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Acid Reflux / GERD

What to know about indigestion or dyspepsia

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Dyspepsia, also known as indigestion, is a term used to describe upper abdominal discomfort or pain. This is not an disease.

The term refers to a group of symptoms commonly associated with bloating, discomfort, nausea, and burping.

Indigestion is associated, in most situations, with eating or drinking. It may also be attributed to diseases or the use of other medicines.

Fast facts on dyspepsia

  • Dyspepsia is the same as indigestion, and it is not a disease. It is the name for a group of symptoms that cause discomfort in the abdomen.
  • Overeating, consuming greasy or spicy foods, and hiatus hernia can all cause indigestion.
  • An endoscopy can be used to identify the root cause.
  • Dietary choices and medication are used to manage dyspepsia symptoms.

What is dyspepsia?

Dyspepsia is not a specific condition but rather a collection of symptoms.

Many people with indigestion suffer from abdominal or chest pain and discomfort. Generally, the feeling comes soon after eating food or drink. During a meal, it can make a person feel full or depressed even if they haven’t eaten a large amount of food.

Treatments

Indigestion care depends on the cause of the symptoms and their severity.

If the symptoms are moderate and rare, changes in lifestyle will likely relieve them. It usually involves less fatty and spicy foods and less caffeine, sugar, and chocolate intake. Sleeping every night for at least 7 hours can also help ease a mild indigestion.

Daily exercise and quitting smoking are effective lifestyle changes in indigestion treatment as well.

Medications

In severe or frequent cases of indigestion, a doctor may prescribe medication.

Antacids: These counter the effects of stomach acid. Examples include Alka-Seltzer, Maalox, Rolaids, Riopan, and Mylanta. These are over-the-counter (OTC) medicines that do not need a prescription. A doctor will usually recommend an antacid medication as one of the first treatments for dyspepsia.

H-2-receptor antagonists: These reduce stomach acid levels and last longer than antacids. However, antacids act more quickly. Examples include Zantac, Tagamet, Pepcid, and Axid. Some of these are OTC, while others are only available on prescription.

Some people may experience nausea, vomiting, constipation, diarrhea, and headaches after taking these. Other side effects may include bruising or bleeding.

Proton pump inhibitors (PPIs): Examples include Aciphex, Nexium, Prevacid, Prilosec, Protonix, and Zegerid. PPIs are highly effective for people who also have gastroesophageal reflux disease (GERD). They reduce stomach acid and are stronger than H-2-receptor antagonists.

Speak to a doctor about possible side effects.

Prokinetics: This medication is helpful for stomachs that empty slowly. One example of a prokinetic drug is Reglan. Side effects may include tiredness, depression, sleepiness, anxiety, and muscle spasms.

Antibiotics: If H. pylori is causing peptic ulcers that result in indigestion, an antibiotic will be prescribed. Side effects may include an upset stomach, diarrhea, and fungal infections.

Antidepressants: If the doctor finds no causes for indigestion after a thorough evaluation, and the person with dyspepsia has not responded to treatments, the doctor may prescribe low-dose antidepressants.

Antidepressants sometimes ease discomfort by reducing the sensation of pain. Side effects may include nausea, headaches, agitation, constipation, and night sweats.

Psychological therapy: For people with functional dyspepsia, psychological therapy can help manage the cognitive aspects of indigestion. Cognitive behavioral therapy, biofeedback, hypnotherapy, and relaxation therapy may be recommended.

The doctor may also recommend that changes be made to a person’s current schedule of medication if they believe it could cause indigestion. Often, a course of aspirin or ibuprofen may be halted and alternative drugs may be recommended.

Changing drugs is only necessary under the supervision of a doctor.

Dyspepsia symptoms

Indigestion is not a condition but a group of symptoms that affect digestion.
Indigestion is not a condition but a group of symptoms that affect digestion.

The following symptoms of dyspepsia are also common:

  • nausea
  • belching
  • pain
  • a feeling of fullness, or satiety
  • feeling bloated

In very rare cases, indigestion may be a symptom of stomach cancer.

Mild dyspepsia occasionally involves further testing, and should not be a cause for concern. A doctor visit is only required if the symptoms persist for more than 2 weeks.

