But in a study funded by Schwarz Pharmaceuticals and conducted by Harris Interactive, it was discovered that 40 percent of American adults reported difficulty swallowing pills. This resulted in delayed doses, skipped doses, and, in 4 percent of cases, discontinuing the medication.
Difficulty swallowing is clinically known as dysphagia, a condition in which swallowing takes more time and effort than normal. This problem may be accompanied by pain, and in some cases, swallowing anything is impossible for the sufferer.
Occasional difficulty swallowing is relatively common and may be related to eating too fast, not chewing food, or a gag reflex for things that must be swallowed whole, like pills. However, if dysphagia persists, it can be a sign of a serious underlying medical condition.
What Problems Swallowing Could Mean
Here are several categories of dysphagia that seem to crop up most frequently, along with the probable causes of the issue.
1) Esophageal dysphagia – This is the sensation of food sticking in the esophagus while starting to swallow. This can be caused by achalasia, a situation where the lower esophageal muscle (sphincter) doesn’t relax to allow food to enter the stomach, or weak stomach muscles may cause the condition.
2) Diffuse spasm – This is a series of poorly coordinated contractions of the esophagus, usually after swallowing. These multiple, high-pressure spasms usually attack the involuntary muscles in the walls of the lower esophagus.
3) Esophageal stricture – A narrow esophagus (stricture) actually can trap food. Scar tissue or tumors also can cause this narrowing.
4) Esophageal tumors – These can block the tube as they grow, making complete swallowing increasingly difficult.
5) Foreign bodies – Sometimes, the sensation that something is blocking the food is not imaginary. Those who have dentures and those who don’t properly chew food can get something lodged in the throat or esophagus.
6) Esophageal ring – This is a thinning of the lower esophagus that can intermittently cause difficulty swallowing foods.
7) Gastroesophageal reflux disease (GERD) – When stomach acid backs up into the esophagus, it can lead to scarring and narrowing of the lower esophagus.
8) Scleroderma – This scar-like tissue can harden and weaken the lower esophageal sphincter, which allows acid to back up into the esophagus and promotes heartburn.
9) Eosinophilic esophagitis – An overpopulation of cells called eosinophils in the esophagus can cause this condition. Food allergies may play a role.
10) Radiation therapy – If you are being treated for cancer with radiation, the treatments can lead to scarring of the esophagus.
Symptoms of Difficulty Swallowing
Symptoms of difficulty swallowing include pain while performing the act; being unable to swallow; having the feeling that food is lodging in the throat, chest or behind the sternum; hoarseness; drooling; regurgitation of food; frequent heartburn; stomach acid backing up into the throat; unexpected and unexplained weight loss; coughing or gagging while attempting to swallow; and having to dice finely foods to swallow or avoiding foods that cause trouble swallowing.
Of course, if swallowing results in an obstruction that compromises breathing, emergency treatment is in order. But difficulty swallowing is something that should be discussed with a doctor.
Sometimes the cause of swallowing problems can’t be identified; the swallowing mechanism of the body is complex, and several issues can impact on the condition.
Throat muscles can be weakened by a condition called oropharyngeal dysphagia, which makes it difficult to transition food from the mouth into the throat and down into the esophagus. The afflicted start to gasp, choke and cough, as the sensation of food traveling down the windpipe may occur or sometimes the feeling that food is traveling up the nose.
The condition is caused by neurological disorders like multiple sclerosis, muscular dystrophy and Parkinson’s disease; neurological damage from a stroke, brain injury or spinal cord injury that affects the ability to swallow; pharyngeal diverticula, a small pouch that can collect food particles in the throat and leads to difficult swallowing; and cancer, which can create swallowing difficulties. All of the above are particularly found in the aged, when wear and tear on the esophagus creates issues.
People with the condition often suffer from malnutrition, weight loss and dehydration because difficulty swallowing makes adequate calorie and fluid intake difficult; and respiratory problems, as food and liquids enter the airway, creating conditions that propagate pneumonia or upper respiratory infections.
Treating Difficulty Swallowing
If you have a swallowing issue, the doctor will do a complete physical exam to determine the causes. Potential tests may include an X-ray with a barium solution that will coat the esophagus and allow a better examination of its shape and muscle activity; a dynamic swallowing study, which uses barium-coated foods of different consistencies in an effort to monitor them as they travel through the body; and a visual examination of the esophagus through an endoscope, a lighted, thin tube that is passed down the throat so the esophagus can be viewed.
There may be a fiber-optic endoscopic camera used to monitor the swallowing process. Other imaging scans may include a CT scan or an MRI, all designed to see what problems occur and where they occur in the swallowing process.
Generally, swallowing issues are treated with liquid diets, and in some severe cases, a feeding tube. Doctors may recommend a change in eating habits, in which the patient has smaller and more frequent meals featuring smaller bites and trying foods with different textures to see which cause the most difficulty. It’s also recommended that patients avoid alcohol, caffeine and tobacco because these tend to make heartburn worse.