What Is Difficulty Swallowing?
Swallowing is a process that occurs through the coordinated work of the tongue, throat, larynx, and esophagus. This system slows down with age, muscle strength decreases, and reflexes weaken. As a result, some individuals develop difficulty swallowing (dysphagia).
Difficulty in the passage of food or liquids from the mouth to the stomach can manifest itself with symptoms such as sensation of being stuck in the throat, inability to swallow pills, or coughing while swallowing. This condition both reduces quality of life and can lead to consequences such as weight loss or lung infection.
Changes Seen with Age
As age progresses, the following changes may occur in the swallowing mechanism:
- Weakness in tongue and pharyngeal muscles
- Relaxation of laryngeal muscles and volume loss in vocal cords
- Decrease in saliva production and dry mouth
- Slowing of the swallowing reflex
- Decrease in throat sensitivity
These changes prolong the swallowing time and can particularly make the passage of solid foods difficult. However, although this picture is seen as “normal aging,” it can sometimes be the first sign of another underlying condition.
Other Causes of Difficulty Swallowing
Many factors besides age can cause dysphagia. The most common among these are:
1.Nervous System Diseases
Neurological diseases such as stroke, Parkinson’s disease, ALS (Amyotrophic Lateral Sclerosis), or Multiple Sclerosis affect the nerves that control swallowing muscles, increasing the risk of aspiration.
2.Muscle Diseases
Muscle diseases such as Myasthenia Gravis or Muscular Dystrophy lead to the inability of muscles involved in swallowing to contract with sufficient force.
3.Mechanical or Structural Obstacles
Tumors in the neck region, thyroid enlargement or nodules, esophageal strictures due to reflux, or tissue hardening after radiotherapy can physically make swallowing difficult.
4.Infections and Inflammations
Throat infections, aphthae, or fungal lesions can make swallowing painful and difficult; although usually temporary, evaluation is needed in recurring cases.
5.Psychological Factors
Functional conditions such as stress, anxiety, and “lump in throat sensation” (globus sensation) can create swallowing difficulty without physical obstruction.
When Should You See a Doctor?
If any of the following conditions exist, you need to be evaluated by an Ear Nose Throat (ENT) specialist:
- Food or pills getting stuck in the throat
- Coughing or choking sensation while drinking water
- Pain or burning during swallowing
- Weight loss, decrease in food intake
- Recurrent pneumonia or lung infections
These findings may indicate a swallowing disorder that needs to be treated, beyond age-related changes.
Diagnosis and Treatment Approach
In the evaluation of difficulty swallowing, endoscopic swallowing examination, video-fluoroscopic swallowing test, or esophageal passage examination can be performed.
Treatment varies depending on the source of the problem:
- Swallowing exercises and physiotherapy
- Diet modification and liquid-solid balance
- Oral hygiene and saliva-increasing recommendations
- Medication treatment or reflux control
- Speech-swallowing therapy in necessary cases
- Elimination of causes that can be corrected surgically
The goal is to regain safe and comfortable swallowing.
Information from Prof. Dr. Gediz Murat Serin
“Although some changes are natural with age, difficulty swallowing should never be considered ‘normal.’
With early examination and simple tests, it is possible to both preserve quality of life and detect serious diseases early.”
