Acid reflux is a common condition in the lower chest area which features a burning pain, known as heartburn. As stomach acid flows back into the food pipe it happens.
Gastroesophageal reflux disease (GERD) is diagnosed on incidence of acid reflux more than twice a week.
Exact numbers vary but acid reflux-related diseases are the most common gut problem seen by medical departments in the U.S.
According to the American College of Gastroenterology, over 60 million Americans suffer heartburn at least once a month, and at least 15 million as often as every day.
In Western countries, GERD is most common, affecting an estimated 20 to 30 percent of the population.
Chronic heartburn can carry severe complications.
Fast facts on acid reflux
- Acid reflux is also known as heartburn, acid indigestion, or pyrosis.
- It happens when some of the acidic stomach contents go back up into the esophagus.
- Acid reflux creates a burning pain in the lower chest area, often after eating.
- Lifestyle risk factors include obesity and smoking.
- Drug treatments are the most common therapy and are available on prescription and over the counter (OTC).
Acid reflux occurs when some of the stomach’s acid content travels into the esophagus, into the gullet, and pushes food from the mouth downwards. Heartburn has nothing to do with the heart, in spite of its name.
The stomach contains hydrochloric acid, a strong acid that helps break down food and protect against bacterial pathogens.
The stomach lining is specially adapted to shield it from the infectious acid, but it does not protect the esophagus.
A muscle ring, the gastroesophageal sphincter, usually functions as a valve allowing food to get into the stomach but not back into the esophagus. The signs of acid reflux, such as heartburn, are felt when this valve fails and stomach material is regurgitated into the esophagus.
GERD affects people of all ages, sometimes for reasons unknown. It is often attributed to a factor in lifestyle but it can also be due to factors that can not always be avoided.
A hiatal hernia (or hiatus) is one condition that is not preventable. A break in the diaphragm allows the upper part of the stomach to enter the cavity of the chest, occasionally contributing to GERD.
Other risk factors are more easily controlled:
- smoking (active or passive)
- low levels of physical exercise
- medications, including drugs for asthma, calcium-channel blockers, antihistamines, painkillers, sedatives, and antidepressants
Pregnancy can also cause acid reflux due to extra pressure being placed on the internal organs.Diet
Food and dietary habits that have been linked to acid reflux include:
- a high intake of table salt
- a diet low in dietary fiber
- eating large meals
- lying down within 2 to 3 hours of eating a meal
- consuming chocolate, carbonated drinks, and acidic juices
A recent study suggests that dietary choices may be as effective as using proton pump inhibitors (PPIs) in treating acid reflux.
The main treatment options for acid reflux are:
- PPIs, including omeprazole, rabeprazole, and esomeprazole
- H2 blockers, including cimetidine, ranitidine, and famotidine
- Over-the-counter treatments, such as antacids,
- Alginate drugs, including Gaviscon
The key treatment options for people who experience persistent acid reflux in GERD are either PPIs or H2 blockers, both drugs.
PPIs and H2 blockers reduce the acid production and decrease the potential for acid reflux damage.
These drugs are usually safe and effective but they are not ideal for all people with reflux disease like any prescription drug and can cause side effects.
They can cause nutrient absorption problems, for example. That can result in malnutrition.
OTC remedies for acid reflux
OTC medications are available for people who rarely experience heartburn or indigestion, perhaps in combination with occasional food and drink causes, to reduce the acidity of the stomach contents.
These formulations of liquids and tablets are called antacids, and hundreds of brands are available, all having similar effectiveness. These should not operate for everybody so there should be talk with a doctor about the need for regular use.
Antacids provide fast, yet short-term relief by reducing stomach acidity.
They contain chemical compounds such as carbonate of calcium, bicarbonate of sodium, aluminium and hydroxide of magnesium. They can also inhibit absorption of nutrients, which leads to deficiencies over time.
Alginate drugs such as Gaviscon
Gaviscon is probably the best-known heartburn treatment. It has a different mode of action than antacid drugs. Alginate medications such as Gaviscon vary slightly in structure, but they usually contain an antacid.
