DRUG INDEX
Swallowing Problems
(Dysphagia)
While there are many causes of swallowing difficulties, there are two main causes of food getting caught in the esophagus (the food pipe that connects the throat with the stomach) after it is swallowed. The first is an abnormality in the way the muscles of the esophagus work. (The muscle normally propels the swallowed food through the esophagus and into the stomach.) The second is narrowing of the inner diameter of the esophagus.
The most common causes of narrowing of the esophagus are esophageal rings or webs (Schatzki's rings) or strictures that are usually due to inflammation from GERD. As the esophagus becomes narrowed by these rings or strictures, solid food (beef, turkey etc.) can be caught. Some patients try to induce vomiting to clear the obstructing food while others just wait for the food to pass the obstruction on its own. Rarely, persistent obstruction has to be relieved by a doctor inserting a flexible endoscope into the esophagus to retrieve the obstructing food. Less common causes of obstruction of the esophagus include cancer of the esophagus.
Working with your doctor to establish an accurate diagnosis is important. Tests that can be done include upper GI tests or upper endoscopy. If esophageal rings or strictures are found, they can be carefully fractured or dilated using balloons or other instruments during upper endoscopy. Strictures sometimes recur and require dilating again.
If no rings, strictures, or other narrowing are found in the esophagus, there may be a problem with the muscle of the esophagus. One common muscle problem of the esophagus that can lead to difficulty swallowing is achalasia . Muscle problems can be diagnosed with an esophageal motility study (also known as esophageal manometry ), a study in which the way the muscle works is examined by passing a small tube down the patient's esophagus and having the patient swallow sips of water. Muscle problems may be difficult to treat; however, there are medications that frequently can be of help.
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