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