Request an appointment with the UofL Health – Reflux, Swallowing and Hernia Center by calling 502-588-4571. Our nurse navigator, Kelsey Schneider, is available to assist you with any questions and get you scheduled with our specialists.

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 (a swallowing disorder that affects your esophagus)
  • Dysphagia (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

The sensation that things get stuck when someone is swallowing is termed dysphagia. This sensation can be related to many things, but the most important thing to know is that it is never normal to feel that food or liquids are not “going down” when a person swallows. The first step in the evaluation is to let a practitioner perform and upper endoscopy (EGD, ‘scope’) to try to find out what is causing the symptom.

Pills can be a challenge to swallow, particularly when they are large or shaped strangely. However, if a little lubrication (such as water) does not make that sensation go away then it is probably best to speak to a practitioner.

Yes! One of the major reasons that people get dysphagia is changes to the lower esophagus that happen when a person has had reflux for an extended period of time. There are various things that can happen, but it is only possible to know which of these issues is causing the symptoms if an evaluation is performed.

Often times, yes. There are many things that cause dysphagia and many of them can be treated, either with surgery or even in real-time when an endoscopy is performed. Medications, for example, can often be used to prevent the trouble swallowing from coming back.

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