Swallowing Disorders (cont)

  • Dynamic swallowing study. In this test, you swallow foods of different consistencies that have been coated with barium. This test provides a visual image of these foods as they travel through your mouth and down your throat. It’s helpful for diagnosing oropharyngeal dysphagia because your doctor can see if there are any problems with how the muscles of your mouth and throat work when you swallow. This test can also detect if any material goes into the breathing tube (aspiration).
  • A visual examination of your esophagus (endoscopy). A thin, flexible, lighted instrument (endoscope) is passed down your throat so that your doctor can view your esophagus. Your doctor may also do a test called a fiber-optic endoscopic evaluation of swallowing (FEES), which uses a small lighted tube (flexible laryngoscope) placed in the nose. This allows your doctor to see what’s going on when you swallow.
  • Esophageal muscle test (manometry). In manometry (muh-NOM-uh-tree), a small tube is inserted into your esophagus and connected to a pressure recorder. This allows measurement of the muscle contractions of your esophagus as you swallow.

Treatment for swallowing difficulties is often tailored to the particular type or cause of your swallowing disorder.

Oropharyngeal dysphagia
For oropharyngeal dysphagia, your doctor may refer you to a speech or swallowing therapist, and therapy may include:

  • Exercises. Certain exercises may help coordinate your swallowing muscles or restimulate the nerves that trigger the swallowing reflex.
  • Learning swallowing techniques. You may also learn simple ways to place food in your mouth or to position your body and head to help you swallow successfully.

Esophageal dysphagia
Treatment approaches for esophageal dysphagia may include:

  • Esophageal dilation. For a tight esophageal sphincter (achalasia) or an esophageal stricture, your doctor may use an endoscope with a special balloon attached to gently stretch and expand the width of your esophagus or pass a flexible tube or tubes to stretch the esophagus (dilatation).
  • Surgery. For an esophageal tumor, achalasia or pharyngeal diverticula, you may need surgery to clear your esophageal path.
  • Medications. Difficulty swallowing associated with GERD can be treated with prescription oral medications to reduce stomach acid. You may need to take these medications for an extended period of time.

If you have esophageal spasm but your esophagus appears normal and without GERD, you may be treated with medications to relax your esophagus and reduce discomfort.

Severe dysphagia
If difficulty swallowing prevents you from eating and drinking adequately, your doctor may recommend:

  • Special liquid diets. This may help you maintain a healthy weight and avoid dehydration.
  • Feeding tube. In severe cases of dysphagia, you may need a feeding tube to bypass the part of your swallowing mechanism that isn’t working normally.


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