Dysphagia

It is easy to take swallowing for granted. As with breathing, you swallow so frequently that you're mostly not even aware that you are doing it.

But for some people, swallowing even a small amount of food, liquid, or saliva can be difficult. Difficulty swallowing (dysphagia) is a common disorder, occurring in about 10 percent of adults older than 50. When people with dysphagia (dis-FA-zhuh) swallow, they often say that food gets "stuck" or "hangs up," or that it "just won't go down right."

Down the Hatch

When you swallow, food or liquid moves from your mouth through the back of your throat (pharynx) and into the tube (esophagus) connecting your pharynx to your stomach. A wave of coordinated contractions of the muscles lining your esophagus helps pass foods to your stomach.

Muscle bands, call sphincters, at the top and bottom of the esophagus open every time you swallow. When the food is through your esophagus, the lower sphincter quickly closes, keeping stomach acid from coming up into the esophagus.

What's the Hang Up?

Dysphagia occurs when something goes wrong at any stage of the swallowing process. Any condition that weakens or damages the muscles and nerves involved in swallowing may cause dysphagia.

Age-related factors also may be a cause of dysphagia. For example, muscles of the esophagus may weaken with age, making swallowing more difficult. Diseases affecting the coordinated movements of the esophagus, such as achalasia (ak-uh-LA-zhuh) or scleroderma, also can dysphagia. cause

The two most common forms of dysphagia

•Oropharyngeal dysphagia. This occurs when you can't start the swallowing process and have difficulty moving food and liquid from your mouth and pharynx into your upper esophagus. In the midd of a swallow, liquids or food particl may come back up through your nos Food may hang up in your throat. I some cases, you may feel like the food or liquid is entering your windpipe causing you to cough or to choke.

Weakened throat muscles ofter cause pharyngeal dysphagia Muscles can become weak due to stroke, muscular dystrophy, on neurodegenerative conditions such as Parkinson's disease or amyotrophic lateral sclerosis (ALS, or Lou Gehrig's disease). A dry mouth also may cause swallowing difficulty since lubrication from saliva is needed to swallow food.

Another cause of dysphagia is the formation of a small pouch (Zenker's diverticulum) at the junction of your pharynx and upper esophagus. If the pouch is large enough to trap some food you eat, you may hear a gurgling sound or regurgitate food particles after eating.

•Esophageal dysphagia. This is when you can start the swallowing process but feel that the food or liquid gets "hung up" in the base of your throat or chest before it gets to the stomach Pressure or pain in your chest occur. Pain with swallowing may may suggest irritation or inflammation caused by certain infections.