Swallowing Disorders

Swallowing is as common as breathing and we rarely give it a second thought. In most cases when difficulty swallowing occurs, it isn’t serious and is often short-lived. In some instances, however, a swallowing difficulty requires medical treatment or special home care.

Swallowing problems are also known as dysphagia. In rare cases, swallowing problems are tied to a serious illness. For example, a stroke, Parkinson’s disease or late-stage Alzheimer’s disease can make swallowing difficult and possibly lead to choking.

Zenker’s Diverticulum

Zenker's diverticulum—also called pharyngoesophageal diverticulum, pharyngeal pouch or hypopharyngeal diverticulum—is a diverticulum located above the upper sphincter of the esophagus. (A diverticulum is an out-pouching of a hollow structure in the body.) A relatively rare disorder, it is found mostly in older adults. When small and asymptomatic, no treatment is necessary. Larger cases can be treated by surgery or by non-surgical endoscopic techniques.

Causes of Swallowing Disorders

Swallowing problems can be caused by dehydration. They can also be caused by not chewing long enough or taking bites of food that are too big. Other swallowing problems stem from gastroesophageal reflux disease (GERD) which occurs when bile or stomach acid flows back into your esophagus (or food pipe). Many medications—such as nitrates, calcium channel blockers, aspirin, iron tablets, and vitamin C—can cause difficulty swallowing. Other culprits include allergies and even the common cold.

Diabetes, thyroid disease, a tumor in the mouth or throat, or high blood pressure could also be to blame. Problems with your vocal chords; insertion of a tracheotomy, or breathing, tube, or oral or throat surgery can also affect the way you swallow.

Learn more about swallowing disorders.

Symptoms of Swallowing Disorders

  • Feeling of a lump in your throat
  • Hoarseness
  • Sensation that food or liquid is stuck in your throat
  • Pain or tightness in your throat or chest
  • Weight loss or not getting the nutrition you need because of trouble swallowing
  • Choking or coughing caused by bits of food or drink that get caught in your throat
  • Drooling

Diagnosis of Swallowing Disorders

Swallowing problems are rarely serious and most resolve without medical or surgical intervention, but you should contact an otolaryngologist if the swallowing problem:

  • Doesn’t clear up quickly
  • Causes you to choke, cough or have trouble breathing
  • Affects your ability to eat

A medical evaluation including a health history and special testing will help your doctor pinpoint the cause of your swallowing difficulty.

Treatment for Swallowing Disorders

Your otolaryngologist will create a treatment plan based on the results of your evaluation. You may need to take medications. In some cases, your doctor may suggest dilation or widening of the esophagus. This is most often done when a stricture, or narrowing of the esophagus, is causing the swallowing difficulty.

If your swallowing problem is related to a serious illness, such as head and neck cancer, you may need more comprehensive treatment provided by an otolaryngologist.

Learn more about treating swallowing disorders.

What You Should Expect

You will receive a thorough diagnostic examination to evaluate if you have a swallowing disorder and determine what course of treatment is needed. Careful monitoring and the involvement of an experienced otolaryngologist are important to the successful outcome for patients with ear, nose and throat disorders and conditions.

If you are having surgery or a procedure, you will likely be scheduled for a visit to the Weiner Center for Preoperative Evaluation for pre-operative information and tests.

The day of surgery, you will be taken care of in the operating room by otolaryngologist, anesthesiologists and nurses who specialize in surgery for patients with swallowing disorders. After surgery, you will go to the post-surgical care unit where you will receive comprehensive care by experienced surgical and nursing staff.

Learn more about your hospital stay, patient-centered care and returning home.

Multidisciplinary Care

Brigham and Women’s Hospital provides a multidisciplinary approach to patient care by collaborating with colleagues who have extensive experience in diagnosing and treating ear, nose and throat disorders and conditions. In addition, patients have full access to BWH’s world-renowned academic medical community, with its diverse specialists, and state-of-the-art facilities.

Otolaryngology-Head and Neck Surgery Appointments and Locations


Learn more about swallowing disorders (dysphagia) in our health library.

Visit the Kessler Health Education Library in the Bretholtz Center to access computers and knowledgeable staff.

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