Swallowing is an essential function that most people take for granted until something goes wrong. If you have problems swallowing, it’s essential to consult with an ENT for diagnosis and treatment.
Usually, difficulty swallowing (known as dysphagia) is a symptom of another underlying concern. It’s important to address this issue and restore your ability to swallow as soon as possible.
Four Stages of Swallowing
Swallowing affects your digestion and hydration, allowing you to sustain the body through food and liquid consumption. There are several stages of swallow, which all work together to move materials from the mouth into the stomach:
- Oral Preparation: In the first stage, the liquid and food are prepared in the mouth. This process involves saliva production and chewing to break down the food before swallowing.
- Oral Stage: Now that the food is broken down by the chewing function, the tongue moves to push the food into the back area of the mouth. This movement activates a swallowing response.
- Pharyngeal Stage: The next stage is when the liquid or food moves out of the mouth and down the digestive tract. The movement of swallowing causes these things to move through the pharynx and throat and then into the esophagus (the long connection from the throat to the stomach).
- Esophageal Stage: The final stage is when the liquid and food reach the end of the esophagus and move into the stomach. At this point, swallowing was adequate to get the food and liquid to the destination.
When a person has swallowing issues, it could be affecting one or more of these stages. Therefore, an ENT can assess your situation and provide a diagnosis to determine the root cause of swallowing problems.
Symptoms of Swallowing Problems
If you are experiencing difficulty swallowing, then you might notice these symptoms:
- Choking or coughing when eating or drinking
- Discomfort in the chest or throat
- Food feels difficult to move through the esophagus and throat
- Feeling like food is stuck in the throat
- Coughing up blood
- Vocal changes
- The sensation of having a lump in the throat
- Weight loss
When you can’t swallow correctly, it can have a domino effect on overall health. Swallowing issues make it hard to maintain a healthy diet, which can lead to dehydration and malnutrition – issues that contribute to many other health concerns.
Root Causes: Swallowing Problems
In most situations, swallowing problems are actually symptoms of deeper, underlying causes. Common root causes that can lead to difficulty swallowing include:
- Acid reflux
- Throat infections (viral or bacterial)
- Medication side effects
- Muscle weakness (more common with age)
- Tumors in the esophagus, lungs, or throat
- Paralysis of the vocal cords
- Other medical conditions (stroke, Gravis disease, multiple sclerosis, Parkinson’s disease, etc.)
- Dental issues or ill-fitting dentures
Finding the root cause is the more critical step in the diagnostic process. When the ENT can get to the underlying issues, it improves the likelihood of finding a successful treatment. In addition, addressing these root causes will naturally reduce related symptoms, including swallowing problems.
For example, one of the most common causes of swallowing issues is acid reflux. Conditions like gastroesophageal reflux can damage the esophagus and make it difficult for food to move down to the stomach. In addition, the stomach acid moves up the esophagus and causes damage – so treating the acid reflux issues will naturally reduce the risk of swallowing problems.
Comprehensive Diagnosis for Swallowing Issues
An ENT can use various tests to identify why you are having a hard time swallowing. Testing might include:
- Flexible Endoscopic Evaluation of Swallowing (FEES): This test uses a small tube inserted through the nose to give the doctor a look at your throat. With this scope in place, you might be asked to drink or eat to show the swallowing process on camera – including the throat, tongue, and voice box.
- Barium Swallow: Another method is to use x-ray technology to see how liquid and food are being swallowed. This method is an alternative for patients who can’t have a tube inserted in their nose.
- Trans-Nasal Esophagoscopy (TNE): This test is a way to look at the stomach and esophagus using a flexible camera. It works in a similar manner to the FEES testing but allows the scope to reach further into the digestive tract – all the way to the stomach.
Additionally, sometimes it’s necessary for the ENT to consult with other medical specialists, such as a speech-language pathologist, gastroenterologist, neurologist, etc. This comprehensive approach optimizes the results of initial treatments and minimizes complications in the future.
Treatment for Swallowing Problems
Once a diagnosis is determined, then an effective treatment plan can be designed. Your ENT will have an in-depth conversation with you about your medical history and the specific difficulties you are experiencing.
Potential treatment recommendations might include:
- Medication: Different types of medication can treat different causes of swallowing problems. Your ENT might prescribe antacids or muscle relaxants
- Speech-Language Pathology: Sometimes, working with a speech-language pathologist is an effective way to improve swallowing and alleviate related issues
- Swallowing Retraining: Exercises to retrain the tongue and throat to move the food properly into the stomach
- Dilation: Opening the digestive tract is common if the passage is small because of acid reflux and esophageal scarring
- Surgery: To correct physical deformities or issues that are blocking a person from swallowing
If a swallowing condition is severe and can’t be corrected, then the doctor will recommend enteral feeding (using a feeding tube). These treatments help to improve nutrition and caloric intake when it isn’t safe to take food or liquid by mouth.
Should You See an ENT for Swallowing Problems?
Everyone chokes on their food occasionally, and a one-time incidence isn’t a cause for serious concern. But if you are having ongoing issues with the way food is moving from your mouth to the stomach, then it’s time to talk to a specialist about your concerns.
Most primary care physicians don’t have the medical experience to diagnose and treat these complicated conditions. The best solution is to schedule a consultation with an ENT if you are experiencing any issues affecting the throat, ears, or nose.
ENTs can address symptoms affecting the throat specifically, as well as other medical concerns affecting the nose and ears. While treatments are available for these areas individually, it’s common for medical problems to involve a combination of 2 or 3 areas in the upper respiratory system.
For more information, talk to our team at Collin County Ear, Nose, and Throat. These services are available for families in the Dallas and Collin County areas, with offices open in Frisco and Plano, TX. Complete our online form if you’d like to schedule an appointment, or call: (972) 596-4005.