The alginic acid works by creating a mechanical shield against the stomach acid, forming a foamy gel that sits at the top of the gastric pool itself.
Some reflux is then relatively harmless as it consists of alginic acid and not destroying stomach acid.
The active ingredient — alginate — is found naturally in brown algae.
Other possible treatment methods include:
- Sucralfate acid suppressants
- Potassium-competitive acid blockers
- Transient lower esophageal sphincter relaxation (TLESR) reducers
- GABA(B) receptor agonist
- mGluR5 antagonist
- Prokinetic agents
- Pain modulators
- Tricyclic antidepressants
- Selective serotonin reuptake inhibitors (SSRIs)
- Theophylline, a serotonin-norepinephrine reuptake inhibitor
If GERD is serious and unresponsive to medical treatment, it may require surgical intervention known as fundoplication.
Lifestyle measures that may help include:
- improving posture, for instance, sitting up straighter
- wearing loose clothing
- losing weight if overweight or obese
- avoiding increased pressure on your abdomen, such as from tight belts or doing sit-up exercises
- stopping smoking
Acid reflux usually causes heartburn, whether it is due to an overeating or prolonged GERD episode.
Heartburn is an unpleasant feeling of burning that occurs in the esophagus, and is felt behind the breastbone. Lying down or leaning over seems to get worse. It can take several hours to last and sometimes worsens after eating food.
Heartburn pain can move upward towards the neck and throat. In some cases, stomach fluid can reach the back of the mouth, causing a bitter or sour taste.
If heartburn happens twice a week or more, it is known as GERD for short.
Other symptoms of GERD include:
- dry, persistent cough
- asthma and recurrent pneumonia
- throat problems, such as soreness, hoarseness, or laryngitis (voice box inflammation)
- difficulty or pain when swallowing
- chest or upper abdominal pain
- dental erosion
- bad breath
Risks and complications
Without medication, GERD can lead to serious long-term complications including increased cancer risk.
Persistent exposure to gastric acid can harm the esophagus, resulting in:
- Esophagitis: the lining of the esophagus is inflamed, causing irritation, bleeding, and ulceration in some cases
- Strictures: damage caused by stomach acid leads to scar development and difficulties swallowing, with food getting stuck as it travels down the esophagus
- Barrett’s esophagus: a serious complication where repeated exposure to stomach acid causes changes in the cells and tissues lining the esophagus with potential to develop into cancer cells
Both esophagitis and Barrett’s esophagus are associated with a higher risk of cancer.
30 to 50 percent of women in the U.S. develop heartburn during pregnancy, even though they hadn’t had it before.
Changes to diet during pregnancy, such as not eating too late at night and preparing small meals, are recommended.
Every woman who suffers from severe reflux during pregnancy should explore treatment options with her doctor.
Acid reflux and heartburn are normal and relatively easy to diagnose, but other chest problems such as:
- heart attack
- chest wall pain
- pulmonary embolus
GERD is often diagnosed simply by finding little improvement in the symptoms of heartburn in response to changes in diet and acid reflux medications.
Gastroenterologists may also coordinate the investigations as follows:
- endoscopy: camera imaging
- biopsy: taking a tissue sample for laboratory analysis
- barium X-ray: imaging the esophagus, stomach, and upper duodenum after swallowing a chalky liquid that helps provide contrast on images
- esophageal manometry: pressure measurement of the esophagus
- impedance monitoring: measuring rate of fluid movement along the esophagus
- pH monitoring: acidity testing
Upper GI bleed: What you should know
Upper gastrointestinal (GI) bleeding happens when there is bleeding in the oesophagus, stomach, or upper portion of the small intestine. It’s a sign of something else going on, and it can be dangerous.
An upper GI bleed sends over 100,000 people to the hospital in the United States every year. Severe bleeds can be life-threatening and must be treated right away.
We’ll take a closer look at upper GI bleeds in this post, including their causes and treatment options.
