Having difficulty swallowing has a name: it’s dysphagia. This results in a feeling of discomfort or obstacle when passing food after swallowing. There are many signs that can be associated with it, including:

• gagging, or coughing or choking when trying to swallow

• feeling food sticking in your throat

• difficulty in starting to swallow

• pain when swallowing

• drooling or salivating excessively

The difficulty in swallowing can be quite occasional: when you eat too quickly or when the food is not chewed enough, or in case of pharyngitis, for example.

But it can also be linked to more serious causes, which should be discovered quickly. Why ? Because swallowing is directly related to the ability to eat and drink, and being able to continue to eat normally is crucial. In the most severe cases, it is sometimes essential to resort to solutions such as tube feeding or infusion, if dysphagia interferes with feeding.

There are two types of dysphagia:

• so-called oropharyngeal dysphagia: difficulty initiating swallowing and propelling food towards the esophagus

• so-called esophageal dysphagia: it corresponds to a feeling of food blockage, discomfort in their progression felt lower in the chest

 Some of the root causes of oropharyngeal dysphagia include:

• neurological disorders, such as Parkinson’s disease or multiple sclerosis

• neurological damage, such as a stroke or damage to the spinal cord

• involvement of the ENT sphere: angina or pharyngitis, Zenker’s diverticulum (herniation of the internal lining of the esophagus through the muscle wall), or even more serious involvement such as cancer in this area.

Some of the factors that cause esophageal dysphagia include:

• esophageal achalasia: the lower esophageal sphincter (which is a muscle) does not relax enough to pass food to the stomach

• diffuse esophageal spasms: the contractions of the esophagus are poorly coordinated and this can cause pain, in addition of course to difficulty swallowing

• scleroderma: disease which causes the development of scar tissue, which causes hardening of the tissues as well as a loss of flexibility. The esophagus has difficulty performing its normal movements of peristalsis (automatic contraction that moves food forward through the digestive tract).

• esophageal stenosis: narrowing of the diameter of the esophagus that affects the passage of solid foods

• gastroesophageal reflux disease: stomach acid damages tissue in the esophagus and can cause spasms, or scarring and narrowing of the esophagus

• esophagitis (inflammation of the lining of the esophagus)

• esophageal cancer

Difficulty swallowing directly affects the ability to eat and drink. Thus, it is possible that it is accompanied by weight loss, regurgitation or vomiting. In these cases, it is important to quickly consult a doctor who will perform a precise examination to understand the precise origin of the dysphagia.

The best therapy to improve swallowing difficulty is to treat the cause.

If the dysphagia is oropharyngeal:

• certain exercises can help coordinate the muscles involved in swallowing or re-stimulate the nerves that cause the swallowing reflex

• swallowing techniques can be learned to help swallow

If the dysphagia is esophageal:

• enlargement of the lumen of the esophagus

• surgery

• certain medicines to reduce stomach acid, for example

There are also ways to make it easier to swallow and move food to the throat, esophagus, and stomach:

• try foods of different textures, to try to identify the most suitable

• add sauce to make swallowing easier

• soak the dry cookies in tea, milk or coffee to soften them

• cutting food into small pieces to make it easier to chew

• favor mash or soup

• drink plenty of fluids during the day

Knowing that every bite is painful, choose foods high in calories.