Difficulty Swallowing

Dysphagia is a difficulty swallowing. This is a symptom you may experience if you’ve been diagnosed with gastroesophageal reflux disease (GERD). Dysphagia may occur occasionally or on a more regular basis. This depends on the severity of your reflux and the steps you take towards treatment. Causes of reflux-induced dysphagia usually relate to damage of the esophagus.

Chronic reflux of stomach acids into your esophagus can irritate your throat and sometimes cause permanent impairment, according to the Mayo Clinic. Scar tissue can develop in your esophagus, which may also create a narrowing of the structure. This is called an “esophageal stricture.”

Dysphagia can be a direct result of esophageal damage in some cases. The lining of the esophagus could become altered to resemble the tissue that lines your intestines. This is a condition called “Barrett’s esophagus.”

Symptoms

Symptoms of dysphagia vary in each person. You may experience problems swallowing solid foods but have no trouble with fluids. The reverse is true as well: swallowing liquids may become increasingly difficult, though you can manage solids without a problem. Some display symptoms with any ingested substance—even their own saliva.

Additional symptoms may be present in acid reflux-related dysphagia, including:

  • pain upon swallowing
  • sore throat
  • choking
  • coughing
  • gurgling or regurgitating food or stomach acids
  • feeling that food is stuck behind your breastbone
  • burning sensation behind your breastbone (a classic sign of heartburn)
  • hoarseness

Symptoms may act up when consuming foods that are common triggers for acid reflux, such as:

  • tomato-based products
  • citrus fruits and juices
  • fatty or fried foods
  • alcohol
  • caffeinated beverages
  • chocolate
  • peppermint

Treatment

Mild-to-moderate, reflux-related swallowing difficulties first are treated with medication and lifestyle adjustments. Proton pump inhibitors (PPIs) are a class of medications that reduce stomach acids, relieve symptoms of GERD, and can help heal the erosion of the esophagus caused by reflux.

PPI drugs include: 

  • esomeprazole
  • lansoprazole
  • omeprazole (Prilosec)
  • pantoprazole
  • rabeprazole

Proton pump inhibitors are usually taken once daily. Other GERD medications, such as H2 blockers, can alleviate symptoms. However, they don’t provide the healing qualities that are needed when esophageal damage leads to dysphagia.

Lifestyle changes can help make eating and swallowing more comfortable. For example, eliminate alcoholic beverages and nicotine products from your life. Smoking and alcohol can irritate your already-compromised esophagus and can increase the likelihood of heartburn. Ask your doctor for a referral for medication or a support group if you need help quitting drinking or smoking.  

Eat small meals frequently instead of three large meals daily. Moderate-to-severe dysphagia may require you to follow a soft or liquid diet until your esophagus has adequately healed. Avoid sticky foods, such as jam or peanut butter, and be sure to cut your foods into small pieces to make swallowing easier.

Discuss nutritional needs with your healthcare provider. Problems swallowing can interfere with your ability to maintain your weight or get the vitamins and minerals you need to stay healthy.

Surgery

Surgery may be required for patients dealing with severe dysphasia that is unresponsive to medication and lifestyle changes. Some surgical procedures used to treat GERD, Barrett’s esophagus, and esophageal strictures can also reduce or eliminate episodes of dysphagia, including:

  • fundoplication: the upper area of the stomach encircles the lower esophageal sphincter (LES) to act as a support system. The LES, a muscle at the base of the esophagus, becomes stronger and less likely to open so that acids can’t reflux into the throat.
  • endoscopic procedures: strengthen the LES and prevent acid reflux. The Stretta system creates scar tissue in the LES through a series of small burns. The NDO Plicator and EndoCinch procedures strengthen the LES with stitches.
  • esophageal dilation: is a common surgical treatment for dysphagia. In this procedure, a tiny balloon attached to an endoscope stretches the esophagus to treat strictures.
  • partial removal of the esophagus: this procedure removes portions of severely damaged esophagus or areas that have become cancerous due to Barrett’s esophagus and surgically attaches remaining esophagus to the stomach.

Dysphagia can be frightening, but isn’t always a chronic condition. Alert your physician to swallowing difficulties and other symptoms of GERD that you’re experiencing. The sooner you start on medication to heal the damage, the easier swallowing will become and the happier you’ll be.