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Aphagia is the inability or refusal to swallow food, caused by various conditions such as tumors, muscle disorders, and stroke. Diagnosis involves tests and treatment may include modifying eating habits, feeding tubes, and surgery.
Aphagia is the inability or refusal to swallow food. It is often accompanied by a feeling of a lump in the throat, a feeling of pain, or a feeling that food is stuck and not moving. The location of the problem can be anywhere from the back of the mouth to the esophageal sphincter, which controls how fast food is dumped into the stomach. Usually the location of the blockage is lower than the location of the painful or burning sensation.
Many conditions can cause aphagia. These can include physical blockages from tumors, cervical spine disease, or muscle tightness from an emotional anxiety disorder. Cancer therapy drugs, ulcers, and radiation can cause a stricture in the throat, leading to an inability to swallow. In rare cases, aphagia can be caused by the presence of an esophageal rete, a structural abnormality consisting of a membrane of tissue that narrows parts of the esophagus.
Sometimes aphagia can result from nerve or muscle disorders. Aphagia is one of the symptoms of amyotrophic lateral sclerosis or ALS. Neuromuscular disorders and autoimmune diseases such as myasthenia gravis, muscular dystrophy and multiple sclerosis can cause aphagia. An inability or difficulty swallowing can be a symptom of Parkinson’s disease, polio, or scleroderma.
Stroke is the leading cause of aphagia, especially in elderly patients. About half to two-thirds of stroke victims have some degree of swallowing disorder. Treating the inability to swallow is critical because swallowing problems can cause stroke victims to aspirate food or liquids into their lungs and cause pneumonia, the source of one-third of all deaths in stroke victims.
A doctor will likely perform several tests to determine the cause and treatment of aphagia. After a general exam, the doctor may have the patient perform a baryta swallow and undergo X-rays to observe how the liquid moves through the esophagus and digestive tract. Other tests can measure the pressure and acidity of the esophagus. Your doctor may insert a small camera down your throat to view your esophagus.
If a patient has symptoms of aphagia, maintaining nutrition and hydration is critical. It may help to eat slowly and chew well. If symptoms persist, the patient can try eating softer foods or pureeing solid foods to make them easier to break down. Many people who are unable to swallow solid foods are able to swallow liquids. Very hot or cold foods can make symptoms worse.
If these measures don’t help, biofeedback or compensatory swallowing techniques may help. Different types of feeding tubes can be used to supplement nutrition and bypass the area where the swallowing difficulty is located. In rare cases, surgery may be required.
