Difficulty Swallowing

Dysphagia means impaired swallowing with delayed movement of liquid or solid material from the mouth to the stomach. It can be acute or chronic, intermittent or persistent, and may involve the throat, oesophagus, or both.

Eat slowly and note whether liquids, semisolids, or solids are harder to swallow. Coughing or choking during or after meals, throat clearing, and weight loss are symptoms that can occur.

History and physical examination help identify the cause. Further assessment can include bedside testing, barium swallow, endoscopy, and tests that distinguish throat-phase from oesophageal swallowing problems.

Treatment depends on the cause and associated conditions. Management may use compensatory and rehabilitative strategies to improve quality of life and regain physiologic swallowing.

Head tilt, chin-tuck, head rotation, and supraglottic manoeuvres have shown some benefit in minimising or preventing aspiration, although evidence for these techniques is contradictory.

Difficulty swallowing may occur with a sensation of something stuck after eating, food or milk coming back through the nose, a wet voice, breathlessness after eating, or frequent chest infections.

Swallowing difficulty with coughing or choking while eating or drinking, breathlessness after meals, food returning through the nose, or repeated chest infections needs urgent attention. A wet, gurgly voice after eating or drinking and the feeling that something remains in the throat are also listed signs.