Maxfacts

Causes of dysphagia

Swallowing is an incredibly complicated series of chains of commands, involving numerous sensors in your mouth and throat, nerves, muscles, glands, all following several tight feedback loops in order to get the chain of events right. If any one of these components fails, the act of swallowing will fail to work properly in various different ways. Because of the speed of events when swallowing liquids, it turns out to be a common challenge to swallow liquids safely. With so many different essential components involved, there are numerous causes for dysphagia.

Forms of dysphagia occur in many neurological conditions (such as stroke, multiple sclerosis, Parkinson's disease), they may be caused by muscle weaknesses (such as muscular dystrophy), by brain injury or other trauma, by malformation in newly borns or by dementia (such as Alzheimer's disease). In the context of oral and maxillofacial conditions, dysphagia can occur as a symptom of injury, of disease (such as swelling or tumour growth preventing passage of food) or as a consequence of various treatments such as medication or surgery or radiotherapy (causing dry mouth and/or mouth sores).

Possible symptoms of dysphagia

Given the range of causes and resulting different types of dysphagia, symptoms of dysphagia are also varied and cover the whole range of severity from minor nuisance all the way to very serious.

Possible symptoms include:

• Unable to swallow liquids
• Unable to swallow solid food
• Over- or underactive gag reflex
• Unable to chew
• Hoarse voice after eating
• Swallowing the wrong way
• Aspiration
• Coughing after eating
• Impression of increased saliva production
• Much reduced food / drink intake
• Feeling of food stuck in throat
• Feeling of lump in throat
• Repeated need to clear throat

Potential consequences and problems

Dysphagia which is not properly assessed and where no suitable steps are taken to mitigate the problems can lead to considerable further health issues. These include repeated and severe pneumonia caused by aspiration of food particles and/or liquid, aversion to eating/drinking (subsequently leading to weight loss, malnutrition and dehydration and to isolation and depression), fear of eating due to choking.

Dealing with food and drink

Careful assessment of your swallowing will give hints and ideas about suitable textures and temperatures of food that you might want to try and which are safe to eat / drink. This may change over time and the assessment may have to be repeated accordingly.

The finer details of what you can tolerate to take by mouth require some more individual trial and error which, again, is likely to be an ongoing process as problems change over time. With the exception of fish and chips (for which so far nobody has invented a satisfactory, smooth and homogeneous jellied version), just about every kind of food / drink can be prepared at a suitable temperature and in a suitable texture for your needs. This degree of flexibility can reduce the need for alternative (tube) feeding considerably.