Seek emergency treatment if the pain is severe and if there is one of the following, too:

  • loss of appetite or weight loss
  • vomiting
  • inability to swallow
  • black stools
  • yellow coloring in the eyes and skin
  • chest pain during exertion
  • shortness of breath
  • sweating
  • chest pain that spreads to the jaw, arm, or neck

Heartburn and dyspepsia are often mistaken for each other but, although occurring often at the same time, they are two different disorders. Heartburn is a symptom of acid reflux, described as a burning sensation that usually occurs behind the breastbone after eating

Dyspepsia diet

Different type of Fruits
Foods high in fiber, such as fruit, can help prevent indigestion.

A diet high in fibre is a healthy way to manage digestive health. It has the effect of clearing the intestine and making digestion easier, cleaner.

Foods containing fruit, nuts, legumes, and wholegrain are filled with fiber and an excellent choice to protect against indigestion. There were also many yogurts and cereals filled with fibre.

It is important to eat a balanced diet which excludes spicy or greasy foods. Be sure to eat every meal with fluids, as this helps move food through the digestive tract.

It can also support the digestive system by eating four or five smaller meals in a day, as opposed to three larger ones.

Causes

caffeine in the cup
Consuming too much caffeine is one of the many possible causes of dyspepsia.

Indigestion is generally caused by an individual’s lifestyle and the foods that they consume. It may also have an connection with an infection or other intestinal disorders.

The signs are usually caused by contact with the mucosa through the stomach acid. Stomach acids break down the mucous membrane and cause irritation and inflammation. That triggers the uncomfortable indigestion symptoms.

Common causes of indigestion include:

  • eating too much or too rapidly
  • eating fatty, greasy, or spicy foods
  • drinking too much caffeine or alcohol
  • consuming too much chocolate or soda
  • emotional trauma
  • gallstones
  • gastritis, or inflammation of the stomach
  • hiatus hernia
  • infection, especially with a bacteria called Helicobacter pylori (H. pylori)
  • nervousness
  • obesity
  • pancreatitis, or inflammation of the pancreas
  • peptic ulcers
  • smoking
  • certain medications, such as antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs)
  • stomach cancer

If a doctor is unable to find cause for indigestion, the individual may develop functional dyspepsia. This is a type of indigestion to explain the symptoms, without any pathological or metabolic disease. It may be caused by stomach disease, which prevents it from eating and digesting food in a normal manner.

Diagnosis

For most people with signs dyspepsia is mild and rare. In such cases there is no need for treatment.

People with daily indigestion or severe abdominal pain should see a primary care doctor.

A doctor should ask the person with dyspepsia about the symptoms thereof. You will also find out about their personal and family backgrounds, and analyze the stomach and arms. This may include pressing down on different areas of the abdomen to decide whether any are under pressure sensitive, tender, or painful.

If the doctor suspects an underlying cause, they can use the following diagnostic tests to identify any underlying health problems:

  • Blood test: If the person with indigestion also has any symptoms of anemia, the doctor may order a blood test.
  • Endoscopy: People who have not responded to previous treatment for dyspepsia may be referred for a more detailed examination of the upper gastrointestinal (GI) tract. A long thin tube with a camera at the end is inserted through the mouth and into the stomach. This produces clear images of the mucosa. The doctor can also perform a biopsy during this procedure to test for cancer.
  • Tests to diagnose H. pylori infection: These may include a urea breath test, a stool antigen test, and a blood test. An endoscopy would also identify H. pylori as well as any peptic ulcers that are present. Peptic ulcers are often caused by H. pylori.
  • Liver function test: If the doctor suspects a problem with the bile ducts in the liver, they may request a blood test to assess how the liver is working.
  • X-rays: X-ray images are taken of the esophagus, stomach, and small intestine.
  • Abdominal ultrasound: High-frequency soundwaves make images showing movement, structure, and blood flow in the abdomen. A gel is applied to the abdomen and a hand-held device pressed against the skin. The device gives off sound waves, and the doctor can see a detailed picture of the inside of the abdomen on a monitor.
  • Abdominal CT scan: This may involve injecting a dye into the veins. The dye shows up on the monitor. The CT scan takes a series of X-ray images to produce a 3D image of the inside of the abdomen.

Further examinations are often only used in severe cases.

Complications

In most cases, dyspepsia is mild, and uncommon. Nevertheless, the following conditions will occasionally cause severe indigestion.

