Swallowing Problems

What are the different types of swallowing issues?

Reflux and swallowing issues can be neurologic, autoimmune or medication-related, and sometimes occur despite doctors never knowing the exact cause. Specific diseases or symptoms may include:

• Achalasia https://uoflhealth.org/articles/what-is-achalasia/ (a swallowing disorder that affects your esophagus)
• Dysphagia https://uoflhealth.org/articles/dont-get-choked-up-solving-your-swallowing-issue/  (difficulty swallowing foods or liquids)

How are swallowing issues diagnosed?

The first step in evaluating anyone with trouble swallowing is to do a good endoscopic evaluation (EGD, esophagogastroduodenoscopy). However, many additional tools can either help or definitively make a diagnosis. The following procedures may be used to diagnose swallowing issues:

• Manometry (measures the strength and muscle coordination of your esophagus when you swallow)
• Functional Lumen Imaging Probe, or FLIP (measures the area across the inside of a gastrointestinal organ, such as the esophagus, and the pressure inside that organ)
• Functional endoscopic evaluation of swallowing, including esophagram or modified barium swallow

What are the treatment options for swallowing issues?

Once your health care provider finds a cause of your swallowing issue, treatment options available they may choose to include are:

• Procedures to stretch the esophagus
• Learning new swallowing methods with speech and language therapy
• Altering how you eat

Surgical procedures include:

• Heller myotomy (surgery for achalasia): this is a surgical procedure that is performed laparoscopically and entails the division of the muscles which constitute the lower esophageal sphincter (the valve between the esophagus and the stomach).
• Per oral endoscopic myotomy (POEM) (surgery for achalasia): this is an endoscopic procedure that entails the division of the muscles which constitute the lower esophageal sphincter (the valve between the esophagus and the stomach).
• Radiofrequency ablation (RFA) (removes diseased tissue)

Ear, nose and throat procedures include:

• Targeted speech therapy
• Botox and dilation of the vocal cords
• Cricopharyngeal myotomy
• Vocal fold injection
• Medialization thyroplasty
• Scar release
• Vocal fold procedures to remove obstructing tissue