1 What is dysphagia?
Dysphagia is divided into two groups
2 How do swallowing difficulties develop?
The swallowing process Problems with organs, muscles and nerves can lead to swallowing disorders
3 Pain when swallowing: What you can do
If your swallowing pain is accompanied by any of the following symptoms, you should make an appointment with a doctor If you experience any of the following symptoms, you should go to hospital immediately If your swallowing pain occurs without any accompanying symptoms and you find it bothersome, you may be able to relieve the pain with the following measures
4 Eating when you have difficulty swallowing

Just like breathing or blinking, swallowing is a relatively intuitive mechanism that you probably pay little attention to in everyday life. However, if you have ever experienced swallowing problems due to a cold or flu, you will understand how irritating pain when swallowing can be. Here you can find out the potential causes of swallowing problems and what you can do about them!

What is dysphagia?

Even if you may not be familiar with the term, you've probably experienced it. Among doctors, all types of swallowing problems (this includes not only swallowing problems, but also pain when swallowing) are classified under the term: Dysphagia is summarized.

Swallowing difficulties are divided into two groups

  • oropharyngeal dysphagia (difficulty swallowing in the mouth or throat)
  • Oesophageal dysphagia (difficulty swallowing in the oesophagus)1

Despite growing nutritional awareness and improved food safety in developing countries, malnutrition is a pervasive public health issue. While caloric deficiencies and famines are now history in most countries, deficiencies of individual nutrients due to unbalanced diets are on the rise in some countries.1

How do swallowing difficulties develop?

Swallowing is something completely intuitive for you as a human being. You don't need to concentrate on swallowing - it is one of many subconscious mechanisms in your body. Nevertheless, the act of swallowing is more complex and sophisticated than you might think. In order to understand the enormous variety of causes, it is important to understand the mechanism of swallowing. Every swallow you make goes through three phases.

The swallowing process

Phase 1 - The oral phase

 The tongue collects liquids and solid food and prepares them for swallowing.

Phase 2: The pharyngeal phase

This phase begins as soon as the tongue pushes the food to the back of the mouth. A swallowing reaction is induced in which the food passes through the pharynx or throat. During this phase, the respiratory function is blocked to prevent food or liquids from entering the trachea or lungs.

Phase 3: The oesophageal (gullet) phase

The food then enters the esophagus. Depending on the consistency of the food, this phase can take a little longer. When swallowing a Saturo-drink probably only about 3 seconds, when swallowing a larger tablet or large, solid food a little longer.2

Problems with organs, muscles and nerves can lead to swallowing disorders

Older adults are most frequently affected by swallowing difficulties3Difficulty swallowing occurs when there is a problem with the nerve control, muscles or organs that are directly or indirectly involved in the swallowing process.

Here are some of the many potential causes of dysphagia:

Congenital and developmental problems

Sometimes problems with swallowing are due to growth or genetics:

  • Cleft lip and palate: A common birth defect that results in a cleft in the upper lip or palate. Also known as harelip.
  • Learning disabilities
  • Cerebral palsy - a collective term for various neurological disorders that can affect your movement and coordination4
Damage or irritation of the nerves

Damage to the nervous system (especially in the brain and spinal cord) can disrupt the nerves responsible for initiating and regulating the swallowing mechanism. Neurological causes include

  • a stroke
  • myasthenia gravis - a rare disease that weakens muscles
  • Neurological diseases that cause chronic damage to the brain and nervous system, including Parkinson's disease, multiple sclerosis, dementia and motor neuron diseases5
  • Brain tumor
Physical blockages

Conditions that cause a blockage in the throat or a narrowing of the esophagus can make swallowing difficult.
These include

  • Cancer of the larynx or esophagus
  • Pharyngeal pouch is a rare disease that usually occurs in older people. A sac forms in the upper part of the oesophagus, which can impair the ability to swallow.
  • Radiotherapy can cause scarring, which can narrow the throat and esophagus.
  • GERD (reflux disease) - stomach acid can also lead to scar tissue in the esophagus, which narrows it.
  • Esophagitis - this inflammation, in which the esophagus burns, can in turn be caused by various infectious diseases such as thrush or tuberculosis.
Muscular diseases

Rare diseases that affect the muscles used to push food down the esophagus and into the stomach can cause dysphagia.

