Dysphagia happens when the muscles that direct swallowing aren’t working correctly. It can lead to food or liquids entering the airways or the lungs, a complication known as aspiration.

Compassionate Healing Starts Here

Click below to learn more about where you can find compassionate care.

At UC Health, we know how critical your voice and your ability to swallow is to your everyday life. Our team of subspecialists have deep expertise in the injuries and conditions that affect the voice and swallowing, and use the latest research to deliver the best treatments and therapies. We also know how important your voice is to your identity — that’s why we offer transgender voice therapy for those who wish to modify their voice and speaking.

To schedule an appointment, please call the UC Health Voice & Swallowing team at 513-475-8400.

Our Smell, Hearing & Communication Disorders Center brings together subspecialists who are experts in the full spectrum of neurologic disorders of the senses. Knowing that these conditions often have more than one cause, our highly trained teams collaborate to bring you an accurate diagnosis and customize your treatment plan backed by the latest research.

To schedule an appointment, please call the UC Health Smell, Hearing & Communication Disorders Center team at 866-941-8264.

About This Condition

Understanding Dysphagia

What is dysphagia?

When something goes wrong with the muscles that direct swallowing, it’s called dysphagia.

Problems with any of the phases of swallowing can cause dysphagia.

You normally swallow hundreds of times a day without even thinking about it. You swallow foods, liquids, and the normal saliva and mucus that your body makes.

When you swallow food, it passes through your mouth and into a part of your throat called the pharynx. From here, the food passes through a long tube (esophagus) before entering your stomach and the rest of your gastrointestinal tract. This requires a series of actions from the muscles along the path. It also requires coordination with the muscles of breathing. Breathing pauses when you swallow.

Swallowing is a very complex process. It requires the coordination of several nerves and muscle groups. Doctors describe it in three phases:

  • Oral preparatory phase. During this phase, you chew your food to a size, shape, and consistency that can be swallowed. This is called a bolus. The arch of your mouth and your tongue connect to prevent food or liquid entering the pharynx. Then, your tongue rises, squeezing the bolus back along the roof of your mouth and into your upper pharynx. You have some conscious control over these actions.

  • Pharyngeal phase. Here, the muscles of your pharynx contract in sequence. This moves the bolus down toward the esophagus. At the same time, the esophageal sphincter relaxes. This is a tight ring of muscles at the entrance to the esophagus. This lets the bolus to enter the esophagus.

  • Esophageal phase. The muscles in your esophagus contract in sequence to move the bolus toward your stomach. The lower esophageal sphincter also relaxes. This is a tight ring of muscles at the bottom of the esophagus. This lets the bolus enters the stomach.

The last two phases are not under conscious control.

What causes dysphagia?

Dysphagia and aspiration might cause some of the following symptoms:

  • Sense of food sticking in your throat or coming back into your mouth.

  • Pain when swallowing.

  • Trouble starting a swallow.

  • Coughing or wheezing during or after.

  • Excess saliva.

  • Feeling congested after eating or drinking.

  • Having a “wet” sounding voice during or after eating or drinking.

  • Shortness of breath or fatigue while eating.

  • Repeated bouts of pneumonia.

Your symptoms may partly depend on the phase of your swallow that is affected.

How is dysphagia diagnosed?

If you have symptoms of dysphagia or aspiration, you need to be checked right away. If you have a condition, such as stroke, that can cause trouble swallowing, you will need to be evaluated for dysphagia.

Diagnosis usually starts with a health history and evaluation. This is often done by a speech-language pathologist (SLP). The SLP may start by asking you about symptoms that might be related to dysphagia. He or she usually asks questions about the kinds of things that give you problems and about the timing of your symptoms.

The SLP will also look at your teeth, lips, jaw, tongue, and cheeks. You may need to move these areas in certain ways and make certain sounds. Your SLP may also check how you swallow different consistencies of liquids and foods. All of this is to help determine what phase of swallowing might be causing your problems. It can also give clues about the underlying cause for your dysphagia.

In some cases, you might need follow-up testing to find the source of your dysphagia. These tests can also help find the phase of swallowing that is causing the problems. These might include:

  • Modified barium swallow test (MBS) to show if material is traveling into your lungs.

  • Fiberoptic endoscopic evaluation of swallowing (FEES) instead of MBS.

  • Pharyngeal manometry if the origin of the dysphagia is still in question, to check the pressure inside your esophagus.

How is dysphagia treated?

If possible, your medical team tries to address the underlying cause of dysphagia. In certain cases, you may need surgery to treat the root cause. You also may be able to take medicine to reduce the flow of saliva to address the cause of your dysphagia.

The symptoms of dysphagia also need to be managed. Depending on the specific type of your dysphagia, this might include:

  • Changing your diet. This might mean using thickening liquids or having no liquids at all.

  • Changing your position while eating. This might mean eating upright, tilting your head back, or bending your neck forward.

  • Decreasing distractions during meals, and eating when you are most alert.

  • Practicing special exercises to strengthen your lips and tongue.

  • Learning special swallowing techniques.

As you recover, you might need to use fewer of these steps. Dysphagia after a stroke may greatly improve with time.

Some people are at high risk of aspiration, even with these changes. If this is the case for you, you might need a feeding tube to prevent aspiration, at least temporarily.

What are the possible complications of dysphagia?

A major complication of dysphagia is lung damage from aspiration.

Aspiration also increases your chance of getting pneumonia. This usually needs treatment with antibiotics. It can sometimes even cause death. With dysphagia, aspiration is always a risk.

Other possible complications include:

  • Dehydration.

  • Poor nutrition and weight loss.

  • Increased risk of other illness.

Contact Us

At UC Health, we lead the region in scientific discoveries and embrace a spirit of purpose – offering our patients and their families something beyond everyday healthcare. At UC Health, we offer hope.