Yeni Yüzyıl University Gaziosmanpaşa Hospital Gastroenterology Specialist Assoc. Dr. Hakan Yıldız explained the causes and treatment methods of Dysphagia. Dysphagia, difficulty in swallowing among the public, failure in the function of any of the various muscles or nerves to perform the swallowing function properly may predispose to dysphagia.
What is swallowing difficulty?
Difficulty swallowing (dysphagia) is defined as a feeling of 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 quickly or if you do not chew your food well enough, is usually not a cause for concern. However, persistent dysphagia can indicate a serious medical condition that requires treatment.
WHAT ARE THE REASONS?
Neurological causes: Conditions that affect the nervous system such as stroke, head injury, multiple sclerosis, or dementia can cause dysphagia.
Cancers: Cancers such as mouth or esophageal cancer.
Radiotherapy: Applying radiotherapy to the head and neck region of the patient for cancer treatment may cause inflammation, hardening and dysphagia in the esophagus.
WHAT ARE THE SYMPTOMS OF DYSPHAGE?
- Pain when swallowing (odynophagia)
- Inability to swallow
- A feeling that food is getting stuck in the throat or behind the breastbone
- Continuous drooling from the mouth
- Hoarseness
- Reflux: stomach acid or contents getting into the throat or mouth
- Having frequent heartburn
- Coughing or choking while swallowing
- Breaking food into smaller pieces or avoiding certain foods due to swallowing difficulties
- Sometimes food comes back through the nose
- Inability to chew food adequately
- Sound of mouth foaming when eating or drinking
At what age does it appear?
Dysphagia can occur at any age, but is more common in older adults. The causes of swallowing problems vary and the method of treatment varies depending on these reasons.
TREATMENT PROCESS
Dysphagia, which has many treatment methods, includes surgical or non-surgical conditions. Although experts often do not choose a surgical method, it can occur in cases where surgical intervention is required.
NON-SURGICAL TREATMENTS
Pneumatic expansion: A balloon is placed by endoscopy 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 a 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 later surgery if necessary.
Medication: Your doctor may recommend muscle relaxants such as nitroglycerin (Nitrostat) or nifedipine (Procardia) before eating. These drugs have limited therapeutic effect and serious side effects. Medications are usually only considered if you are not a candidate for pneumatic dilatation or surgery and Botox has not helped.
Surgical Treatments
NEW TREATMENTS ARE DEVELOPED
Thanks to POEM (Peroral endoscopic myotomy), which is a newly developed method by experts, the patient is treated surgically without any scar.
Peroral endoscopic myotomy (POEM): POEM In the procedure, GASTROENTROLOG uses an endoscope that is inserted down your mouth and throat to make an incision in the lining of your esophagus. Then, as with a Heller myotomy, the gastroenterologist cuts the muscle at the lower end of the esophageal sphincter. The advantages of surgery are the ability to cut a longer amount of muscle compared to surgery, the shorter hospitalization period, and the absence of an incision on the skin.
Heller myotomy: The Specialist Doctor cuts the muscle at the lower end of the esophageal sphincter to allow food to pass into the stomach more easily. Some people with Heller myotomy may later develop gastroesophageal reflux disease (GERD).
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