Difficulty in swallowing (Dysphagia)

Written by: Professor Guri Sandhu
Published: | Updated: 19/04/2023
Edited by: Laura Burgess

Dysphagia is difficulty in normal swallowing, which can range from a minor sensation of something stuck in the throat, coughing during eating, to having to constantly spit out saliva.

Causes of swallowing problems

The exact cause of dysphagia is unknown as it has so many different causes, such as:



How to diagnose dysphagia

Diagnosis of dysphagia is usually made on taking a medical history from a patient. Some patients may not be aware of swallowing problems, present with recurrent chest infections, through silently breathing in food and drink.

Severity of the dysphagia is assessed clinically but also through specialist tests such as X-Ray videos of the patient swallowing (videofluoroscopy) and direct observations of the patient swallowing with a trans-nasal flexible camera device (fibreoptic endoscopic evaluation of swallowing).

Dysphagia is usually managed by specialist multidisciplinary teams (MDTs). The aims are to gain sufficient nutrition, protect the airway and allow for the pleasures of taste and social aspects of eating.



Treatment of dysphagia

Dysphagia treatment very much depends on the cause. Where possible, the priority is to treat the underlying medical condition.

The patient could simply be advised to modify the consistency or types of food they eat. There are also strengthening exercises, such as exercising the swallowing muscles and head and neck manoeuvres to make each swallow safer.

Alternative feeding methods such as nasal, or directly into the stomach feeding tubes, may be considered for the short- or long-term in more severe cases.



Surgery for swallowing difficulties

Surgical techniques that improve the swallow mechanism again depend on the underlying cause. They are varied and should only be offered by dysphagia specialists. These may include a tracheostomy to look after the airway, swallowing muscles surgery or on the vocal cords or pharyngeal pouch surgery. Other procedures include diverting the airway to a hole in the neck or even removing the larynx.




If you require expert treatment for dysphagia, arrange an appointment with Professor Sandhu via his Top Doctors profile

By Professor Guri Sandhu
Otolaryngology / ENT

Professor Gurpreet (Guri) Sandhu is a world leading surgeon, academic and pioneer in otolaryngology/ENT. He treats the full range of ear, nose, and throat conditions in both adults and children. He has a special interest in voice, airway and swallowing problems, as well as minimally invasive techniques for the management of head and neck tumours.

He has a large private practice across London, managing the problems experienced by professional voice users from stage, music, and media, and is ENT surgeon to the Royal Society of Musicians, and has made outstanding contributions to the field of laryngology. 

Professor Sandhu is Professor of Practice in Laryngology and the lead for the Airway Reconstruction Unit at Imperial College London. This is one of the largest multidisciplinary adult airway services in Europe, achieving National Centre for Airway Reconstruction status. 
He has pioneered minimally invasive approaches to airway diseases that have reduced morbidity and hospital stays for patients.

Professor Sandhu has published over 150 research papers, 15 book chapters and three textbooks. He is committed to education and training, runs several postgraduate courses, and is frequently invited to lecture nationally and internationally.

He is president of the British Laryngological Association and past president for the Royal Society of Medicine section for laryngology and rhinology.

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