Swallowing disorders: why does food stay in the throat and cannot be swallowed?

Swallowing disorders are also known as dysphagia, a condition in which a person has difficulty swallowing a mouthful of food or water. Sometimes swallowing disorders are accompanied by pain when swallowing. Alternatively, liquids or food may return to the oral cavity or nasal cavities.

If there are problems swallowing even empty without food, there may be a serious restriction of the passage of the tube. In this case, a medical examination and professional help should be sought immediately.

Swallowing difficulties and respiratory diseases

Some diseases of the upper respiratory tract can also cause swallowing disorders. Painful swallowing is present, for example, in laryngitis (inflammation of the larynx). The inflammation is most often of viral origin and manifests itself most markedly with a dry cough and sore throat.

Tumours may also form in the larynx, oral cavity, nasopharynx, oesophagus or other parts of the larynx. In the case of a laryngeal tumour, hoarseness is a frequent symptom and the sufferer also has breathing problems. Swallowing is often painful and the sufferer may also have frequent swallowing disorders associated with a foreign body sensation.

In some cases, nasopharyngitis may also present with pain and difficulty swallowing. The more common symptoms are dry cough, a stuffy nose, and increased body temperature. Sometimes there is also a sore throat.

Swallowing disorders and oral cavity problem

Often the cause is a problem in the oral cavity. For example, in the case of tonsillitis (inflammation of the tonsils), there is pain in the throat even at rest. Swallowing is accompanied by severe pain.

Even in the case of oral cancer, there is pain when swallowing. Swallowing is also made more difficult by the enlargement of the tumour in the oral cavity.

Unfortunately, the tumour only manifests itself in this way in the later stages of its development. Its treatment is often complicated at this point. Some types of cleft lip or maxillary cleft, for example, also present this symptom. Salivary gland disorders are another case where swallowing is impaired.

Esophagus, stomach and impaired swallowing

The oesophagus is a very important organ for the passage of food to the stomach. And even here, tumours can occur. Cancer of the oesophagus mainly affects the upper part of it. Although not common, it is a rather dangerous disease, which also manifests itself in speech disorders.

Esophagitis is much more common, however. It occurs when the oesophageal mucosa is irritated and damaged. Heartburn is a very characteristic symptom, but swallowing disorders also occur.

Dysphagia and pain when swallowing can also occur in oesophageal reflux disease. Gastroesophageal reflux disease (you may also see GERD) is characterised by the penetration of acidic stomach contents into the oesophagus.

Digested food and gastric juices, which also contain hydrochloric acid, pass into the esophagus and sometimes into the oral cavity. Long-term exposure results in chronic inflammation of the esophageal lining, ulceration of the esophagus or even narrowing of the esophagus.

The narrowing of the oesophagus itself is often the cause of difficulty in swallowing food and liquids. Achalasia is a disease characterised by a disorder at the nervous level. It is characterised by a disruption of the innervation of the muscles and thus their mobility.

The muscles of the esophagus normally move during swallowing, which moves the bite from the esophagus to the stomach.

Symptoms such as:

• pain on swallowing, pressure behind the sternum
• feeling of a foreign body
• pyrosis (heartburn)
• vomiting - vomiting with fresh blood or dark coffee grounds
• coughing fits
• weakness
• weight loss

Another cause is a bowel movement of the oesophageal wall, also called oesophageal diverticulum. Food accumulates in the bowel, causing difficulty in swallowing. Vomiting, bad breath and chest pain may be associated.

People with stomach cancer can also sometimes have problems swallowing. Swallowing can also be painful and often a person affected by this cancer, for example, has a feeling of being stuck in the food system with an inability to swallow.

Swallowing disorders due to neurological problems

Certain diseases of the nervous system affecting the nerves or directly the neuromuscular junction in the throat and oral cavity or oesophagus can also cause swallowing disorders. For example, in Huntington's disease, neurodegenerative diseases occur that cause mobility problems as well as swallowing and speech disorders.

Other neurodegenerative and neurological diseases that can cause a problem are:

• ALS (amyotrophic lateral sclerosis).
• multiple sclerosis
• Parkinson's disease
• myasthenia gravis
• cerebral palsy
• dementia
• stroke

Other causes of impaired swallowing

Another cause of impaired swallowing can be a condition following surgery in the mouth, throat or head. It also occurs in the case of chemotherapy and radiotherapy. This is due to nerve damage and therefore innervation, scarring and swelling of the tissues.

Swallowing disorder also occurs in myopathy. Muscle inflammation and muscle weakness occur. The affected person also has problems with the muscles in the neck and the muscles in the neck.

Swallowing problems also occur in alcoholism. Firstly, there is pain and also swallowing disorders. The cause may be the aforementioned oesophageal reflux disease, which occurs due to prolonged drinking of alcohol.

The feeling of a foreign body in the throat, the sensation of a ball, lump or bite of food in the throat also causes psychogenic tightening of the oesophageal muscles. It is known professionally as globus hystericus.

It also arises in some infectious diseases, such as tetanus. Tetanus affects the muscles of the face and oral cavity with spasms. It is possible to find swallowing problems, but it is not a characteristic symptom.

Eating and swallowing disorders are often the result of decayed dentures. They also occur with incorrectly made or damaged dentures. Various injuries and post-traumatic conditions in the head and oral region can contribute to swallowing disorders.

For example, swallowing problems can also occur in thyroid cancer, where the tumour presses on the trachea and oesophagus.

Characteristic of thyroid cancer are enlarged lymph nodes in the neck and breathing problems.

Outside pressure on the oesophagus and problems with swallowing are also caused by enlargement of the thyroid gland (goiter). But malignant or benign tumours in the neck and chest, such as lung cancer, can also be the cause.

Complications of swallowing disorders

If impaired swallowing persists for a long time, it is a risk factor for other complications. An example is the inhalation of food or water (aspiration). This aspiration then causes complicated pneumonia (technically, aspiration pneumonia).

Impaired swallowing is often caused by dehydration, but also by inadequate nutrition - impaired food intake and weight loss. In addition to reduced weight, the body lacks important nutrients and minerals that are needed for the normal functioning of the body.

Whenever pain, impaired swallowing and inability to swallow occur, the sufferer should seek medical attention as soon as possible.

Swallowing disorders in children

Swallowing in children occurs in the same stages as in adults. The difference is mainly anatomical, namely in the size of the oral cavity and tongue in newborns and young children. The newborn's oral cavity is largely filled with the tongue. Breathing and swallowing alternate.

Swallowing occurs in utero. After birth, the sucking reflex and swallowing are adapted to breastfeeding. In some cases, swallowing disorders occur in children, which can have a negative impact on the child's thriving, weight gain and development.

The main causes of swallowing disorder in infancy:

• Underdeveloped muscles that are needed for sucking and swallowing
• neurological diseases (neurogenic causes), such as cerebral palsy
• premature birth
• genetic disorders
• neuromuscular diseases
• muscle diseases
• after surgery on the head, brain, oral cavity, throat
• after trauma
• cleft lip, palate
• heart disease
• infections in the oral cavity, for example tonsillitis
• respiratory diseases
• diseases of the digestive tract
• psychogenic causes such as stress, psychological strain
• anorexia and bulimia