When a portion of the upper digestive tract is damaged or inflamed, it can cause a bleed.
A GI bleed is a symptom of another disorder rather than a health condition in itself. GI bleeds are classified as upper or lower bleeds, depending on the source of the blood.
Lower GI bleeds can occur in the:
- lower part of the small intestine
Upper GI bleeds can occur in the:
- duodenum, the initial part of the small intestine
GI bleeds can be acute or chronic. Acute bleeds are sudden and serious, while recurrent bleeding occurs over time and is usually less noticeable. If not treated, both of these conditions can lead to serious health problems.
Upper GI bleeding can be caused by a variety of factors. There are some of them:
Peptic ulcers are sores that form on the stomach and upper portion of the small intestine lining. A Helicobacter pylori infection or inflammation from nonsteroidal anti-inflammatory drugs (NSAIDs) including aspirin or ibuprofen are the most common causes.
Many people who have ulcers have no symptoms. If symptoms do appear, they can include the following:
- pain, often in the upper abdomen
- nausea or vomiting
- feeling full or bloated
The symptoms of esophagitis include:
- pain in the chest when swallowing
- difficulty swallowing
- nausea or vomiting
- lack of appetite
- chronic cough
When the small intestine becomes inflamed, usually as a result of a bacterial or viral infection, enteritis develops. Radiation therapy, some drugs, alcohol, or inflammatory bowel disease (IBD) may all cause enteritis .
Nausea, vomiting, diarrhoea, cramping, and rectal bleeding may occur when enteritis is caused by an infection.
There are tears in the oesophageal lining that occur often as a result of excessive vomiting or coughing.
Mallory-Weiss tears may result in a significant amount of bleeding. While they can recover on their own in certain cases, this isn’t always the case. Some people may need medical help to stop the bleeding and prevent serious blood loss.
Symptoms of oesophageal varices typically do not appear until the veins begin to bleed. If these blood vessels bleed, they may bleed profusely. Among the signs and symptoms are:
- stomach pain
- vomiting blood
- bloody stool
Gastritis is a stomach inflammation. The majority of people with gastritis have no symptoms, but it can lead to the following:
- pain in the upper abdomen
- feeling full after eating little
- loss of appetite
- unintentional weight loss
Gastritis can lead to ulcers or damage to the stomach lining, resulting in bleeding. NSAID use, illness, IBD, or infection may all cause this condition.
Cancer is a less common cause of upper GI bleeding. The following are some of the most common oesophageal cancer symptoms:
- difficulty swallowing
- a persistent cough
- vomiting blood
- unexplained weight loss
Cancer may also manifest itself elsewhere in the upper GI tract, causing bleeding.
The type of symptoms a person can experience are influenced by the location of a GI bleed and the rate of bleeding.
The symptoms of a GI bleed can include:
- black, tarry stool
- vomit that is bright red or resembles coffee grounds
- stomach cramps
- unusually pale skin
- feeling faint, dizzy, or tired
Occult bleeding, which happens when blood is present in the stool but is not noticeable, may also occur. A stool test may be used to detect this blood.
When do you seek assistance?
Acute GI bleeding can rapidly escalate into a serious situation. If a person shows symptoms of a GI bleed unexpectedly, they should seek medical attention right away.
Acute GI bleeds can also cause shock, which is a life-threatening condition. Among the signs and symptoms are:
If a person exhibits these symptoms, they should call 911 or the nearest emergency room.
Chronic GI bleeding is a form of gastrointestinal bleeding that lasts for a long time or comes and goes. However, it can also cause serious health problems, such as anaemia.
When exercising, people with anaemia sometimes feel lightheaded, exhausted, or short of breath. It’s also possible that they’ll appear paler than normal.
Anyone who thinks they could be suffering from a chronic GI bleed or anaemia should see a doctor as soon as possible to get a diagnosis and treatment.
If a doctor thinks bleeding is the cause of a patient’s symptoms, he or she may take a medical history and conduct a physical examination. They can then enquire about the individual’s symptoms, as well as their bowel movements and stool colour.
