Dysphagia, difficulty in swallowing among the public, disruption in the function of any of the various muscles or nerves may predispose to dysphagia. Gastroenterology Specialist Assoc. Dr. Hakan Yıldız explained the causes and treatment methods of dysphagia.
Difficulty in swallowing (dysphagia) is defined as a feeling of being stuck in the esophagus when eating solid or liquid food. Dysphagia can often be accompanied by chest pain. In some cases, swallowing may be impossible. Difficulty swallowing, which can occur when you eat too fast or don’t chew your food well enough, is usually not a cause for concern. But persistent dysphagia may indicate a serious medical condition that requires treatment.
WHAT ARE THE REASONS?
Neurological causes: Conditions affecting the nervous system such as stroke, head injury, multiple sclerosis or dementia can cause dysphagia.
Cancers: Cancers such as mouth or esophageal cancer.
Radiotherapy: Radiotherapy to the head and neck area of the patient for cancer treatment may cause inflammation, hardening and dysphagia in the esophagus.
WHAT ARE THE SYMPTOMS OF DYSFAGIA?
. Pain when swallowing (odynophagia)
• Not being able to swallow
• Sensation of food getting stuck in the throat or behind the breastbone
• Constant drooling from the mouth
• Reflux: Stomach acid or contents coming into the throat or mouth
• Experiencing frequent heartburn
• Coughing or gagging while swallowing
• Breaking food into smaller pieces or avoiding certain foods due to difficulty swallowing
• Sometimes food comes back from the nose
• Inability to chew food adequately
• Bubbling-like sound from the mouth while eating or drinking something
AT WHAT AGE DOES IT OCCUR?
Dysphagia can occur at any age, but is more common in older adults. The causes of swallowing problems vary and the treatment method is also different depending on these reasons.
Dysphagia, which has many treatment methods, includes surgical or non-surgical conditions. Although specialists often do not choose the surgical method, it can occur in cases where surgical intervention is required.
Pneumatic expansion: By endoscopy, a balloon is placed in the center of the esophageal sphincter and inflated to enlarge the opening. This outpatient procedure may need to be repeated if the esophageal sphincter does not remain open. About one-third of people treated with balloon dilation need repeat treatment within five years. This procedure requires sedation.
Botox: (botulinum toxin type A). This muscle relaxant can be injected directly into the esophageal sphincter with an endoscopic needle. Injections may need to be repeated, and repeated injections may make it difficult to perform surgery later if necessary.
Medication: Your doctor may recommend muscle relaxants such as nitroglycerin (Nitrostat) or nifedipine (Procardia) before a meal. These drugs have limited therapeutic effect and serious side effects. Medications are usually only considered if you are not a candidate for pneumatic dilation or surgery and Botox has not helped.
NEW TREATMENTS ARE DEVELOPED
Thanks to POEM (Peroral endoscopic myotomy), which is a newly developed method by experts, surgical treatment is performed without leaving a scar on the patient.
Peroral endoscopic myotomy (POEM): In the POEM procedure, the GASTROENTROLOGIST uses an endoscope that is inserted down your mouth and throat to create an incision in the lining of your esophagus. Next, as with a Heller myotomy, the gastroenterologist cuts the muscle at the lower end of the esophageal sphincter. Being able to cut a longer amount of muscle, shortening the hospital stay, and not having an incision on the skin are seen as advantages to surgery compared to surgery.
Heller myotomy: The Specialist cuts the muscle at the lower end of the esophageal sphincter to allow food to pass more easily into the stomach. Some people with Heller’s myotomy may later develop gastroesophageal reflux disease (GERD).