Why Is It Hard to Swallow?

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Many conditions can make it hard for you to swallow. In general, swallowing difficulties—also called dysphagia—fall into distinct categories based on the part of the swallowing process that has been disrupted. This is because swallowing involves the brain, tongue, pharynx, esophagus, and many other structures of the body and physiological processes.

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Swallowing Difficulties

Difficulty swallowing may manifest in several different ways, including:

  • Feeling like there’s a lump in your throat or chest
  • Choking and/or coughing while you’re trying to swallow
  • Experiencing pain when swallowing
  • Having a sore throat
  • Suffering heartburn
  • Getting food stuck in your throat
  • Having a weakened voice (laryngitis)

If you are having a hard time swallowing, you should see a doctor right away to avoid complications like aspiration (inhaling food into your lungs) and pneumonia, and to reduce your risk of choking.

Causes

If this is the first time you’ve had a hard time swallowing, and no significant event has occurred to cause this problem, it is more likely to be an infection or the progression of a chronic condition you already have, rather than a neurological problem, such as a stroke.

All of the following conditions have been known to cause swallowing difficulties.

Infections

  • Meningitis
  • Epiglottitis
  • Syphilis
  • Enlarged tonsils from strep throat or mononucleosis
  • Any infection that has the potential to cause swollen tonsils, a swollen tongue, or swelling of other structures involved in the swallowing process

Disorders That Affect the Esophagus

  • Narrowing of the esophagus due to scar tissue: Scar tissue can be caused by untreated gastroesophageal reflux disease (GERD), swallowing chemicals, radiation exposure, eating disorders, excessive vomiting, and more.
  • Esophageal webs, sometimes called esophageal rings
  • Ulcers
  • Barrett’s esophagus
  • Esophageal cancer
  • Esophageal spasms
  • Eosinophilic esophagitis
  • Perforated esophagus

Neurological Disorders and Problems With Weak Muscles

  • Lou Gehrig’s disease (ALS)
  • Stroke
  • Parkinson’s disease
  • Multiple sclerosis
  • Achalasia
  • Myasthenia gravis
  • Muscular dystrophy
  • Polymyositis
  • Cerebral palsy
  • Spinal cord injury
  • Dementia
  • Head and neck cancer
  • Head and neck surgery
  • Anatomical problems, such as cleft lip palate
  • Zenker’s diverticulum
  • Motility disorders of the esophagus which cause a disruption in peristalsis
  • Severe anxiety disorders in which the ability to relax the muscles is affected
  • Anaphylactic reaction, a serious allergic reaction which requires immediate medical care

Treatment

Your treatment will depend on what, specifically, is making it hard for you to swallow. For example, if you have anatomical problems, such as cleft lip palate, they can often be corrected surgically.

Conditions such as GERD can be treated with medication, while some infections just need to run their course or be treated with antibiotics. In rare or severe cases, swollen tonsils can be treated with steroids or surgically removed to help with swallowing difficulties.

No matter what is making it hard for you to swallow, the following measures can help you go about your day and stay safe:

  • Chew your food extremely well and take your time when eating.
  • Avoid foods that are likely to get stuck in your throat (steak or similar meats, for example).
  • Try drinking thickened liquids.
  • Make sure you are in an upright position while eating.

It’s also important to know when medical attention is necessary. See a doctor if difficulty swallowing is accompanied by a fever or excessive drooling. If your condition is rapidly getting worse, call 911 or go to your nearest emergency room—this may be a sign of a life-threatening anaphylactic reaction.

Additionally, if symptoms of difficulty with swallowing last more than two weeks, make sure you see a doctor to determine if a tumor or cancer is present.

While dysphagia can be a dangerous condition, many of the things that make it hard to swallow are temporary and/or can be treated.

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