Dr Stephen John Middleton MA MD FRCP FAHE

Consultant Gastroenterologist

Swallowing problems

When people have a problem swallowing this is called dysphagia.
Transfer dysphagia
This can be very high in the throat, where food can not be moved from the mouth to the oesophagus.  It is often due to discoordination of muscle activity in the throat.  Sometimes it is caused by a pharyngeal pouch and rarely by a tumour.

Oesophageal dysphagia. 
This is difficulty in swallowing food once it has entered the oesophagus.  It can be caused by narrowing (stricture) in the oesophagus, sometimes caused by acid burning the oesophagus and causing scaring, tumours and occasionally by muscle or nerve disorders that cause spasm or discoordination of oesophageal movement.   Once the problem has been identified and the cause found by oesophageal x-ray studies or an endoscopy. A narrowing can often be stretched using a balloon and then the cause, which is usually acid reflux, is treated with an acid blocker.  People who have spasms in the oesophagus, if caused by acid reflux find acid blocker treatment helps.  Otherwise injection of Botox into the oesophageal wall to relieve the spasm works well:  hover mouse over image to see the improvement in spasm after Botox injection
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