These include:

  • Scleroderma - the immune system attacks healthy tissue, leading to stiffening of the throat and esophageal muscles6
  • Achalasia - muscles in the oesophagus lose their ability to relax and open, preventing food and liquids from entering the stomach
Can the causes of swallowing difficulties be psychological?

Psychogenic dysphagia is a rare swallowing disorder without an obvious cause or organic disease. The most common symptom appears to be fear of swallowing. However, psychogenic dysphagia is often misdiagnosed. Doctors may tend to attribute the patient's dysphagia to their psychological condition if they cannot find any physical causes.7

Pain when swallowing: What you can do

The serious diseases mentioned above, such as multiple sclerosis, esophageal cancer or Parkinson's disease, are only rarely the cause of dysphagia.

In particular, swallowing difficulties that are accompanied by pain or swallowing pain alone are usually caused by relatively harmless infections, allergic reactions or inflammation. The most common of these causes are

  • Acid reflux with heartburn
  • Chronic cough
  • Sore throat
  • Common cold
  • Flu
  • An infectious disease in the throat
  • Tonsillitis8

If your swallowing pain is accompanied by any of the following symptoms, you should make an appointment with your doctor

  • joint pain
  • a foreign body sensation in the neck or neck pain with difficulty swallowing
  • a rash
  • a bloody cough
  • Symptoms that do not improve and last a week or longer
  • A hoarse voice that persists for several weeks

If you experience any of the following symptoms, you should go to hospital immediately

  • You find it difficult to open your mouth
  • Breathing problems
  • Extreme sore throat that gets worse

If your swallowing pain occurs without any accompanying symptoms and you find it bothersome, you could possibly alleviate the pain with the following measures

  • Drink enough fluids. At least eight glasses of water a day will not only hydrate you, but also soothe and moisturize your (probably irritated) throat.
  • Mix 1 teaspoon of salt into a glass of water and gargle it down your throat. Then spit out the liquid. The salt water can reduce your swelling and thus relieve the associated pain. 
  • Drink plenty of warm liquids such as sage tea (sage has an antiseptic and antibacterial effect) or water to relieve pain.
  • A humidifier increases the humidity in a room. Breathing in this humid air can soothe sore throats and relieve throat pain. If you don't have a humidifier, you can also take a hot shower and breathe in the steam from the shower cubicle.
  • Avoid things that are known to put extra stress on your throat. Various chemicals and smoke from cigarettes and cigars are particularly irritating to the throat.9

Eating when you have difficulty swallowing

Regardless of whether you suffer from chronic swallowing difficulties or they are the result of a temporary infection, they are always annoying. You may then tend to eat less or change your diet to one-sided foods that are easy to swallow. However, as swallowing difficulties are usually caused by illnesses that have to be fought by the immune system, it is important that you nourish your body well to strengthen your immune system.


What can cause swallowing difficulties?

As already mentioned, swallowing is a surprisingly complex mechanism involving many organs, muscles and nerves. Accordingly, there is a wide range of potential causes for dysphagia.

What can I do if I have difficulty swallowing?

You should get to the bottom of the cause without worrying unnecessarily. In most cases, common infections or inflammations are responsible for swallowing difficulties. You can find out above when action is needed. Of course, you can also try to alleviate your symptoms at home with the remedies mentioned above, but these should never replace a consultation with a doctor.

What is difficulty swallowing?

Difficulty swallowing is also known as dysphagia. It is often accompanied by the following symptoms.

  • Coughing when eating or drinking
  • Chronic drooling
  • Not being able to chew food properly
  • Choking food back up, sometimes through the nose
  • A feeling that food is stuck in the throat or chest
  • A "gurgling" wet-sounding voice when eating or drinking

Are swallowing difficulties dangerous?

Difficulty swallowing can be dangerous or indicate a serious illness. However, this is not usually the case. The majority of swallowing problems can be attributed to the typical annual recurring illnesses and inflammations. Nevertheless, there is a need for clarification if swallowing problems persist for a longer period of time. If the pain suddenly gets much worse or you experience breathing problems, you should always call an emergency doctor.10

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  9. Triggs, J., & Pandolfino, J. (2019). Recent advances in dysphagia management. F1000Research, 8, F1000 Faculty Rev-1527.
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