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What causes difficulty in swallowing? 12 possible conditions

What is Swallowing Difficulty?

Swallowing difficulty is the inability to swallow foods or liquids with ease. People who have a hard time swallowing may choke on their food or liquid when trying to swallow. Another medical name for swallowing difficulty is dysphagia. This symptom isn’t always indicative of a medical condition. In fact, swallowing difficulty may be temporary and go away on its own.

What Causes Swallowing Difficulty?

Trouble swallowing may come from an obstruction in the throat such as trapped food, a swollen throat, or medical conditions that cause the esophagus to become inflamed.

A swollen tongue or swelling in the esophagus can also cause difficulty in swallowing.

The following can also cause trouble swallowing:

  • dry throat
  • allergic reaction
  • swollen tongue
  • swollen tonsils
  • esophageal reflux disease

According to Mayo Clinic, there are 50 pairs of muscles and nerves used to help you swallow. In other words, there are lots of things that can go wrong and lead to problems swallowing.

Types of Dysphagia

Swallowing difficulty falls into three groups: esophageal, oropharyngeal, and unknown.


Esophageal dysphagia is the feeling that something is stuck in your throat. This condition is caused by:

  • spasms in the lower esophagus (diffuse spasms or inability of the esophageal sphincter to relax)
  • tightness in the lower esophagus (due to an intermittent narrowing of the esophageal ring)
  • narrowing of the esophagus from growths or scarring
  • foreign bodies lodged in the esophagus or throat
  • a swelling or narrowing of the esophagus from inflammation or gastroesophageal reflux (GERD)
  • scar tissue in the esophagus (due to chronic inflammation or post radiation treatment)


Oropharyngeal dysphagia is caused by disorders of the nerves and muscles in the throat, which make the muscles weak. This makes it difficult for a person to swallow without choking or gagging. The causes of oropharyngeal dysphagia are conditions that primarily affect the nervous system such as:

  • multiple sclerosis
  • Parkinson’s disease
  • nerve damage from surgery or radiation therapy
  • post-polio syndrome

Oropharyngeal dysphagia can also be caused by cancer of the esophagus or by an obstruction in the upper throat or pharynx or pharyngeal pouches that collect food.

Identifying Dysphagia

If you think you may have swallowing difficulty, there are certain symptoms that may be present along with difficulty swallowing.

They include:

  • drooling
  • a hoarse voice
  • feeling that something is lodged in the throat
  • regurgitation
  • unexpected weight loss
  • heartburn
  • coughing or choking when swallowing
  • pain when swallowing

These sensations may cause a person to avoid eating, skip meals, or lose their appetite.

Children who have difficulty swallowing when eating may:

  • refuse to eat certain foods
  • have food or liquid leaking from their mouths
  • regurgitate during meals
  • have trouble breathing when eating
  • lose weight without trying

How Is Swallowing Difficulty Diagnosed?

Talk to your doctor about your symptoms and when they began. Your doctor will do a physical examination and look at your tonsils to check for abnormalities or swelling.

More specialized tests may be needed to find the exact cause.

Barium X-Ray

A barium X-ray is often used to check the inside of the esophagus for abnormalities or blockages. During this examination, you will swallow liquid or a pill containing a dye that shows up on an abdominal X-ray. The doctor will look at the X-ray image as you swallow the liquid or pill to see how the muscles in your throat function. This will help identify any weaknesses or abnormalities.


An endoscopy may be used to check all areas of your esophagus. During this examination, the doctor will insert a very thin flexible tube with a camera attachment down into your esophagus. This allows the doctor to see the esophagus in detail.


Another invasive test called a manometry can be used to check the inside of your throat. More specifically, this test checks the pressure of the muscles in your throat when you swallow. The doctor will insert a tube into your esophagus to measure the pressure in your muscles when they contract.

Treating Swallowing Difficulty

Swallowing difficulties may improve on their own without treatment.

However, if swallowing problems are persistent, they can result in malnutrition and dehydration, especially in the very young and elderly, and recurrent respiratory infections and aspiration pneumonia. All of these complications are serious and life-threatening and must be treated definitively.

If symptoms are mild and intermittent, your doctor may show you exercises used to help strengthen the muscles in your throat. He or she may also show you swallowing techniques, which will help you to swallow the food without choking.

If your swallowing problem is caused by a tightened esophagus, a procedure called esophageal dilation may be used to expand the esophagus. During this procedure, a small balloon is placed into the esophagus to widen it. The balloon is then removed.

If there are any abnormal growths in the esophagus, surgery may be necessary to remove them. Surgery may also be used to remove scar tissue.

If you have acid reflux or ulcers, you will be given prescription medication to treat them.

In severe cases, you may be admitted into the hospital and given food through a feeding tube. This special tube goes right into the stomach and bypasses the esophagus. Liquid diets may also be necessary until the swallowing difficulty improves. This prevents dehydration and malnutrition.

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See a list of possible causes in order from the most common to the least.


Types of Acid Reflux

Acid reflux symptoms are caused when stomach contents flow up from the stomach back into the esophagus, causing symptoms like heartburn, stomach pain, and burping.

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Heartburn typically occurs when contents from the stomach back up into the esophagus. This causes a burning sensation in the chest and a bitter taste in the throat or mouth. Heartburn may be prevented by avoiding food...

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This condition is considered a medical emergency. Urgent care may be required.

Epiglottitis is characterized by inflamed tissue in your epiglottis. It's a potentially life-threatening illness. The epiglottis is at the base of the tongue.

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A goiter is the abnormal increase in the size of your thyroid gland, a gland in the neck. Goiters have many possible causes, including iodine deficiency. The primary symptom of a goiter is noticeable swelling in you...

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Esophagitis is inflammation of the esophagus that can be caused by acid reflux or certain medications. You may develop a sore throat or heartburn.

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Esophageal Cancer

Esophageal cancer occurs when a malignant (cancerous) tumor forms in the lining of the esophagus, which is the muscular tube responsible for moving food from the throat to the stomach. As the cancer grows, it can affec...

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Stomach Cancer (Gastric Adenocarcinoma)

Stomach cancer occurs when cancerous cells form in the stomach lining. Because it's difficult to detect, it's often not diagnosed until it's more advanced.

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Herpes Esophagitis

Herpes esophagitis is caused by the herpes simplex virus type 1 (HSV-1). The infection can cause some chest pain and difficulty swallowing.

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Herpes Stomatitis

Recurrent herpes simplex labialis, also known as oral or orolabial herpes, is an infection of the mouth area caused by the herpes simplex virus. It is a common and contagious infection that spreads easily.

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Thyroid Nodule

A thyroid nodule is a lump in your thyroid gland that can be solid or filled with fluid, and is rarely cancerous.

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Infectious Mononucleosis

Infectious mononucleosis, or "mono," is a group of symptoms caused by the Epstein-Barr virus. One potential symptom is a pink rash that looks like the measles.

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Snake Bites

A venomous snake bite can be deadly and is a medical emergency. Even a bite from a harmless snake can cause infection or an allergic reaction, producing symptoms like pain and swelling, convulsions, nausea, or paralysis.

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This feature is for informational purposes only and should not be used to diagnose.
Please consult a healthcare professional if you have health concerns.