Types of Dysphagia, Symptoms

Dysphagia is any difficulty with swallowing. While pain is sometimes a feature of dysphagia, the medical term ‘dysphagia’ indicates impairment of swallowing. Dysphagia should not be confused with odynophagia, which is painful swallowing although the process of swallowing is not impaired in odynophagia.

Signs and Symptoms of Different Types of Dysphagia

There are two types of dysphagia – oropharyngeal and esophageal.

The first part of swallowing involving the mouth and throat (pharynx) is a reflex action which quickly moves food and liquid into the esophagus. Failure to either move the food into the esophagus or pass it out into the front of the mouth at this stage will lead to gagging, drooling, coughing or regurgitating of food through the nose. This is known as oropharyngeal dysphagia. There may also be the sensation of food being stuck in the throat or back of the mouth. Refer to Causes of Oropharyngeal Dysphagia for more signs and symptoms of the conditions that cause this type of dysphagia.

The second part of swallowing involving the food pipe (esophagus) is under the control of  network of nerves in the area known as the myenteric plexus and the brainstem. A ‘wave’ created by the sequential contraction of muscles of the esophagus transports the food down to the stomach. This is known as peristalsis. Any impairment of the movement of food down the esophagus and into the stomach is known as esophageal dysphagia. One of the symptoms characteristic of this type of dysphagia is a discomfort or pain in the chest (breastbone pain) which is often described as a tightness or pressure. This is sometimes described as the sensation that ’something is stuck in the chest’.

Other signs and symptoms of dysphagia may include :

• A lack of appetite and loss of weight are common signs of dysphagia and should not be mistaken for one of the different types of eating disorders.
• Heartburn.
• Sore throat.
• Pain upon swallowing (odynophagia).
• Excessive belching.
• Chest pain (refer to Gastric Chest Pain).
• Regurgitating food and drink.
• Recurrent pneumonia – a complication of tracheal aspiration.
• Prolonged feeding times.
• Unusual eating habits and behavior which are common in children and infants who cannot express that they are experiencing difficulty with swallowing.

If there is a total inability to swallow, possibly indicating a complete obstruction, weight loss or the development of any neurological signs and symptoms not previously assessed by a doctor, then emergency medical treatment is essential.