and gustatory stimulation.

In some cases, nasogastric tube feeding may be necessary.

Treatment for esophageal dysphagia depends on the root cause, but it can be done with the intake of acid-inhibiting drugs in people with gastroesophageal reflux, with corticosteroids in cases of eosinophilic esophagitis and muscle relaxants, in people who have spasms of the esophagus. See which remedies are indicated for the treatment of reflux.

In addition, treatment can also be done with medical procedures that promote dilation of the esophagus or with surgery, in cases of obstruction by tumors or diverticula, for example.