Difficulty Swallowing and Dysphagia Evaluation in Cypress and Katy, TX

When Difficulty Swallowing Is an Emergency

Call 911 when a person:

• Cannot breathe
• Is choking and cannot speak or cough effectively
• Develops sudden swallowing difficulty with facial weakness, arm weakness, speech difficulty, severe dizziness, or another possible stroke symptom
• Has severe chest pain or another potentially life-threatening symptom

Go to the nearest emergency department promptly when:

• Food feels completely stuck and does not pass
• You cannot swallow liquids
• You cannot swallow your own saliva
• You are drooling because you cannot swallow
• Swallowing difficulty begins suddenly during a meal and does not resolve
• You have repeated choking or trouble breathing after swallowing
• You vomit blood or material resembling coffee grounds
• You have black, tarry stool
• You have severe chest or neck pain after food becomes stuck
• You are becoming dehydrated because you cannot swallow safely

A persistent sensation that food is stuck in the esophagus requires immediate emergency evaluation. Complete esophageal blockage may prevent a person from swallowing even saliva and may require urgent endoscopic removal.

Do not use the online appointment form for an emergency.

Do not repeatedly force food or liquids down when something feels firmly stuck.

What Is Dysphagia?

Dysphagia means difficulty moving food, liquid, medicine, or saliva from the mouth to the stomach.

It is more than occasionally swallowing a bite too quickly. Persistent dysphagia can make eating take longer, limit food and fluid intake, and increase the risk of dehydration, poor nutrition, choking, or aspiration of food or liquid into the airway.

Dysphagia is a symptom, not a diagnosis. Treatment depends on where the swallowing problem occurs and what is causing it.

Common Symptoms of Dysphagia

Difficulty swallowing may cause:

• Food sticking in the throat
• Food sticking behind the breastbone
• Trouble starting a swallow
• Coughing during or immediately after eating
• Choking during meals
• Gagging when swallowing
• Difficulty swallowing pills
• Difficulty swallowing solid food
• Difficulty swallowing liquids
• Needing repeated swallows for one bite
• Food or liquid coming back into the mouth
• Food or liquid coming through the nose
• Drooling
• A wet, gurgling, weak, or hoarse voice after swallowing
• Pain or burning when swallowing
• Chest discomfort during meals
• Frequent throat clearing while eating
• Taking an unusually long time to finish meals
• Avoiding meat, bread, rice, or other difficult textures
• Cutting food into extremely small pieces
• Drinking large amounts of liquid to help food pass
• Recurrent pneumonia or chest infections
• Unexplained weight loss
• Dehydration
• Fear or anxiety about eating because food may become stuck

Coughing, gagging, hoarseness, food sticking, painful swallowing, regurgitation, drooling, and weight loss are recognized symptoms that may lead to dysphagia testing.

Oropharyngeal Dysphagia Versus Esophageal Dysphagia

Determining where the swallowing problem begins is an important part of the evaluation.

Oropharyngeal dysphagia

Oropharyngeal dysphagia involves the mouth, tongue, throat, or the beginning of the esophagus.

Possible signs include:

• Difficulty starting the swallow
• Coughing immediately after swallowing
• Choking on liquids
• Food or liquid entering the nose
• A wet or gurgling voice
• Drooling
• Weakness of the tongue or face
• Repeated swallowing for one bite
• A sensation that food remains in the throat
• Recurrent respiratory infections
• Symptoms beginning after a stroke, neurologic illness, head injury, or head-and-neck treatment

Oropharyngeal dysphagia often involves the nerves and muscles that control chewing, airway protection, and the first stage of swallowing. Food or liquid entering the airway is called aspiration and may contribute to aspiration pneumonia.

Evaluation may involve a speech-language pathologist, ear-nose-and-throat specialist, neurologist, radiologist, or another appropriate specialist in addition to a gastroenterologist.

Esophageal dysphagia

Esophageal dysphagia occurs after the swallow begins.

A person may describe:

• Food sticking in the neck or chest
• Solid food moving slowly
• Meat or bread getting stuck
• Food returning to the mouth
• Chest pressure during meals
• Difficulty swallowing pills
• Progressively worsening swallowing
• Intermittent episodes of food impaction
• Difficulty with both solids and liquids
• Associated heartburn or acid regurgitation

Esophageal dysphagia may be caused by narrowing, inflammation, abnormal muscle movement, or another disorder of the esophagus.

Advanced Care for Swallowing Disorders.

Dysphagia, Painful Swallowing, and a Lump-in-the-Throat Sensation

These symptoms are related but are not identical.

