Question

I have problems swallowing. What is the cause and what can I do to relieve this?

Answer

The nature of the problem causing the difficulty depends on how long you have had it and on its location, radiation (spread outwards) of the sensation and on its pathology (disease process). It is also important to know what you can and cannot swallow, i.e. some people find dry foods difficult whereas liquids are easy or alternatively very liquid things are difficult to swallow and lead to choking whereas more solidified things are easier. It is important to know what provokes and what relieves the problems. The cause depends on where in the swallowing from the mouth to the stomach the problem occurs. If it is high then there may be structural abnormalities or motor dysfunction (i.e. affecting physical movements). There is usually coughing and spluttering because some of the food or fluid goes into the trachea (windpipe). If the hold up is low down then usually the patient complains that they feel the food will not go through to the stomach. This restriction may be due to nothing more sinister than fibrosis (formation of excessive fibrous tissue) and scarring, a neurological problem to do with the nerves), compression of the swallowing tube (oesophagus) by something outside the oesophagus, or to something within the space (lumen) of the oesophagus such as a growth (which may be benign). Finally, the progression of symptoms is most important. If they have been there for some time and have not got worse, then it is likely the obstruction is not serious but if there is a progression of severity over a period of time then that may be more serious. So you can see that the management of swallowing difficulties depends on the cause of those difficulties. There are some medicines that will relieve oesophageal spasm, or acid regurgitation, which may be important. But self-help remedies such as vitamins are of no help at all. We must stress how important it is for you to go and see your physician before embarking on treatment with self-medication.

Links

• Dysphagia