Difficulty swallowing, known as dysphagia, occurs when it becomes hard to move food or liquid
from the mouth into the stomach. Some people may feel that food sticks in the throat or
chest, while others may experience coughing or choking when trying to swallow.
Swallowing involves a complex coordination of muscles and nerves in the mouth, throat, and
esophagus, and problems can occur at any point along this pathway. Because dysphagia can
sometimes signal an underlying medical condition, persistent symptoms should be evaluated.
Symptoms of Dysphagia
People with swallowing difficulty may experience:
● Food feeling stuck in the throat or chest
● Pain with swallowing
● Coughing or choking during meals
● Difficulty swallowing pills
● Regurgitation of food or liquids
● Unexplained weight loss
● Frequent throat clearing after swallowing
Some individuals may also notice hoarseness, chronic cough, or a sensation of a lump in
the throat.
Common Causes of Difficulty Swallowing
Throat or Esophageal Narrowing
Conditions that narrow the swallowing passage can make it difficult for food to move normally.
These may include:
● Esophageal strictures (narrowing of the esophagus)
● Inflammation from acid reflux
● Growths or masses
Acid Reflux (Laryngopharyngeal Reflux or GERD)
Chronic reflux can irritate the throat and esophagus, leading to inflammation and swallowing
discomfort.
Symptoms may include:
● Throat irritation
● Chronic cough
● Hoarseness
● A sensation of a lump in the throat
Neurologic Conditions
Swallowing requires precise nerve and muscle coordination. Neurologic conditions such as
stroke, Parkinson’s disease, or other nerve disorders can affect swallowing function.
Muscle or Motility Disorders
Sometimes the muscles of the esophagus do not move food efficiently toward the stomach.
These conditions can cause difficulty swallowing both solids and liquids.
Structural Issues in the Throat
Enlarged tonsils, tumors, or other structural abnormalities in the throat may interfere with
swallowing.
How Difficulty Swallowing Is Evaluated
Evaluation usually begins with a detailed review of symptoms and an examination of the mouth,
throat, and neck.
Additional testing may include:
● Flexible endoscopy to examine the throat and voice box
● Swallow studies using imaging to evaluate swallowing function
● Esophageal imaging or endoscopy to examine the esophagus
These tests help identify where the swallowing problem occurs and determine the most
appropriate treatment.
Treatment Options
Treatment depends on the underlying cause of dysphagia.
Possible treatments include:
● Managing acid reflux
● Treating inflammation or infections
● Swallow therapy with a speech-language pathologist
● Medications to improve esophageal function
● Procedures to widen narrowed areas of the esophagus
Addressing the underlying condition often improves swallowing function.
When to Seek Medical Attention
You should seek evaluation if you experience:
● Persistent difficulty swallowing
● Food becoming stuck in the throat or chest
● Choking or coughing while eating
● Unexplained weight loss
● Pain with swallowing
Difficulty swallowing that develops suddenly or causes choking should be evaluated promptly.
Schedule a Consultation
If you are experiencing difficulty swallowing, a consultation can help determine the cause and
develop a treatment plan to improve swallowing and ensure safe eating and drinking.
Hoarseness
Hoarseness refers to an abnormal change in the voice, often described as a voice that
sounds rough, raspy, strained, or weaker than usual. It occurs when the vocal cords (voice
box or larynx) become irritated, inflamed, or do not move normally.
Most people experience temporary hoarseness at some point, often due to a cold or excessive
voice use. However, hoarseness that persists for several weeks may indicate an underlying
condition and should be evaluated.
Common Causes of Hoarseness
Voice Overuse or Strain
Excessive talking, yelling, or singing can strain the vocal cords and cause temporary
hoarseness. This is common in individuals who use their voice frequently, such as teachers or
performers.
Upper Respiratory Infections
Viral infections such as the common cold or laryngitis can inflame the vocal cords and lead to
hoarseness.
Acid Reflux (Laryngopharyngeal Reflux)
Stomach acid can travel upward and irritate the throat and voice box. This condition is called
laryngopharyngeal reflux (LPR).
Symptoms may include:
● Hoarseness
● Frequent throat clearing
● Chronic cough
● A sensation of mucus or a lump in the throat
Many patients with LPR do not experience typical heartburn.
Allergies or Postnasal Drip
Chronic mucus drainage from the nose and sinuses can irritate the throat and vocal cords,
contributing to voice changes.
Vocal Cord Nodules or Polyps
Benign growths on the vocal cords can develop from repeated voice strain or irritation and may
cause persistent hoarseness.
Smoking or Environmental Irritants
Exposure to tobacco smoke or environmental pollutants can irritate the vocal cords and lead to
chronic voice changes.
Symptoms Associated With Hoarseness
People with hoarseness may notice:
● A raspy or breathy voice
● Difficulty projecting the voice
● Voice fatigue after speaking
● Frequent throat clearing
● A sensation of throat irritation
Hoarseness may be constant or may worsen with prolonged voice use.
How Hoarseness Is Evaluated
Evaluation usually involves examining the throat and vocal cords using a flexible camera
called a laryngoscope. This allows direct visualization of the vocal cords and their movement.
Additional evaluation may be recommended depending on the findings.
Treatment Options
Treatment depends on the underlying cause of hoarseness.
Possible approaches include:
● Voice rest and hydration
● Treatment of acid reflux
● Managing allergies or postnasal drip
● Voice therapy to improve vocal technique
● Treatment of vocal cord growths when present
Many cases of hoarseness improve once irritation or inflammation of the vocal cords is
addressed.
When to Seek Evaluation
You should consider evaluation if hoarseness:
● Persists longer than two to three weeks
● Occurs without a clear cause
● Is associated with difficulty swallowing or throat pain
● Occurs in individuals with a history of smoking
Persistent hoarseness should always be evaluated to rule out more serious conditions.
Schedule a Consultation
If you are experiencing persistent hoarseness or voice changes, a consultation can help identify
the cause and develop a treatment plan to restore healthy voice function.