Dysphagia (swallowing problems)
Dysphagia means difficulty swallowing food or drink. Find out the possible causes, how it is diagnosed and treated, and when to seek urgent help.
Worried about your condition? Talk to a GP.
Book an appointment onlineDysphagia is the medical term for difficulty swallowing. It can mean some foods or drinks are hard to get down, or in more severe cases, that you can't swallow at all.
What causes dysphagia?
Dysphagia is usually caused by another health condition and can happen at any age. Common causes include:
- a condition affecting your nervous system or brain, such as a stroke, head injury, dementia, cerebral palsy, Parkinson's disease or multiple sclerosis
- problems with your oesophagus (gullet), such as acid reflux (GORD), a narrowed or scarred oesophagus, or achalasia, where the muscle at the bottom of your oesophagus doesn't open properly
- cancer, such as mouth cancer or oesophageal cancer
- some medicines, such as antipsychotics
- a learning disability, or being born with a cleft lip and palate.
Wearing dentures and having trouble chewing can also make it easier for food to become blocked in your throat or oesophagus.
Are there different types of dysphagia?
Yes. Doctors often describe dysphagia by which part of the swallowing process it affects:
- oral dysphagia: the problem is in your mouth, where your tongue and palate normally hold and control food while you chew
- pharyngeal (or 'high') dysphagia: the problem is in your throat, in the split second after your brain triggers the swallow reflex
- oesophageal (or 'low') dysphagia: the problem is in your oesophagus, the muscular tube that normally takes 6 to 8 seconds to carry food down to your stomach.
How is dysphagia diagnosed?
Your GP will examine you and ask about your symptoms, then may refer you to a specialist, a speech and language therapist, or a dietitian. Tests you might be offered include:
- a barium swallow (or videofluoroscopy), where you swallow a liquid that shows up on an X-ray so your doctor can watch it travel down
- an upper endoscopy, where a thin, flexible tube with a camera is passed into your oesophagus to look inside
- manometry, which measures the strength and timing of your oesophagus's contractions
- a pH test, which checks whether acid reflux is contributing to your symptoms.
How is dysphagia treated?
Treatment depends on what's causing your dysphagia and how severe it is. If it's linked to a short-term problem such as acid reflux, it may improve with medication or get better on its own. Longer-term causes usually need specialist treatment to keep eating and drinking safe, which may include:
- swallowing therapy with a speech and language therapist, including exercises and changes to your head or body position while eating
- changing the texture of your food and drink, such as softer foods or thickened liquids
- special cups, plates or cutlery designed to make swallowing easier
- medicines to treat acid reflux
- botulinum toxin injections to relax the muscles in your oesophagus if achalasia is the cause, though the effect usually only lasts around 6 months
- a procedure to stretch a narrowed oesophagus, or surgery to widen it
- a feeding tube, through your nose or directly into your stomach, if it's not safe for you to swallow.
Everyday changes can also help make eating safer:
- sit upright at a 90-degree angle when eating and stay upright for 15-20 minutes afterwards
- cut food into small pieces, taking no more than half a teaspoon at a time
- chew thoroughly until food is almost liquid before swallowing
- swallow 2 to 3 times per mouthful if needed, and clear your throat gently if food catches
- sip fluids often, and try ice or lemon-flavoured drinks to help produce more saliva
- ask your pharmacist whether your medicines can be taken as a liquid or mixed into food, rather than swallowed whole.
When should I see a doctor?
Ask for an urgent GP appointment or call 111 if you, your child, or someone you care for:
- has difficulty swallowing
- coughs or chokes while eating or drinking
- feels like something's stuck in the throat after eating
- keeps bringing food or milk back up, sometimes through the nose
- cries a lot or arches their back when feeding (babies and young children)
- has a wet, gurgly voice after eating or drinking
- is short of breath after eating or drinking
- gets lots of chest infections.
Call 999 or go to A&E if food becomes completely stuck and won't pass after around 15 minutes, or if breathing becomes difficult.
FAQs
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What is the main cause of dysphagia?
There's no single main cause. It's usually the result of another health condition, most often something affecting the nervous system, such as a stroke or dementia, a problem with the oesophagus, or gastro-oesophageal reflux disease (GORD).
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What's usually the first sign of a swallowing problem?
Pain when swallowing or frequently choking on food are often the first signs people notice. If either of these happens regularly, it's worth speaking to a doctor.
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How common is dysphagia?
It's more common than many people realise. Studies suggest around 1 in 25 adults experience a swallowing problem in a given year, rising to as many as 22% of adults over 50.
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Can dysphagia lead to other health problems?
Yes. Food or drink can end up in your airway instead of your stomach, which can cause choking or repeated chest infections and pneumonia. Difficulty swallowing can also lead to poor nutrition, dehydration and, in children, problems with growth and development.
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Can medicines cause dysphagia?
Yes, some medicines, including antipsychotics, are linked to swallowing difficulties. Tell your doctor about any medicines you take if you develop dysphagia, as changing or adjusting them may help.
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How long do botulinum toxin injections help swallowing difficulties caused by achalasia?
The effect usually lasts around 6 months. Because it wears off, botulinum toxin is often used alongside, or instead of, other treatments such as dilation or surgery.