Dysphagia is when you have difficulty swallowing. You may experience this if you have gastroesophageal reflux disease (GERD). Dysphagia may occur occasionally or on a more regular basis. The frequency depends on the severity of your reflux and your treatment.
Chronic reflux of stomach acids into your esophagus can irritate your throat. It can sometimes cause permanent damage. Scar tissue can develop in your esophagus. The scar tissue can narrow your esophagus. This is known as an esophageal stricture.
Dysphagia can be a direct result of esophageal damage in some cases. The lining of the esophagus can alter to resemble the tissue that lines your intestines. This is a condition called Barrett’s esophagus.
Symptoms of dysphagia vary in each person. You may experience problems swallowing solid foods but have no trouble with fluids. You may also experience the opposite, where swallowing liquids becomes increasingly difficult but you can manage solids without a problem. Some people have trouble swallowing any substance, even their own saliva.
You may have additional symptoms, including:
- pain when swallowing
- sore throat
- 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)
Symptoms may act up when you consume foods that are common triggers for acid reflux, such as:
- tomato-based products
- citrus fruits and juices
- fatty or fried foods
- caffeinated beverages
Medication is one of the first treatments for dysphagia related to reflux. Proton pump inhibitors (PPIs) are medications that reduce stomach acids and relieve symptoms of GERD. They can also help heal erosion of the esophagus caused by reflux.
PPI drugs include:
- omeprazole (Prilosec)
Proton pump inhibitors are usually taken once daily. Other GERD medications, such as H2 blockers, can reduce symptoms. However, they can’t actually heal the damage to your esophagus.
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 they 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 heals adequately. 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 doctor. Problems swallowing can interfere with your ability to maintain your weight or get the vitamins and minerals you need to stay healthy.
Surgery may be necessary for patients dealing with severe dysphagia 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. These procedures include:
- Fundoplication: In this procedure, 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: These 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: This 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 the remaining esophagus to the stomach.
Dysphagia can be frightening, but it isn’t always a chronic condition. Alert your doctor 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.