The diagnosis process of swallowing problems

Written by: Professor Stuart Winter
Published:
Edited by: Sarah Sherlock

There are a variety of causes for swallowing problems, so the right tests and examinations must be done to consider the correct treatment. Professor Stuart Winter, an expert otolaryngologist, has explained what some of the problems are and how he diagnoses them.

 

swallowing problems

 

What happens first?

The first thing is to take a comprehensive history. I want to understand how long you've had a swallowing problem for, what you find difficult with swallowing and where you feel the swallowing is a problem and at what level. When did it start, did it come on quickly? Has it come on more slowly? Is it progressing? What sorts of foods do you find difficult to swallow? Other things I will ask about include:

 

  • your background
  • any other medical conditions you may have and the impact it's having on them
  • if you have a cough
  • if you've lost any weight
  • if you bring food back up

 

These questions can give a huge amount of information in regards to the underlying cause for the problem.

 

 

How is a swallowing problem tested?

Next is an examination of you and your neck, followed by a look at the structures and the anatomy of your swallowing mechanism by testing with a camera through your nose and seeing where foods go during the consultation. From that, further investigations may be needed. An x-ray swallow test, whereby you take a mouthful of a contrast (i.e. blue liquid, yoghurt, cake, etc.) and we look at how the muscles move, is a very good way of understanding where and how the swallowing problem is affecting you.

 

It may be that an examination of your esophagus further down using instrumentation is required, either through the nose or through the mouth to look at the rest of the esophagus and into the stomach. This can all be arranged depending on cause for your swallowing problems.

 

 

How is a swallowing problem diagnosed?

The results from the initial questions, physical exam, and any scans or x-rays are used to determine what is happening and where. Once the location of the swallowing problem is understood, we can direct treatment accordingly.

 

 

If you are experiencing issues while swallowing and would like a consultation, you can go to Professor Winter's Top Doctors profile to schedule a visit.

By Professor Stuart Winter
Otolaryngology / ENT

Professor Stuart Winter is an experienced consultant ear, nose & throat (ENT) surgeon with a specialist interest in tumours of the head and neck. Based across the major private hospitals in Oxford, Mr Winter runs a full ENT practice for adults and children. He runs a specialist swallowing clinic at the Churchill Hospital. He holds, and has held a number of positions nationally including with NICE, ENT-UK, and is a member of the national Clinical Reference Group (CRG) for complex Head and Neck Cancer.

Originally qualifying from the University of Bristol, Mr Winter completed his surgical training in the south west of England, where he developed an early interest in head and neck cancer. In order to further develop advanced techniques for head and neck cancer and sinus surgery, he spent a year working at the Royal Adelaide Hospital in South Australia. During this time he received a number of awards, including the Lionel College Memorial Fellowship and the Ethicon Travelling Fellowship.

As Consultant Ear, Nose & Throat Surgeon at Oxford University Hospitals, Mr Winter leads an active research program into head and neck cancer, and to date has over 70 publications in peer-reviewed journals. He is regularly invited to speak at national and international conferences and he teaches on a number of local and national courses.

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