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Difficulty Swallowing


Overview, Causes, & Risk Factors

Difficult swallowing describes any type of trouble a person may have when trying to swallow food or liquids.

What is going on in the body?

A person may have trouble swallowing for many different reasons. It can be caused by an anatomical problem, a nervous system problem, or a muscle problem. The cause may or may not be serious. Further testing is often needed to determine the exact cause.

What are the causes and risks of the condition?

There are many possible causes of this condition. These can be divided into four main categories.

Narrowing of the esophagus, which is the tube that connects the throat to the stomach, can cause swallowing difficulties. Narrowing can be caused by:

  • a swollen and sore throat
  • epiglottitis, a lower throat infection usually seen in children
  • esophagitis, which is an infection of the esophagus
  • esophageal strictures, which are abnormal narrowings that can be caused by pills that get stuck in the esophagus or by gastroesophageal reflux disease, or heartburn
  • esophageal cancer or cancer of the throat and larynx
  • Compression from the outside the throat and esophagus can also cause swallowing difficulties. Compression may be caused by:

  • abnormalities of the spine or neck
  • goiter, which is an enlarged thyroid gland
  • tumors
  • A person may have difficulty starting to swallow if he or she has a very dry mouth. This can occur in a condition called Sjogren syndrome, which also causes dry eyes. Nerve or brain damage, such as damage to a nerve called the vagus nerve, may also cause this problem.

    A person may also have difficulty swallowed because of muscle weakness caused by:

  • autoimmune disorders, such as myasthenia gravis or scleroderma. Autoimmune disorders occur when a person's immune system attacks his or her own body.
  • achalasia, a nerve related disorder that interferes with the mechanics of swallowing
  • nerve or brain damage, which can weaken or paralyze the muscles used in swallowing. This may occur after a stroke or in degenerative nerve disorders such as amyotrophic lateral sclerosis, also called Lou Gehrig's disease.
  • Other causes are also possible. Sometimes, no cause can be found.


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