The doctor can also refer the patient to a gastroenterologist or order diagnostic tests. They may use a variety of tests to aid in their diagnosis, including:
- Stool tests: These can detect inflammation, occult bleeding, or infections, such as H. pylori.
- Blood tests: These tests can reveal anemia.
- Upper endoscopy or enteroscopy: A doctor passes an endoscope down the esophagus to view the stomach or small intestine.
- Gastric lavage: This procedure involves removing the contents of the stomach to determine the source of any bleeding.
- A biopsy: A doctor will take a small sample of tissue from an affected area and send it to a lab for analysis.
- Imaging tests: Examples include CT scans and barium X-rays.
The treatment options for an upper GI bleed are determined by a number of factors, including the location, severity, and cause of the bleeding.
The goal for people who go to the emergency room with serious bleeds is to stop the bleeding. Doctors can accomplish this by:
- injecting a medication directly into the bleeding site
- using heat to treat the bleeding site via a probe or laser
- placing a clip on the blood vessel to seal it shut
If doctors locate the source of the bleed during medical tests such as an endoscopy, they may use one of these methods.
The next move is to address the underlying cause of the bleeding. This treatment may include:
- taking medications to treat underlying conditions, such as antibiotics to clear an H. pylori infection or proton pump inhibitors (PPIs) to suppress stomach acid production and allow ulcers to heal
- stopping any medications or practices that are causing ulceration or bleeding, such as NSAID use
- surgery, which a doctor may recommend if they cannot stop the bleeding in other ways
Intravenous fluids or a blood transfusion may be needed for people who have lost a lot of blood.
Risk factors and how to avoid them
The conditions that can cause GI bleeds are caused by a variety of factors.
- calcium channel blockers
- tricyclic antidepressants
If a drug is worsening ulcers or bleeding, a person should consult a doctor about other options or dosage adjustments. It is important, however, to never alter the dose without first consulting a medical professional.
A doctor may assist a patient in determining the cause of a GI bleed as well as how to treat or handle it. This method is normally the most effective at preventing further bleeds.
People who have had GI bleeds or ulcers in the past will reduce their risk of GI bleeding by:
- avoiding alcohol
- stopping smoking, if a smoker, or avoiding secondhand smoke
- limiting or stopping the use of NSAIDs
Certain dietary changes can also help people with GERD relieve their symptoms by reducing pain and inflammation. People should try avoiding:
- minty, spicy, or acidic foods
- high fat foods
Sudden and severe GI bleeding is a medical emergency, but slower, chronic bleeding can also become serious over time. Anyone who thinks they have a GI bleed should seek medical attention as soon as possible.
Doctors may use drugs to avoid or monitor upper GI bleeding, or they can use heat or surgery to close wounds. The underlying condition should then be treated to avoid further bleeding.
- Acid reflux (GER & GERD) in adults. (n.d.).
- Symptoms, causes, and treatment of an upper GI bleed https://www.medicalnewstoday.com/articles/upper-gi-bleed
- Gastrointestinal (GI) bleeding. (n.d.).
- Mallory-Weiss tear. (n.d.).
- Schafer, T. W., et al. (2012). Peptic ulcer disease.
- Signs and symptoms of esophageal cancer. (2020).
- Symptoms & causes of gastritis & gastropathy. (2019).
- Tielleman, T., et al. (2015). Epidemiology and risk factors for upper gastrointestinal bleeding [Abstract]. /
Burning sensation in the lungs
A burning sensation in the lungs has several potential causes. Although this symptom is not generally a cause for alarm, occasionally it may indicate a serious condition needing treatment.
Especially if the cause is unclear, burning pain in the chest area can be troubling. Many causes are relatively benign, however.
We look at some of the common causes of a burning sensation in the lungs in this article and clarify when an individual needs medical emergency support.
We also look at the current evidence linking burning chest pain to COVID-19, the disease that the novel coronavirus, SARS-CoV-2, causes.
Is it serious?
