Dysphagia

What is dysphagia?

Dysphagia is difficulty swallowing. But sometimes it is difficult for people to distinguish this condition from odynophagia, which is painful swallowing. For example, food sticking to the esophagus can cause pain. Technically this is dysphagia but affected people may describe it as painful swallowing or odynophagia.

However, it is important to distinguish between the two conditions, as the causes of each can be quite different. When dysphagia is mild, it may cause the sufferer to stop eating for just a minute and take a few sips of water. But when it is severe, the affected person may not be able to get enough calories.

What are the symptoms of dysphagia?

Some sufferers have difficulty swallowing both solid food and liquids. While in other cases, difficulties arise only when trying to swallow solid food. But occasionally, those affected may also have difficulty swallowing liquids.

• If food is retained, more often liquids, swallowing can cause coughing due to its entry into the larynx – the upper part of the trachea or further down – into the lungs.
• If harder food gets stuck in the lower part of the throat, it can cause choking and this prevents breathing.
• If solid food particles get stuck in the esophagus, the affected person feels a strong discomfort in the chest.
• If food remains in the lower esophagus, it may be regurgitated at night. Those affected wake up coughing and choking because food has entered the throat, larynx or lungs.
• In rarer cases, after swallowing the food, it is almost immediately regurgitated.

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What are the causes?

The clinical condition is caused by a disturbance in one of the stages of swallowing. Ingestion takes place in three stages. First among the possible causes is a possible anatomical obstruction in the passage of food. Secondly, functional deviations of the nerves of the brain, throat and esophagus, whose function is to coordinate the different stages of swallowing, are possible. It is also possible that the condition is due to a change in the muscles of the esophagus.

Treatment of dysphagia

Physiotherapy is prescribed in most cases. This type of therapy can consist of recommendations such as:

• Changing the position of the head while eating;
• Exercises that are aimed at strengthening the muscles that are involved in the process of swallowing and coordination exercises for the tongue, lips and jaw.< /li>

If the person affected has symptoms of gastroesophageal reflux /GERD/ they should:

• Avoid eating before going to bed;
• Give up smoking;
• He should stand up immediately after eating and keep his back straight when eating;

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Treatment with medication

Symptoms of reflux such as heartburn, if the sufferer has such complaints are treated with drugs to reduce stomach acid such as:

• Antacids;
• H2-blockers such as nizatidine, famotidine, ranitidine, etc.
• Proton pump inhibitors such as esomeprazole, lansoprazole, omeprazole, etc.

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Those affected by achalasia or other esophageal motility disorders can be treated with medications that relax the lower esophageal sphincter. These are nitrate preparations such as isosorbitol dinitrate and calcium channel blockers such as nifedipine and verapamil. These drugs are not always effective and surgical intervention is required.