What is Dysphagia?

Dysphagia is a clinical term that refers to any condition interfering with swallowing. The patients may have difficulty swallowing solids, liquids, or both. While in some people this is more of a rapid onset problem, others experience a slow gradual onset. In the more severe forms, patients may experience such severe difficulty that they may have problems with weight loss or with dehydration. Some patients also experience choking episodes, and this may eventually lead to pneumonia and other complications.

A review of the anatomy can help us better understand the mechanisms behind dysphagia. Our breathing organ (nose) and swallowing organ (mouth) start off separately in our head. In our throat, the two converge, and later they split again into the food pipe (esophagus) and the wind pipe (larynx and trachea). This requires a very delicate balance of muscular coordination that would facilitate breathing and swallowing all at the same time. Occasionally, one of these mechanisms may not be functioning properly, and patients may then experience issues with swallowing disorder or choking episodes.

Some of the more common reasons for dysphagia include recent stroke, trauma to the throat, muscular incoordination from neurologic diseases, a growth in the throat, acid reflux issues, or various other possibilities. The diagnosis is usually made based on taking extensive history of the symptoms, as well as physical examination and other necessary tests.

A Barium Esophagram test used to be the most commonly performed test for swallowing disorders. This consists of giving the patients various different textures of foods and liquids to swallow, and taking x-rays or fluoroscopy of the swallowing at the same time that the patient is handling those foods. The radiographs are then analyzed and proper diagnosis is made. This test usually takes about half-an-hour, and it does involve quite a bit of radiation.

A more recent test for swallowing disorders is called flexible endoscopic evaluation of swallowing (FEES) or flexible endoscopic evaluation of swallowing with sensory testing (FEESST). This is a much less invasive type of test, and it can be easily done in an office setting. Basically, it consists of performing endoscopy of the throat, and then giving the patient various textures of food to handle. The results of the testing can be immediately seen on the video monitor. That immediate diagnosis can then be shared with the patient, and any treatment plans can be started right away.

Although barium esophagram is still considered to be the gold standard of all tests for swallowing disorder, the endoscopic test has a 95% correlation rate in diagnosis accuracy and is much faster and easier on the patient. If you are suffering from swallowing disorders, your ear, nose, and throat specialist can perform this test for you in an office setting to confirm the diagnosis.

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