Pain in the chest might be linked to any of the organs and systems in that part of the body. These include the tube that connects the throat and stomach, which is the ribcage, lungs , heart, and esophagus (food pipe).
Experiencing a burning sensation in the lungs is not unusual, and it is typically not something serious. However, it could be a sign of a heart attack in some situations.
When to seek emergency help
When the heart stops obtaining the oxygen-rich blood it needs to survive, a heart attack occurs. Immediate treatment is required in this medical emergency.
Symptoms of a heart attack in males
The signs of a heart attack for males might include:
- pain or discomfort in the center of the chest, which may feel like burning, pressure, or squeezing
- pain that lasts more than a few minutes or comes and goes over time
- pain or discomfort in one or both arms or the back, neck, jaw, or stomach
- shortness of breath
- cold sweat
Symptoms of a heart attack in females
In addition to experiencing of chest pain or discomfort, a woman with a heart attack is more likely to experience:
- shortness of breath
- nausea or vomiting
- pain in the jaw
- pain in the back
People can immediately call 911 if they or anyone else has signs of a heart attack.
Burning pain in the chest can be caused by a different variety of causes.
In the chest, neck, throat, or jaw, it may cause a painful, burning sensation. Heartburn is the probable cause if the pain goes away when the person belches.
The symptoms of heartburn can be relieved by over-the-counter ( OTC) drugs.
In order to treat a bacterial chest infection, physicians can prescribe antibiotics.
Asthma is a disorder that is long-term. People with asthma have bronchial tubes that are inflamed. These are the passageways in and out of the lungs that carry air.
When the muscles around the tubes tighten, an asthma attack occurs, making the air passages very narrow.
A person who has an asthma attack may feel as if someone is sitting on his chest.
The episode could only last a few minutes and get better on its own, or it could run for hours. People find it so difficult to breathe often that they need to go to the hospital for help.
Typically, people with asthma have an inhaler that helps relax the muscles around the tubes, allowing air to get more quickly into and out of the lungs.
Less common causes
A burning sensation in the lungs can also be caused by less common conditions.
A blockage in the arteries that supply the lungs with the blood they need to survive is a pulmonary embolism.
A common cause of pulmonary embolism is deep vein thrombosis, which is a blood clot in the leg. If a blood clot breaks out, begins circulating the body, and becomes trapped in a lung artery, blocking the flow of blood, pulmonary embolism occurs.
It is a very dangerous condition that can cause the lungs and other organs to undergo irreversible damage.
The signs of a pulmonary embolism could include:
- chest pain
- shortness of breath
- coughing up blood
Doctors will usually treat the problem with medication to thin the blood or dissolve the clot.
They can also prescribe the removal of a catheter-assisted thrombus. To reach into the lung and extract the clot, this surgical technique involves using a flexible tube.
A burning sensation in the chest can be a symptom of lung cancer in rare cases.
For all, the symptoms are different, and some individuals may have no symptoms at all. Those who do might encounter:
- a pain in the chest that gets worse with deep breathing, coughing, or laughing
- a cough that does not go away or keeps getting worse
- appetite loss
- tiredness or weakness
- chest infections that keep coming back
Treatment choices will be determined by the form and severity of the cancer.
Burning pain in the chest and COVID-19
Researchers do not yet know if COVID-19 can cause burning chest pain, but there has been a correlation between this symptom and the disease noted by some researchers.
A potential symptom of COVID-19 is chest pain, according to the Centers for Disease Control and Prevention ( CDC).
There are other signs that may include:
- fever or chills
- shortness of breath
- new loss of taste or smell
- muscle aches
- a headache
- a sore throat
- a stuffy or runny nose
- nausea or vomiting
A doctor will first question them about the symptoms and their personal and family medical history to decide why a person is feeling a burning pain in their chest.
In order to listen to the chest and perform blood tests, X-rays, and other tests, they can use a stethoscope.
If the doctor suspects COVID-19, he or she will ask the individual to take a SARS-CoV-2 virus swab test.
If it is due to heartburn, OTC pain relief drugs may help alleviate moderate chest pain, but people should consider talking to a doctor in most cases.