Dysphagia

Dysphagia means that food, liquid, pills, or saliva do not pass normally when you try to swallow.

Odynophagia

Odynophagia means pain with swallowing.

Pain may be felt:

• In the throat
• Behind the breastbone
• In the upper chest
• While swallowing food, liquids, or pills

Painful swallowing may occur with inflammation, infection, medication injury, reflux-related injury, or other esophageal conditions.

Globus sensation

Globus is a persistent feeling of a lump or something present in the throat, even when you are not swallowing.

Unlike dysphagia, globus does not necessarily stop food or liquid from passing. ACG distinguishes globus from dysphagia because true dysphagia occurs specifically when a person attempts to swallow.

Persistent or unexplained symptoms still deserve medical evaluation.

When Should You See a Gastroenterologist for Difficulty Swallowing?

Schedule an evaluation when swallowing difficulty:

• Happens repeatedly
• Persists for more than a brief isolated episode
• Is gradually becoming worse
• Causes food to stick
• Causes you to avoid certain foods
• Makes meals unusually long
• Requires excessive chewing or repeated swallowing
• Causes you to drink liquids to force food down
• Occurs with heartburn or acid regurgitation
• Occurs with chest discomfort
• Occurs with unexplained weight loss
• Occurs with persistent vomiting
• Occurs with anemia or gastrointestinal bleeding
• Has caused a previous food impaction
• Returns after prior esophageal dilation
• Occurs after reflux surgery or another upper digestive procedure
• Is associated with food allergies, asthma, eczema, or possible eosinophilic esophagitis
• Has not been explained by previous testing

Even intermittent episodes of food sticking should be medically evaluated because they may represent narrowing, eosinophilic esophagitis, or another esophageal disorder.

NIDDK also recommends medical evaluation for swallowing difficulty when it occurs with persistent vomiting, gastrointestinal bleeding, loss of appetite, chest pain, or unexplained weight loss.

What Causes Difficulty Swallowing?

Dysphagia can have many causes. The symptom pattern may provide useful clues, but symptoms alone cannot confirm the diagnosis.

Acid reflux and esophageal stricture

Long-term gastroesophageal reflux disease may irritate the esophagus and contribute to scar tissue or narrowing, called an esophageal stricture.

A stricture may cause:

• Solid food sticking
• Progressive difficulty swallowing
• Trouble swallowing pills
• Food impaction
• Heartburn or acid regurgitation

GERD can cause swallowing difficulty or painful swallowing, and reflux-related scarring can narrow the esophagus.

Schatzki ring

A Schatzki ring is a thin ring of tissue that narrows the lower esophagus.

Symptoms may include:

• Intermittent solid-food dysphagia
• Meat or bread getting stuck
• Sudden food impaction
• Long symptom-free periods between episodes

A patient may be able to swallow normally most of the time and still have a clinically important narrowing.

Eosinophilic esophagitis

Eosinophilic esophagitis, often called EoE, is a chronic inflammatory disease of the esophagus.

Adults may experience:

• Difficulty swallowing solid food
• Food impaction
• Chest discomfort
• Heartburn
• Prolonged meals
• Excessive chewing
• Avoidance of difficult food textures
• Drinking large amounts of liquid to help food pass

Diagnosis generally requires upper endoscopy with esophageal biopsies. Current ACG guidance bases diagnosis on symptoms of esophageal dysfunction together with characteristic biopsy findings and exclusion of other causes.

EoE can lead to narrowing or strictures. Dilation may improve narrowing, but treatment of the underlying inflammation is also important.

Achalasia

Achalasia is a swallowing disorder in which the lower esophageal muscle does not relax normally and the esophagus does not move food toward the stomach effectively.

Possible symptoms include:

• Difficulty swallowing solids and liquids
• Regurgitation of undigested food
• Chest discomfort
• Coughing at night
• Weight loss
• Slowly progressive symptoms

Esophageal manometry is commonly used to diagnose achalasia and other movement disorders after a structural blockage has been excluded.

Other esophageal motility disorders

Abnormal esophageal muscle contraction may cause:

• Difficulty with solids and liquids
• Chest pain
• Regurgitation
• Intermittent swallowing problems

Examples include esophageal spasm and weak or absent esophageal contractions.

Esophageal inflammation

Inflammation may be caused by:

• Acid reflux
• Eosinophilic esophagitis
• Certain infections
• Pills or medications that irritate the esophagus
• Radiation treatment
• Other inflammatory disorders

Pain while swallowing may be more prominent when inflammation is present.

