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Overview Esophagus Esophagus The esophagus is a muscular tube that connects your mouth and your stomach. Rings of muscle (sphincters) in the upper and lower portions contract and relax to allow food and liquid to pass. Dysphagia is difficulty swallowing — taking more time and effort to move food or liquid from your mouth to your stomach. Dysphagia can be painful. In some cases, swallowing is impossible. Occasional difficulty swallowing, such as when you eat too fast or don't chew your food well enough, usually isn't cause for concern. But persistent dysphagia can be a serious medical condition requiring treatment. Dysphagia can occur at any age, but it's more common in older adults. The causes of swallowing problems vary, and treatment depends on the cause. Products & Services Symptoms Signs and symptoms associated with dysphagia can include: - Pain while swallowing - Inability to swallow - A sensation of food getting stuck in the throat or chest or behind the breastbone (sternum) - Drooling - Hoarseness - Food coming back up (regurgitation) - Frequent heartburn - Food or stomach acid backing up into the throat - Weight loss - Coughing or gagging when swallowing When to see a doctor See your health care provider if you regularly have difficulty swallowing or if weight loss, regurgitation or vomiting accompanies your dysphagia. If an obstruction interferes with breathing, call for emergency help immediately. If you're unable to swallow because you feel that food is stuck in your throat or chest, go to the nearest emergency department. From Mayo Clinic to your inbox Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. ErrorEmail field is required ErrorInclude a valid email address To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail. Thank you for subscribing! You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. Sorry something went wrong with your subscription Please, try again in a couple of minutes Causes Swallowing is complex, involving many muscles and nerves. Any condition that weakens or damages the muscles and nerves used for swallowing or leads to a narrowing of the back of the throat or esophagus can cause dysphagia. Dysphagia generally falls into one of the following categories. Esophageal dysphagia Esophageal dysphagia refers to the sensation of food sticking or getting caught in the base of your throat or in your chest after you've started to swallow. Some of the causes of esophageal dysphagia include: - Achalasia. When the lower esophageal muscle (sphincter) doesn't relax properly to let food enter the stomach, it can cause food to come back up into the throat. Muscles in the wall of the esophagus might be weak as well, a condition that tends to worsen over time. - Diffuse spasm. This condition causes high-pressure, poorly coordinated contractions of the esophagus, usually after swallowing. Diffuse spasm affects the involuntary muscles in the walls of the lower esophagus. - Esophageal stricture. A narrowed esophagus (stricture) can trap large pieces of food. Tumors or scar tissue, often caused by gastroesophageal reflux disease (GERD), can cause narrowing. - Esophageal tumors. Difficulty swallowing tends to get progressively worse when esophageal tumors are present due to narrowing of the esophagus. - Foreign bodies. Sometimes food or another object can partially block the throat or esophagus. Older adults with dentures and people who have difficulty chewing their food may be more likely to have a piece of food become lodged in the throat or esophagus. - Esophageal ring. A thin area of narrowing in the lower esophagus can cause difficulty swallowing solid foods off and on. - GERD. Damage to esophageal tissues from stomach acid backing up into the esophagus can lead to spasm or scarring and narrowing of the lower esophagus. - Eosinophilic esophagitis. This condition, which might be related to a food allergy, is caused by too many cells called eosinophils in the esophagus. - Scleroderma. Development of scar-like tissue, causing stiffening and hardening of tissues, can weaken the lower esophageal sphincter. As a result, acid backs up into the esophagus and causes frequent heartburn. - Radiation therapy. This cancer treatment can lead to inflammation and scarring of the esophagus. Oropharyngeal dysphagia Certain conditions can weaken the throat muscles, making it difficult to move food from your mouth into your throat and esophagus when you start to swallow. You might choke, gag or cough when you try to swallow or have the sensation of food or fluids going down your windpipe (trachea) or up your nose. This can lead to pneumonia. Causes of oropharyngeal dysphagia include: - Neurological disorders. Certain disorders — such as multiple sclerosis, muscular dystrophy and Parkinson's disease — can cause dysphagia. - Neurological damage. Sudden neurological damage, such as from a stroke or brain or spinal cord injury, can affect the ability to swallow. - Pharyngoesophageal diverticulum (Zenker's diverticulum). A small pouch that forms and collects food particles in the throat, often just above the esophagus, leads to difficulty swallowing, gurgling sounds, bad breath, and repeated throat clearing or coughing. - Cancer. Certain cancers and some cancer treatments, such as radiation, can cause difficulty swallowing. Risk factors The following are risk factors for dysphagia: - Aging. Due to natural aging and normal wear and tear on the esophagus as well as a greater risk of certain conditions, such as stroke or Parkinson's disease, older adults are at higher risk of swallowing difficulties. But dysphagia isn't considered a normal sign of aging. - Certain health conditions. People with certain neurological or nervous system disorders are more likely to have difficulty swallowing. Complications Difficulty swallowing can lead to: - Malnutrition, weight loss and dehydration. Dysphagia can make it difficult to take in enough nourishment and fluids. - Aspiration pneumonia. Food or liquid entering the airway during attempts to swallow can cause aspiration pneumonia as a result of the food introducing bacteria into the lungs. - Choking. Food stuck in the throat can cause choking. If food completely blocks the airway and no one intervenes with a successful Heimlich maneuver, death can occur. Prevention Although swallowing difficulties can't be prevented, you can reduce your risk of occasional difficulty swallowing by eating slowly and chewing your food well. However, if you have signs or symptoms of dysphagia, see your health care provider. If you have GERD, see your health care provider for treatment.
