Dr Sarah Jarvis
Swallowing problems
There are lots of reasons you can find it hard to swallow. Often it’s nothing to worry about and will settle on its own. But, just occasionally it can be a sign of cancer of the oesophagus (gullet). That’s why, if you have swallowing problems that don’t settle within days, you should always see a doctor urgently. They may well be able to reassure you.
The medical term for swallowing problems is dysphagia. When you swallow, a whole series of muscles in your throat and gullet coordinate to move food or liquid from your mouth to your stomach. That means all sorts of problems can affect swallowing, and the ones you have can give a clue.
Infections. These can cause problems swallowing if they’re severe. The obvious cause is severe tonsillitis or an aabscess on the tonsils. HHowever, if your glands aare swollen they can ppress on your gullet.
Globus. This is a ccommon problem wwhere you have a feeling of a lump in the throat. However, there’s nothing found when your doctor examines you. The sensation tends to come and go and actually shouldn’t make it hard to swallow. You may notice it most when you try to swallow your own saliva but eating and drinking may make it better. It often settles on its own, but this can take some time, and knowing there’s nothing serious wrong can be enough to relieve it.
Stroke. The contraction of the muscles involved in swallowing are controlled by your nervous system. That means that many conditions affecting your nervous system can make it hard to swallow. Everyone knows a stroke can lead to weakness down one side or difficulties speaking. But, depending on what part of the brain is affected, a stroke can also weaken your swallowing muscles.
Dementia or severe learning disability. As dementia progresses, it can affect your swallowing. However, this tends to be at a late stage of the condition and swallowing problems on their own are highly unlikely to be the first sign you get.
Multiple sclerosis. MS causes patches of inflammation in the brain and/or spinal cord. About 9 in 10 people have symptoms such as eye pain, loss of vision, muscle spasms, tiredness, numbness, weakness or stiffness (spasticity) of muscles. But while these are often temporary at first, they can become permanent and
IF YOU HAVE A SORE THROAT WITH PROBLEMS SWALLOWING, GARGLING WITH SOLUBLE PARACETAMOL MAY HELP
swallowing can be affected. Motor neurone disease doesn’t affect sensation but leads to progressive weakness of muscles, including the gullet.
Parkinson’s disease. The “classic” symptoms of Parkinson’s are tremor, stiffness and slowing down of movement. But swallowing can also be affected, and saliva can pool in your mouth.
Oesophagitis. This is the medical name for inflammation of the gullet. It’s usually caused by stomach acid “refluxing” back into the gullet. It can lead to heartburn, an acid taste in your mouth and sometimes pain or difficulty swallowing.
Oesophageal cancer. This cancer is uncommon and mostly (but not always) affects people over 55 years. A feeling of food sticking, or severe pain on swallowing, is often the
first sign. You may also find you vomit after food, vomit blood, get a cough when you swallow, get a hoarse voice, or lose weight for no apparent reason. Fortunately it’s not common but it’s the main reason swallowing problems should always be checked out.
If you have swallowing issues that go on for any length of time, your doctor will refer you for a gastroscopy. This involves passing a thin, flexible telescope down your throat into your gullet and stomach. Treatment depends on the cause. If a nervous system issue is to blame, speech and language therapists can be invaluable. You may need to adjust your diet to avoid the risk of “aspiration” – food going into your lungs.
NEXT WEEK: Checking out spring allergies