Treatments for Dysphagia

16 October, 2020
Dysphagia is a disease that can appear from several reasons. Because of this, there’s no single treatment. In fact, it’s necessary to establish an accurate diagnosis to choose an appropriate approach. In this article, discover the treatments for dysphagia.

Treatments for dysphagia depend on which type the patient’s suffering from. In this article, you’ll learn all about the different types, as well as how they can be treated.

Most cases require strict medical therapies and even surgery. However, a doctor must make an accurate diagnosis before deciding on a treatment. Some dysphagias are temporary, while others represent a serious, even oncological, problem.

Dysphagia and its types

Dysphagia is difficulty swallowing. In other words, the patient feels pain when something passes down their throat.

If the problem is the throat itself, we may be facing an infectious or inflammatory odynophagia. Dysphagia is when a person has a hard time swallowing food or saliva from the oral cavity into the stomach.

As you can see, several organs play a role in this disorder, which makes it more complex. In addition, it can either be a difficulty either swallowing liquids or solids. Those small symptoms guide the diagnosis to a great extent.

These are the types of clinical presentation:

  • Oropharyngeal. This dysphagia is the classic difficulty swallowing liquids and foods at high levels. It’s located in the throat. The most common causes of this type are neurological. Stroke patients suffer from it, which makes it hard for them to eat. This may lead to other complications, such as dehydration and weight loss.
  • Esophageal. As its name implies, this dysphagia is in the esophagus, lower than the previous one. It occurs in both liquids and solids. The esophagus is a hollow and tubular organ that favors obstruction in neoplastic processes. The most serious cause, of course, is cancer.
A woman with dysphagia.
Dysphagia is a problem characterized by difficulty swallowing both solid and liquid foods.

Keep reading to learn more: Esophageal Foreign Body Removal

Treatments for oropharyngeal or transfer dysphagia

Firstly, to treat oropharyngeal dysphagia, the medical professional has to first diagnose the condition. The first causes they look for are those that can be corrected with habit modifications.

One of the first things medical professionals suggest are dietary changes, such as modifying the textures and volumes of food. The goal is to help the patient be able to swallow and digest foods.

Posture is a determining factor in patients who suffer from neurological disorders due to primary pathologies or after-effects. For many, just changing their neck position when they eat is enough to correct dysphagia.

Rehabilitation processes are also applied for this important daily activity. We learn to eat when we’re young. However, for example, patients who suffer strokes must learn to do it all over again. Both nutritionists and physical therapists teach patients to eat.

In complex cases, doctors may prescribe nutritional support or adaptive feeding devices. If the patient doesn’t eat despite the modifications, or loses weight and becomes dehydrated, then their doctor will prescribe one of these devices.

  • The most common are nasogastric tubes
  • Although the surgical variant is less common, it’s still an option when starvation is a risk

Treatments for dysphagia: esophageal dysphagia

Esophageal cancer isn’t the only cause of this type of dysphagia. Thus, proper treatment depends on proper diagnosis. Perhaps the patient may be suffering from esophagitis, which is inflammation of the esophagus. They may also have achalasia, which is when the lower esophageal muscle (sphincter) doesn’t relax properly to let food enter the stomach.

If a doctor opts for the surgical route, they’ll likely resort to endoscopy. To do this, they insert a flexible fiber tube that runs through the upper gastrointestinal tract, looking for obstructions. The device has a camera and tools for the surgeon to work with. If they find a foreign body, they must remove it. In addition, it also allows surgeons to take biopsies.

The endoscope can also perform dilations to allow elements inside the esophagus to move in patients with severe obstructions due to a decrease in esophageal lumen.

Some of the drugs that can address the problem without surgery are the following:

  • Calcium channel blockers. These drugs claim to regulate smooth muscle contractions in the esophagus. Their effectiveness is disputed by clinical trials.
  • Proton-pump inhibitors. Used more as adjuvants. They reduce the production of hydrochloric acid in the stomach, thus reducing its reflux. This causes esophageal irritation.
  • Botulinum toxin. Experts have experimented with injecting this substance a few times, but the results haven’t been entirely promising. Firstly, the substance has to be applied every 6 months to maintain the effect. The patients who benefited from it also underwent surgery.
A person putting pills on a table.
Treatments for dysphagia vary depending on its cause. Sometimes, dietary changes are enough. But other cases require medications or surgery.

Find out more here: Signs and Symptoms of Esophageal Varices

Treatments for dysphagia are complex

As you’ve seen in this article, it isn’t easy for doctors to address and treat dysphagia. Serious underlying causes, such as cancer, require an accurate diagnosis that leaves nothing to chance.

For this reason, it’s important for patients to see their doctors as soon as possible and follow their indications. This disorder can lead to malnutrition and dehydration.

  • Leonard, Rebecca, and Katherine Kendall, eds. Dysphagia assessment and treatment planning: a team approach. Plural publishing, 2018.
  • Popescu, C. R., et al. “The epidemiology of hypopharynx and cervical esophagus cancer.” Journal of medicine and life 3.4 (2010): 396.
  • García González, María Luisa. “Viscosidad en la dieta de pacientes diagnosticados de disfagia orofaríngea.” (2017).
  • Suárez-Escudero, Juan Camilo, Zulma Vanessa Rueda Vallejo, and Andrés Felipe Orozco. “Disfagia y neurología:¿ una unión indefectible?.” Acta Neurológica Colombiana 34.1 (2018): 92-100.
  • García-Peris, Pilar, C. Velasco, and L. Frías Soriano. “Manejo de los pacientes con disfagia.” Nutrición Hospitalaria 5.1 (2012): 33-40.
  • Chamorro, C. Cabrera, et al. “Dilatación endoscópica con balón de estenosis esofágica en niños.” Cir Pediatr 26 (2013): 106-111.
  • Gil, FJ Rodríguez, C. Martínez Prieto, and R. de Prado Serrano. “Disfagia orofaríngea y trastornos motores esofágicos.” Medicine-Programa de Formación Médica Continuada Acreditado 11.1 (2012): 26-34.
  • San Bruno, A., and J. E. Domínguez-Muñoz. “Protocolo diagnóstico de la disfagia.” Medicine-Programa de Formación Médica Continuada Acreditado 13.7 (2020): 405-408.
  • Terré, R. “Disfagia orofaríngea en el ictus: aspectos diagnósticos y terapéuticos.” Revista de neurología 70.12 (2020): 444-452.