What causes difficulty swallowing?

Throughout the course of our lives, lots of us will find it difficult to swallow at one time or another. It’s often as a result of a minor illness such as a cold or sore throat. Usually, this type of swallowing difficulty goes away within a few weeks as your body fights off the infection causing it[1]. 

However, some people find it difficult to swallow all the time. This is often as a result of a chronic or long-lasting condition, and can severely affect how you go about your day-to-day life. Sometimes, these conditions can prevent the sufferer from eating solid foods.

What is the term used for swallowing difficulties?

In the medical world, having difficulty swallowing is known as dysphagia (pronounced diss-FAY-jee-uh). The word comes from Greek and is split into two parts: ‘dys’, which means bad or difficult; and ‘phagia’, which means eating[2]. Dysphagia isn’t an illness in itself – it’s a symptom of many other conditions. 

There are two forms of dysphagia: oropharyngeal dysphagia and oesophageal dysphagia. The two types are separated based on what causes the difficulty swallowing. 

Oropharyngeal dysphagia is trouble swallowing caused by conditions affecting the mouth and throat. In this word, ‘oro’ refers to the mouth, and ‘pharyngeal’ refers to the throat – also known as the pharynx.

Oesophageal dysphagia refers to swallowing difficulties caused by problems with the oesophagus. This is the tube that goes from your throat all the way down through your chest to your stomach. Food and drink travels down the oesophagus as part of the digestive process[3].

What could cause trouble swallowing?

Swallowing is a complex process in which the muscles in your throat and oesophagus contract to pull food or liquids down from your mouth to your stomach. There are lots of conditions that might cause difficulty swallowing, such as neurological problems, congenital or developmental disorders and obstructions[3]. 

Here is a more in-depth look at some potential causes of dysphagia.

• Neurological problems

The muscles that control swallowing are all part of your nervous system, connected to your brain and spinal cord. In some cases, damage to either of these areas can cause dysphagia, as well as other muscular problems. This includes sudden damage, for example a stroke or head injury. Other causes could be tumours, or degenerative diseases such as dementia or multiple sclerosis[3].

• Congenital or developmental disorders

A congenital disorder is one that you have from birth. Developmental disorders, as the name suggests, are those that affect your development. This can be either before birth or in childhood. Conditions of these types that may cause dysphagia include cleft lip or palate, cerebral palsy and learning disabilities[3].

• Obstructions

Obstructions, or partial blockages in your throat or oesophagus, can also make swallowing difficult. Think of your digestive tract as a motorway – if one of the lanes is blocked, traffic builds up and it’s harder to get to your destination. The same applies to food in your oesophagus.

Mouth or throat cancer can cause an obstruction in this way, as they may narrow the digestive tract. Fortunately, dysphagia can ease if the cancer is successfully treated. However, radiotherapy used to treat cancer can also cause scar tissue to form in the affected area, which may make it harder to swallow.

Additionally, conditions such as pharyngeal pouches, eosinophilic oesophagitis and gastro-oesophageal reflux disease (GORD) can cause obstructions by making your throat or oesophagus swell up. This is also true of illnesses like tuberculosis, thrush and other common throat infections. 

These are just some of the conditions that could potentially cause difficulty swallowing. If you’re experiencing dysphagia, even if you don’t think it’s caused by one of the conditions mentioned above, speak to your doctor. They should be able to help you find out what’s behind it and advise you on treatment options[3].

Resources:

[1] https://www.nhs.uk/conditions/sore-throat/

[2] https://www.merriam-webster.com/dictionary/dysphagia

[3] https://www.nhs.uk/conditions/swallowing-problems-dysphagia/