The American Heart Association ( AHA) suggests that people with heartburn should be able to reduce their symptoms by:
- avoiding alcohol and cigarettes
- refraining from taking aspirin or other anti-inflammatory medication
- avoiding drinking citrus juices
- stopping eating a few hours before bedtime
- raising the head of the bed by about 6 inches, if heartburn occurs at night
- taking OTC medications for indigestion
A burning sensation in the chest has several potential causes. The majority have nothing to worry about, like heartburn.
Some, however, such as a heart attack, are a medical emergency.
Anyone who suspects they may have a heart attack or someone else should call 911 right away.
Doctors are not yet sure whether the symptom of COVID-19 is chest pain, but some assume that it is.
Anyone who suspects that they have COVID-19 should talk to a doctor.
What causes difficulty swallowing (dysphagia)?
Dysphagia refers to a difficulty in swallowing-moving food from the mouth to the stomach requires more effort than normal.
Dysphagia can typically be painful due to nerve or muscle problems, and is more common in older people and babies.
Even though the medical word “dysphagia” is sometimes considered to be a symptom or indication, it is also used to identify a disorder by itself. There are a wide variety of possible causes of dysphagia; if this happens only once or twice, there is usually no significant underlying issue, but if it occurs frequently, a doctor can check it out.
Treatment depends on the underlying cause and there are several explanations why dysphagia can occur.
In this article, the different causes of dysphagia will be addressed along with symptoms , diagnosis, and possible remedies.
What is dysphagia?
A typical “swallow” requires a variety of different muscles and nerves; this process is surprisingly complex. Dysphagia can happen anywhere in the swallowing process due to a difficulty.
There are three forms of dysphagia which are general:
Oral dysphagia (high dysphagia) — the condition is in the mouth, often caused by tongue weakness after a stroke, trouble chewing food, or air-transport problems.
Pharyngeal dysphagia – in the throat is the problem. Neurological problems which affect the nerves (such as Parkinson’s disease, stroke, or amyotrophic lateral sclerosis) often cause problems in the throat.
Esophageal dysphagia (low dysphagia) – in the esophagus the problem is. Typically that is due to a blockage or discomfort. Sometimes, it involves an operating procedure.
It is worth noting that pain is different from dysphagia when swallowing (odynophagia), but both can be felt at the same time. And, globus is the feeling that something is trapped in your mouth.
Causes of dysphagia
Possible Dysphagia causes include:
Amyotrophic lateral sclerosis — an incurable type of progressive neurodegeneration; gradually losing control in the spine and brain, over time.
Achalasia — the lower esophageal muscle is not sufficiently relaxed to allow food to reach the stomach.
Diffuse spasm — muscles contract in an uncoordinated way inside the esophagus.
Stroke — brain cells die because of a lack of oxygen due to reduced blood flow. If it affects the brain cells that regulate swallowing it can cause dysphagia.
Esophageal ring – a small portion of the esophagus narrows, often blocking the passage of solid foods.
Eosinophilic esophagitis – severe eosinophilic levels (a type of white blood cell) in the esophagus. These eosinophils develop and invade the gastrointestinal system in an uncontrolled manner , leading to vomiting and difficulty swallowing food.
Multiple sclerosis — the immune system attacks the central nervous system, killing myelin which normally protects the nerves.
Myasthenia gravis (Goldflam disease) — the muscles under voluntary control quickly become tired and weak as there is an issue with how the nerves induce muscle contraction. This is something of an autoimmune disorder.
Parkinson’s disease and syndromes of Parkinsonism — Parkinson’s disease is an increasingly progressive, degenerative neurological disorder that impairs the motor skills of the patient.
Radiation — some patients who have undergone radiation therapy (radiotherapy) to the area of the neck and head may have difficulty swallowing.
Cleft lip and palate — forms of abnormal facial development due to incomplete bone fusion in the head, resulting in gaps (clasps) in the palate and lip to nose area.
