Dysphagia means difficulty swallowing. Food or fluid may feel like it sticks in the throat or chest, take longer to go down, or cause coughing or discomfort when swallowing. Dysphagia is a symptom, not a diagnosis — our job is to find out what is causing it. There are two broad types: - Oropharyngeal dysphagia — trouble starting a swallow, often with coughing, choking or food going down the wrong way. This usually relates to the throat muscles or nerves. - Oesophageal dysphagia — food feels like it sticks behind the breastbone after swallowing. This relates to the oesophagus (food pipe).

Dysphagia (Difficulty Swallowing)

ShoreGastro
1 day ago
2 min read

Understanding swallowing problems and how we investigate them

What is dysphagia?

Dysphagia means difficulty swallowing. Food or fluid may feel like it sticks in the throat or chest, take longer to go down, or cause coughing or discomfort when swallowing. Dysphagia is a symptom, not a diagnosis — our job is to find out what is causing it.

There are two broad types:

Oropharyngeal dysphagia — trouble starting a swallow, often with coughing, choking or food going down the wrong way. This usually relates to the throat muscles or nerves.
Oesophageal dysphagia — food feels like it sticks behind the breastbone after swallowing. This relates to the oesophagus (food pipe).

Common causes

Reflux disease causing inflammation or a narrowing (stricture) of the oesophagus
Eosinophilic oesophagitis — an allergy-related inflammation, common in younger adults with food impaction
Motility disorders such as achalasia, where the oesophageal muscles do not push food down properly
Rings, webs or, less commonly, tumours of the oesophagus
Neurological conditions (e.g. stroke, Parkinson's disease) affecting the swallowing muscles

How is it investigated?

Difficulty swallowing should always be assessed. Depending on your symptoms, we may recommend:

Gastroscopy — a thin flexible camera examines the oesophagus and stomach under sedation. Biopsies can be taken and narrowings can be stretched (dilated) during the same procedure.
Barium swallow — an X-ray taken while you swallow contrast liquid, showing the shape and movement of the oesophagus.
Oesophageal manometry — a fine catheter measures the pressure and coordination of the oesophageal muscles. This is the key test for motility disorders.

Treatment

Treatment depends entirely on the cause. It may include acid-suppressing medication, dietary or swallowed steroid therapy for eosinophilic oesophagitis, endoscopic dilatation of a narrowing, or specific treatment for motility disorders. Speech pathologists play an important role for throat-related swallowing problems.

⚠ See a doctor promptly if you have Food becoming completely stuck (unable to swallow saliva) — this needs urgent hospital assessmentProgressive difficulty swallowing, first with solids then liquidsUnintentional weight lossVomiting blood or black stoolsPain with every swallow

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This information is general and not a substitute for personalised medical advice. Please discuss any questions with your gastroenterologist or GP. If you develop severe symptoms, call 000 or go to your nearest emergency department.