Lonestar Gastroenterology

What Causes Difficulty Swallowing?

misc image

What Causes Difficulty Swallowing?

The ability to swallow allows us to ingest foods, which is vital to survival. Dysphagia, or difficulty swallowing, can affect any area in the digestive tract leading to the stomach and may have a number of problems. But what causes it?

The digestion process starts in the mouth, where you start breaking down foods through chewing and swallowing. Swallowing food is a normal function requiring a complicated process to get food from your mouth to your esophagus (food tube) and into your stomach. Voluntary and involuntary processes go into swallowing, which also involves areas of your nervous system.

Dysphagia is the name for difficulty swallowing, and one in 25 adults deal with the problem each year which increases as we get older. Problems with this part of digestion can lead to other complications, so let’s learn about the causes of this condition. Here, we’ll examine how your body swallows, what causes dysphagia, and what options for treatment are available.

Dr. Rajesh Mehta and LoneStar Gastroenterology in Austin, Texas, can help those seeking treatment for dysphagia and other digestive problems.

Understanding how your body swallows

Here are the three phases your body undergoes when swallowing food:


The oral phase involves chewing food moistened by saliva (called the bolus), breaking it down to smaller sizes, and pushing it to the back of the mouth. The bolus then moves to the upper part of your throat (or the oropharynx) while using your tongue and other muscles forcing it into the lower throat (pharynx).


Once the bolus is in the throat, sensory nerves start involuntarily swallowing, a process mediated by the medulla (lower brain stem) to push food down the throat into the esophagus — the tube that food goes down to reach your stomach. The epiglottis is a small movable lid that helps to keep your food from getting into your windpipe (trachea), which is essential for breathing.


Once the food enters your esophagus, it uses muscles to lead food to your stomach with powerful, coordinated contractions. It also works in concert with the vagus nerve, the glossopharyngeal nerve, and the nerve fibers in your sympathetic nervous system to accomplish this task. The upper and lower esophageal sphincters work to move food down and help keep you from regurgitating it.

Dysphagia causes

Occasional issues with swallowing do not usually cause alarm, but other problems leading to dysphagia can vary depending on where in the process of swallowing it is happening. Oropharyngeal dysphagia is a condition in the throat area that moves down to your esophagus. This can result in neurological disorders, neurological damage, or pharyngoesophageal diverticulum (a pouch that forms in the throat). Certain cancers and cancer treatments can lead to difficulty swallowing as well.

Esophageal dysphagia is when the problem happens somewhere in your esophagus and can occur for a variety of reasons such as:

  • achalasia
  • a diffuse spasm
  • a narrowed esophagus (esophageal stricture)
  • tumors 
  • foreign bodies
  • GERD
  • eosinophilic esophagitis (a problem related to food allergies) 
  • scleroderma (scar tissue) 
  • radiation therapy

The risk for this condition increases with age and may lead to complications such as malnutrition, dehydration, weight loss, aspiration pneumonia, and choking.

Treatment options

Treatments may vary due to the cause of your specific condition. Oropharyngeal dysphagia may be treated with exercises to help train muscles, stimulate the swallowing reflex, or learn techniques if it is related to a neurological condition. Medications, dietary changes, or surgery are possible treatments for esophageal dysphagia.

Surgical options include laparoscopic Heller myotomy, peroral endoscopic myotomy (POEM), stent placement, esophageal dilation, and onabotulinumtoxinA injection. 

Dysphagia can lead to problems with eating and digesting and may eventually cause more severe complications. If you’re having problems swallowing, make an appointment with Dr. Mehta and LoneStar Gastroenterology today to get help.