Swallowing Disorders

At Montefiore Einstein Otorhinolaryngology – Head and Neck Surgery, you can access exceptional care for swallowing disorders. As a global leader in otorhinolaryngology and head and neck surgery, we are an academic-based, national and international referral site for the most complex and high-risk cases. For over a century, we have been at the forefront of innovation, research and clinical care for ear, nose and throat (ENT) and head and neck conditions.

Ranked in the top 1% of all hospitals in the nation for complex specialty care according to U.S. News & World Report, Montefiore Einstein continues to make advances in the diagnosis and treatment of ENT and head and neck conditions. Our multidisciplinary team of world-renowned specialists has pioneered many of the otorhinolaryngological techniques used today and is passionate about uncovering the latest diagnostic approaches and treatments that can improve outcomes.

At Montefiore Einstein Otorhinolaryngology – Head and Neck Surgery, you can expect compassionate, personalized, research-driven treatment plans that meet the highest standards for quality and safety.

When you need care for swallowing problems, turn to our dedicated providers who will develop a highly personalized treatment plan.

What Are Swallowing Disorders?

Difficulty swallowing is also called dysphagia. It can be a sign of a problem with your throat or esophagus, the muscular tube that moves food and liquids from the back of your mouth to your stomach. Although dysphagia can happen to anyone, it is most common in older adults, babies and people who have problems of the brain or nervous system.

There are many different problems that can prevent the throat or esophagus from working properly. Some of these are minor and others are more serious. If you have difficulty swallowing once or twice, you probably do not have a medical problem. But if you have trouble swallowing on a regular basis, you may have a more serious problem that needs treatment.

Causes of Swallowing Disorders

Swallowing difficulties are caused by a range of conditions that affect the mouth, throat and/or esophagus. Causes include:

  • Acid reflux (gastroesophageal reflux disease—GERD)
  • Aging-related changes in muscle strength and coordination
  • Infections or inflammation
  • Muscle disorders, including achalasia or scleroderma
  • Neurological disorders, including strokes, Parkinson’s disease or multiple sclerosis
  • Abnormal growths in the throat
  • Problems with the movement of the vocal cords
  • Structural abnormalities, including esophageal strictures or tumors

Signs & Symptoms of Swallowing Disorders

Swallowing disorders can cause a varied number of symptoms, including:

  • Coughing, choking or gagging while eating or drinking
  • Difficulty or pain while swallowing
  • Feeling of food stuck in the chest
  • Hoarseness or wet-sounding voice after swallowing
  • Regurgitation of food or liquids
  • Unintentional weight loss or malnutrition

If these symptoms are constant or persistent, prompt evaluation is essential to prevent complications like aspiration or dehydration.

Diagnosing Swallowing Disorders

If you are having difficulty swallowing, your doctor will ask questions about your symptoms and examine you. They will want to know if you have trouble swallowing solids, liquids or both. They will also want to know where you think foods or liquids are getting stuck, whether and for how long you have had heartburn, and how long you have had difficulty swallowing. They may also check your reflexes, muscle strength and speech. Your doctor may then refer you to one of the following specialists:

  • A gastroenterologist, who treats problems of the digestive system
  • A neurologist, who treats problems of the brain, spinal cord and nervous system
  • A speech-language pathologist, who evaluates and treats swallowing problems
  • An otolaryngologist, who treats ear, nose and throat problems

To help find the cause of your dysphagia, you may need one or more tests, including:

  • A barium swallow: This is an X-ray of the throat and esophagus. Before the X-ray, you will drink a chalky liquid called barium, which coats the inside of your esophagus so that it shows up better on an X-ray.
  • Esophagoscopy or upper gastrointestinal endoscopy: During these tests, a thin, flexible instrument called a scope is placed in your mouth and down your throat to look at your esophagus and perhaps your stomach and upper intestines. Sometimes, a small piece of tissue is removed for a biopsy to check for inflammation or cancer cells.
  • Fluoroscopy: This test uses a type of barium swallow that allows your swallowing to be videotaped.
  • Laryngoscopy: This test looks into the throat, using either a mirror or a flexible camera.
  • Manometry: During this test, a small tube is placed down your esophagus. The tube is attached to a computer that measures the pressure in your esophagus as you swallow.
  • Monitoring pH levels: This tests how often acid from the stomach gets into the esophagus and how long it stays there.
  • X-rays: These provide images of your neck or chest.

Treating Swallowing Disorders

Treatment for swallowing disorders depends on the severity of the condition and its underlying cause. Treatments include:

  • Dietary modifications, such as consuming texture-modified foods and thickened liquids, to facilitate safe swallowing
  • Medications for the treatment of underlying conditions like GERD or inflammation
  • Supportive care for neurological conditions, in collaboration with our neurology care team and rehabilitation specialists, to manage dysphagia resulting from stroke or other neurological conditions
  • Surgical procedures, such as esophageal dilation to widen narrowed areas of the esophagus or other interventions to address structural abnormalities or remove obstructions, if necessary
  • Therapeutic interventions conducted in collaboration with our speech-language pathology team, which provides exercises and strategies to strengthen swallowing muscle