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Disfagija je termin za teškoću gutanja, točnije stanje u kojemu je potrebno više vremena i napora da hrana i tekućine prođu put od usta do želuca. U nekim slučajevima gutanje izaziva bol ili je pak onemogućeno. Naziv „disfagija“ dolazi od grčki korjen dys (teškoća, poremećaj) i phagia (jesti). Može se javiti u bilo kojoj dobi, ali najčešća je kod osoba starije dobi. Disfagija ukazuje na problem sa ždrijelom ili jednjakom, mišičnim cijevima koje provode hranu od usta do želuca. Mišići vrata i jednjaka se stišću i kontrahiraju, i tako prenose hranu i tekućine od usta do želuca, međutim katkad u tom prijenosu postoje problemi. Povremene teškoće gutanja, koje mogu nastati pri prebrzom gutanju ili gutanju nedovoljno prožvakane hrane, ne spadaju pod disfagiju. Disfagija je perzistentna teškoća koja zahtijeva medicinski tretman. SIMPTOMI - otežano gutanje krute hrane i/ili tekućina - nesposobnost gutanja - osjećaj „zapinjanja“ hrane u grlu ili prsima - osjećaj “stezanja” u grlu ili prsima - vraćanje hrane i/ili tekućine u grlo nakon gutanja (regurgitacija) - kašljanje/gušenje tijekom ili neposredno nakon gutanja - bol pri gutanju (odinofagija) - gubitak težine zbog nedovoljnog unosa hrane i/ili tekućine - osjećaj dehidratacije zbog nedovoljnog unosa tekućine - slinjenje - promuklost POZVATI DOKTORA AKO … - Ako Vam se teškoće gutanja javljaju često ili su praćene gubitkom težine, regurgitacijom ili povraćanjem. - Ako pri gutanju imate problema s disanjem, ili osjećate kao da Vam nešto blokira disanje, potrebno je potražiti hitnu liječniku pomoć! - Ako ne možete progutati jer osjećate da Vam je hrana „zapela“ u grlu ili prsima, potrebno je potražiti hitnu liječniku pomoć! Uzroci teškoća gutanja variraju, a vrsta tretmana ovisi o uzroku. Gutanje je složena neuromuskularna aktivnost i na njega utječu mnogi procesi. Gutanje započinje kao voljan proces i odvija se u nekoliko faza. Prva faza, oralna faza, je u najvećoj mjeri voljna, dok su ostale faze refleksne. Ovisno o tome koja faza gutanja je narušena, razlikujemo dvije vrste disfagije. OROFARINGEALNA DISFAGIJA dovodi do teškoće prijenosa hrane od usta do jednjaka. Oralna razina podrazumijeva žvakanje (usitnjavanje hrane u konzistentnu masu pogodnu za gutanje, zvanu bolus), pripremu i prijenos bolusa od usana do ždrijela (farinksa). Faringealna razina podrazumijeva prijenos bolusa do jednjaka. EZOFAGEALNA DISFAGIJA, koja nastaje pri oštećenoj funkciji jednjaka, dovodi do teškoće prijenosa hrane kroz jednjak u donji digestivni trakt. Funkcija jednjaka slabi sa starenjem. Normalne promjene kod starenja uključuju slabljenje sfinktera i muskulature jednjaka, a zbog raznih drugih bolesti, disfagije su često sekundarni problem. Katkada nije moguće odrediti točan uzrok disfagije. Faktori rizika za razvoj disfagije su starenje i određena zdravstvena stanja. Uzroci disfagičnih teškoća mogu biti: - Neurološki uzroci (moždani udar, ozljede glave, cerebralna paraliza, Parkinsonova bolest, Huntingtonova bolest, poremećaji perifernog živčanog sustava, myastenia gravis, amiotrofična lateralna skleroza, multipla skleroza, itd.) - Infekcije u orofacijanom području - Tumori i malignomi u predijelu vrata i glave - Specifični poremećaji - Anatomske nepravilnosti - Farmakološki uzroci - Psihogeni uzroci Prevedeno i prilagođeno s Internet stranica klinike Mayo1 i WebMD2 1. http://www.mayoclinic.org/diseases-conditions/dysphagia/basics/definition/con-20033444 2. http://www.webmd.com/digestive-disorders/tc/difficulty-swallowing-dysphagia-overview#1