Swallowing Disorders

The medical term for difficulty swallowing is called dysphagia. When someone has dysphagia, moving liquid or food from the mouth to the stomach takes more time or effort. Difficulty swallowing can happen at any age, but it is most common in older adults.

There are two main types of dysphagia:

• Oropharyngeal dysphagia: Difficulty starting a swallow
• Esophageal dysphagia: A feeling that food is stuck in the throat or chest

What causes dysphagia (a swallowing disorder)?

There are many conditions and reasons that dysphagia may occur. Swallowing is a complex process, and sometimes a cause cannot be determined. The causes of dysphagia also depend on the type.

• Achalasia: When the lower esophageal muscle (sphincter) that lets food enter the stomach doesn’t relax properly, causing food to back up into your throat.
• Esophageal spasm: The muscles in the lower esophagus may contract abnormally, causing dysphagia. An esophageal spasm may also cause chest pain.
• Esophageal stricture: An esophagus that is abnormally narrow (stricture) may block large pieces of food. Strictures may be caused by tumors or scar tissue from acid reflux.
• Esophageal tumors: If tumors are present in the esophagus, it could make swallowing difficult.
• Foreign bodies: A foreign body in the esophagus could partially block the throat or esophagus. This can include food, which is more common in older adults who may have dentures and have difficulty chewing.
• Esophageal ring: A narrowing in the lower esophagus that may cause difficulty swallowing food.
• Eosinophilic esophagitis: An allergic disease that causes esophageal inflammation.
• GERD: Gastrointestinal reflux disease causes damage to esophageal lining. This is caused by stomach acid backing up into the esophagus. GERD may cause spasms or scarring/narrowing of the esophagus.
• Radiation: Radiation for cancer treatment could lead to scarring and inflammation in the esophagus.
• Scleroderma: This condition causes hardening of tissues, and could weaken the lower esophageal muscle. Acid may back up into the esophagus causing heartburn.

Esophageal Manometry for Dysphagia Diagnosis

Esophageal manometry is an excellent diagnostic tool for people with heartburn, swallowing problems, or chest pain. During this procedure, the patient’s throat and nasal cavity are numbed and a slender, flexible tube is passed into the upper GI tract through the nose. An Ogden Clinic gastroenterologist guides the tube from the back of the throat, down the esophagus, and into the stomach through the esophageal sphincter valve to determine the esophagus problem.

Esophageal manometry differs from an EGD test in that there is not a camera system attached to the tube. Instead, the tube has solid-state or liquid-filled pressure transducers designed to measure pressures (manometry) generated by the muscles in the esophagus. This test is used to diagnose conditions such as:

• Non-cardiac chest pain
• Painful swallowing
• Dysphagia
• Regurgitation
• Heartburn (GERD)

Feeding Tubes (PEG Tubes)

There are a few reasons why you or a loved one may need percutaneous endoscopic gastrostomy (PEG) tube placement, also called a feeding tube. People with ongoing trouble swallowing or a deformity in their mouth or throat may require a feeding tube to get enough food into their system. The PEG tube can also be used for patients to receive certain medications through it.

PEG tube placement allows for feeding directly into the GI tract, bypassing the mouth and stomach. Placement is a relatively simple surgery, but your Ogden Clinic gastroenterologist only recommends a feeding tube in the stomach for patients with complex digestive cases.

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