Esophageal stricture: The reflux of acids will cause indigestion. This is a disease in which stomach acids spill back into the esophagus and irritate the stomach’s delicate lining, called the mucosa. The pain can scar the esophagus, which becomes narrow and limited afterwards.

People with an esophageal stringency can begin to find it difficult to swallow. Food can get caught in the mouth, which can cause chest pain. Often, esophageal dilatation is required to expand the esophagus.

Pyloric stenosis: This occurs when stomach acid causes the lining of the digestive system to be irritated for long periods. The pylorus is the pathway between a small intestine and the stomach. It becomes scarred and narrowered in pyloric stenosis. As a consequence the food is not digested properly.

Surgery may be required to widen the pylorus.

Takeaway

Dyspepsia is often mild, and can be treated before symptoms arise by dietary and lifestyle changes.

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Acid Reflux / GERD

Upper GI bleed: What you should know

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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.

Definition

Blood test results

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
  • colon
  • rectum
  • anus

Upper GI bleeds can occur in the:

  • esophagus
  • stomach
  • 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.

Causes

Upper GI bleeding can be caused by a variety of factors. There are some of them:

Peptic ulcer

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

Esophagitis

Esophagitis is a condition in which the oesophagus becomes inflamed. Gastroesophageal reflux disease (GERD) is the most common cause, but it may also be caused by drugs, viruses, and allergies.

The symptoms of esophagitis include:

  • pain in the chest when swallowing
  • difficulty swallowing
  • nausea or vomiting
  • lack of appetite
  • chronic cough

If a person has GERD, they may experience heartburn and acid reflux on a regular basis.

Enteritis

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.

Mallory-Weiss tears

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.

Esophageal varices

Esophageal varices are swollen veins that can form at the esophagus’s lower end. They’re most common in people who have cirrhosis, a type of liver disease.

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

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

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
  • heartburn
  • unexplained weight loss

Cancer may also manifest itself elsewhere in the upper GI tract, causing bleeding.

Symptoms

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
  • weakness

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.

Diagnosis

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.
  • 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.

Medications

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.

GERD is more common in people who smoke, are pregnant, or are obese, for example. It may also be exacerbated by such drugs, such as:

  • NSAIDs
  • calcium channel blockers
  • benzodiazepines
  • 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:

  • caffeine
  • minty, spicy, or acidic foods
  • high fat foods

Conclusion

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.

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Acid Reflux / GERD

Burning sensation in the lungs

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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?

Heart rate checkup

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
  • nausea
  • lightheadedness

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.

Common causes

Burning pain in the chest can be caused by a different variety of causes.

Heartburn

Heartburn, or indigestion of acid, occurs when acid in the stomach rises into the esophagus.

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.

Chest infection

All examples of chest infections include common colds, bronchitis , and pneumonia. As well as chest pain, symptoms that are typical include:

In order to treat a bacterial chest infection, physicians can prescribe antibiotics.

Asthma attack

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.

Pulmonary embolism

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.

Lung cancer

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
  • wheezing
  • chest infections that keep coming back

Treatment choices will be determined by the form and severity of the cancer.

Treatment will usually involve a combination of chemotherapy , radiotherapy, and surgery. Treatment is often not necessary, and doctors will concentrate on relieving the cancer symptoms.

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
  • cough
  • shortness of breath
  • new loss of taste or smell
  • tiredness
  • muscle aches
  • headache
  • a sore throat
  • a stuffy or runny nose
  • nausea or vomiting
  • diarrhea

Diagnosis

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.

Home remedies
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

Summary

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.

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Acid Reflux / GERD

What causes difficulty swallowing (dysphagia)?

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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?

Dysphagia is more common in older adults.
Dysphagia is more common in older adults.

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 cancer — a form of cancer in the esophagus, typically connected to either alcohol and smoking, or GERD.

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

Coughing when swallowing can be a symptom of dysphagia.
Coughing when swallowing can be a symptom 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).

Also, undiagnosed dysphagia can cause dehydration and malnutrition.

Symptoms linked to dysphagia include:

  • Choking when eating.
  • Coughing or gagging when swallowing.
  • Drooling.
  • Food or stomach acid backing up into the throat.
  • Recurrent heartburn.
  • Hoarseness.
  • 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

Head and next x-ray
A barium swallow test can be useful for understanding the reason behind a case 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.

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