Esophageal tumors or external compression

Less commonly, difficulty swallowing may result from:

• Esophageal cancer
• A growth pressing on the esophagus
• Another structural abnormality
• Severe narrowing

Progressively worsening swallowing difficulty, weight loss, bleeding, anemia, or persistent vomiting requires timely medical evaluation.

Neurologic and muscular conditions

Oropharyngeal swallowing problems may occur after or with:

• Stroke
• Parkinson’s disease
• Multiple sclerosis
• Dementia
• Brain injury
• Spinal cord injury
• Certain muscular disorders
• Disorders affecting the nerves that control swallowing
• Head-and-neck cancer or treatment

Government health information identifies stroke, neurologic disorders, head or spinal injury, and head, neck, or esophageal cancer among conditions associated with swallowing disorders.

Structural throat or mouth problems

Difficulty initiating a swallow may also be related to:

• Oral or throat tumors
• Scar tissue
• Diverticula
• Dental problems
• Weakness after surgery
• Head-and-neck treatment
• Structural changes affecting the swallowing pathway

What Should You Do While Waiting for an Appointment?

When you can swallow safely and are not having emergency symptoms:

• Eat slowly
• Take small bites
• Chew thoroughly
• Avoid foods that have repeatedly become stuck
• Sit upright while eating
• Remain upright after meals when reflux is present
• Take note of which foods or liquids cause symptoms
• Record whether symptoms occur at the start of swallowing or after food has passed into the chest
• Bring a complete medicine list to your appointment
• Tell your clinician about prior choking or food-impaction episodes

Do not:

• Force additional food on top of something that feels stuck
• Repeatedly drink large amounts to push down an impaction
• Attempt home remedies for a complete blockage
• Continue eating when choking repeatedly
• Delay emergency care when you cannot swallow saliva or breathe normally

How to Prepare for a Dysphagia Appointment

Bring or record:

• When the problem began
• Whether it is getting worse
• Whether the problem involves solids, liquids, pills, or saliva
• Where food feels stuck
• Whether you cough or choke
• Whether your voice changes after swallowing
• Any previous food impactions
• Any history of reflux
• Any history of asthma, eczema, or food allergies
• Unintentional weight change
• Current medicines and supplements
• Previous EGD, barium-study, or manometry reports
• History of stroke or neurologic illness
• History of head-and-neck surgery or radiation
• History of esophageal dilation
• Family history of upper digestive disease or cancer

This information can help determine whether the problem is more likely to involve the throat, esophageal structure, inflammation, or esophageal movement.

Better Swallowing Begins Here.

Difficulty Swallowing Care in Cypress, Katy, and Greater Houston

United Gastroenterology Associates provides adult gastroenterology consultations at offices in Cypress and Katy.

Cypress gastroenterology office

21216 Northwest Freeway, Suite 640
Cypress, TX 77429

View the Cypress gastroenterology office.

Katy gastroenterology office

23920 Katy Freeway, Suite 555
Katy, TX 77494

View the Katy gastroenterology office.

Appointments

Telephone: (346) 340-4414

Request a non-emergency appointment.

Review insurance information.

Excellence in Esophageal Care.

Why Choose United Gastroenterology Associates for Dysphagia Evaluation?

United Gastroenterology Associates offers:

• Evaluation by a gastroenterologist
• Adult esophageal and digestive care
• Cypress and Katy consultation locations
• Assessment of reflux, esophageal narrowing, inflammation, and motility concerns
• Upper endoscopy when clinically appropriate
• Esophageal biopsies when indicated
• Esophageal dilation for appropriate narrowing
• Coordination of barium imaging or swallowing studies when needed
• Referral to speech-language pathology, ENT, neurology, surgery, or another specialist when appropriate
• A treatment plan based on the actual cause rather than the symptom alone

Meet Muhammad Ali Khan, MD.

Request an Evaluation for Difficulty Swallowing

Recurring swallowing difficulty should not be managed indefinitely by avoiding more foods, chewing excessively, or repeatedly forcing food down with liquids.

An evaluation may help determine whether symptoms are related to:

• Acid reflux
• Esophageal narrowing
• Schatzki ring
• Eosinophilic esophagitis
• Achalasia
• Another esophageal movement disorder
• A throat or neurologic swallowing problem
• Another condition requiring treatment or referral

Call (346) 340-4414 or request a non-emergency appointment at the Cypress or Katy office.

Your Questions, Answered

Frequently Asked Questions