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Dysphagia

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Gastroenterologists at Houston Methodist Lynda K. and David M. Underwood Center for Digestive Disorders provide solutions for patients with complicated, uncomfortable swallowing symptoms.

 

Dysphagia, or trouble swallowing, covers an array of gastrointestinal (GI) swallowing difficulties with mild to severe causes. This symptom can be due to inflammation of the lining of the esophagus from acid reflux, scarring of the esophagus from acid or allergies, or even cancer.  Sometimes severe nerve and muscle disorders affect the swallow function at the level of the head and neck, which can cause trouble swallowing, coughing and hoarseness, among other symptoms.

 

Houston Methodist Hospital is ranked No. 5 in the nation by U.S. News & World Report for Gastroenterology & GI Surgery. U.S. News & World Report has also named Houston Methodist Hospital the No. 1 hospital in Texas every year since the award began and one of the nation’s best as a nationally ranked Honor Roll hospital. Schedule an appointment with any one of our expert gastroenterologists if you have an increased difficulty with swallowing.

Multidisciplinary Team of World-Class Specialists 

Because dysphagia can have complex causes, many skilled medical professionals collaborate across disciplines on research, diagnoses and treatment at our Underwood Center locations in Texas. We often have patients referred to us for testing and care.

 

Our team includes:

  • Gastroenterologists
  • Neurologists
  • Ear, nose and throat (ENT) specialists (i.e., laryngologists)
  • Speech and language therapists (SLTs)
  • Dietitians
  • Social workers 

Associated GI Conditions We Treat

Our team delivers comprehensive medical, surgical and wellness care to patients with swallowing disorders. Once we assess your condition, we’ll discuss a treatment plan that suits your needs now and in the future.

Dysphagia Symptoms, Diagnosis & Treatment

What are the signs and symptoms of dysphagia?

The leading sign of dysphagia is difficulty swallowing. If you also experience any of the symptoms below, contact our Underwood Center specialists:

  • Coughing or choking with intake of food or drink
  • Hypersalivation – Persistent drooling of saliva 
  • Regurgitation – Backflow of food or liquid from the esophagus into the mouth
  • Sensation that food is stuck in your throat or chest after swallowing; usually an indicator of esophageal dysphagia

 

See your doctor today if you have advanced symptoms, such as unintended weight loss or repeated chest infections.

 

 

What are the causes of dysphagia?

Swallowing is a multi-stage process that begins in the mouth and flows through the esophagus. Because approximately 50 pairs of muscles and nerves help digest food and liquid, there may be many reasons for your dysphagia symptoms.

 

Damage to the nervous system can interfere with proper swallowing. Neurological causes can be:

  • Brain and spinal cord diseases – Parkinson's, multiple sclerosis, dementia and motor neuron disease
  • Brain tumors
  • Myasthenia gravis – A rare condition that causes your muscles to weaken
  • Stroke

 

Conditions that cause a narrowed esophagus or an obstruction in the throat can make swallowing difficult. Some causes include:

  • Mouth cancer or throat cancer
  • Zenker diverticulum – outpouching that form in the throat at the top of the esophagus 
  • Eosinophilic esophagitis – allergic inflammation in the lining of the esophagus
  • Radiotherapy treatment – Can lead to scar tissue buildup in your throat and esophagus
  • Yeast or fungal infection causing inflammation of the esophagus

 

There are rare conditions that affect the muscles used to push food down the esophagus and into the stomach. With scleroderma, the immune system causes esophageal muscles to weaken and stiffen when it attacks the healthy tissue it believes to be harmful.

 

Other causes include head or neck surgery complications, as well as head and neck cancer or dental issues.

 

 

How is dysphagia investigated?

Underwood Center researchers and doctors work together to make definitive diagnoses. First, we’ll investigate the location of the injury to distinguish the type of dysphagia present.

 

We may choose from the following procedures based on the duration and frequency of your symptoms, your ability to swallow solids, liquids or both and whether you've had an unexplained weight loss.

  • Barium swallow – A white liquid that traces the pathway from the esophagus into the stomach
  • Esophageal manometry – Measures how well the esophagus squeezes to aid digestion
  • pH probe test – Measures backflow of acid from the stomach into the esophagus
  • Nasoendoscopy – A thin, flexible tube and camera inserted in the nose to examine your throat 
  • Nutritional assessment – Blood tests and a check of your body mass index
  • Water swallow test – An initial assessment of your swallowing abilities done by a speech and language therapist (SLT)

How is dysphagia treated?

Because dysphagia can have minor to major causes, we offer a variety of medical or surgical solutions based upon the problem that is diagnosed to be the cause. The equipment we use will depend on the location of your swallowing problem.

 

Oropharyngeal dysphagia is swallowing difficulties caused by problems with the mouth or throat. There are three primary treatments for dysphagia at the level of the head and neck (oropharyngeal):

  • Dietary changes
  • Feeding tubes – Tubes used to prevent malnutrition and dehydration
  • Swallowing therapy – An SLT teaches you swallowing exercises and therapies
  • Esophageal dysphagia is swallowing difficulty caused by a narrowed, scarred or obstructed esophagus. Esophageal dysphagia can be treated with medication or surgery, such as:
  • Proton pump inhibitors (PPIs) – Acid reduction medication
  • Endoscopic dilatation – Stretching the narrowed area of the esophagus

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    The Foregut Diseases Program

    Underwood Center professionals treat dysphagia as part of the Foregut Diseases Program.

    Discover our program >