Scleroderma — a group of rare autoimmune diseases that harden and tighten the skin and connective tissues.
Esophageal strenght — an esophagus narrowing, it is often linked to GERD.
Xerostomia (dry mouth) — there is insufficient saliva to keep mouth moist.
Symptoms of dysphagia
Some patients have dysphagia and are unaware of it — in these cases, it can go undiagnosed and not treated, increasing the risk of aspiration pneumonia (a lung infection that can grow after saliva or food particles unintentionally inhaled).
Symptoms linked to dysphagia include:
- Choking when eating.
- Coughing or gagging when swallowing.
- Food or stomach acid backing up into the throat.
- Recurrent heartburn.
- Sensation of food getting stuck in the throat or chest, or behind the breastbone.
- Unexplained weight loss.
- Bringing food back up (regurgitation).
- Difficulty controlling food in the mouth.
- Difficulty starting the swallowing process.
- Recurrent pneumonia.
- Inability to control saliva in the mouth.
Patients may feel like “the food has got stuck.”
Risk factors for dysphagia
Dysphagia Risk Factors include:
Aging — older adults are more at risk. Over time this is because of general wear and tear on the body. Also, certain old-age disorders, such as Parkinson’s disease, can cause dysphagia.
Neurological conditions — some nervous system disorders are more likely to cause dysphagia.
Complications of dysphagia
Pneumonia and upper respiratory infections – basically aspiration pneumonia that can occur when something is swallowed down the “wrong way” and is into the lungs.
Malnutrition — this is particularly true of people who are not aware of their dysphagia and are not treated for it. They just do not get enough essential nutrients for good health.
Dehydration – If a person is unable to drink properly, their fluid intake can not be adequate, resulting in dehydration (water shortage in the body).
Diagnosis of dysphagia
A speech-language pathologist may try to assess where the problem lies – which aspect of the mechanism of swallowing is causing problems.
The patient will be asked about the symptoms, how long they have been present, whether the liquids, solids or both are the issue.
Swallow study — this is usually administered by a speech therapist. They measure various food and liquid consistencies to see which causes difficulties. They are also required to do a video swallow test to see where the problem is.
Barium swallow test — the patient swallows a liquid which contains barium. Barium appears in X-rays and lets the doctor assess in greater detail what is happening in the esophagus, particularly muscle activity.
Endoscopy — a doctor uses a camera to view the esophagus downwards. If they find something they think cancer might be, they will take a biopsy.
Manometry — this study tests changes in the pressure created as muscles function in the esophagus. This can be used when there is nothing detected during an endoscopy.
Treatment for dysphagia
Treatment is determined by the form of dysphagia:
Treatment for oropharyngeal dysphagia (high dysphagia)
Because oropharyngeal dysphagia is also a neurological condition it is difficult to provide successful care. Patients with Parkinson’s disease may well lead to Parkinson’s medication for the disease.
Swallowing therapy – A speech therapist and a language therapist can do this. Individuals will discover new ways to sweat properly. Exercises can help the muscles strengthen, and how they respond.
Diet — Some, or combinations of, foods and liquids are easier to drink. It’s also critical that the patient has a well-balanced diet when consuming the easiest-to-swallow foods.
Feeding via a tube — if the patient is at risk of pneumonia, malnutrition or dehydration they may need to be fed through a nasal tube (nasogastric tube) or PEG (percutaneous endoscopic gastrostomy). PEG tubes are inserted surgically directly into the stomach and travel through a slight incision in the abdomen.
Treatment for esophageal dysphagia (low dysphagia)
Osophageal dysphagia normally requires surgical intervention.
Dilation — if the esophagus has to be extended (for example , due to a tightness), a small balloon may be inserted and then inflated (it is removed afterwards).
Botulinum toxin (Botox) — widely used when stiff muscles (achalasia) have been in the esophagus. Botulinum toxin is a potent toxin which can paralyze the stiff muscle and minimize constriction.
If cancer induces the dysphagia, the patient will be referred to an oncologist for treatment and will need to have the tumor removed surgically.