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Cervical dysphagia is difficulty swallowing due to a problem in the upper part of the esophagus. Causes include neurological damage, genetic conditions, injury, chronic disease, and cancer. Treatment options include surgery, medications, and dysphagia therapy. It is important to receive a thorough evaluation and discuss treatment options thoroughly.
Cervical dysphagia is difficulty swallowing due to a problem in the upper part of the esophagus. Patients with this condition will point to their neck when asked to demonstrate where their swallowing problems appear. There are a number of causes for this disorder and the treatment options are varied. Patients with this condition may see a gastroenterologist or an ear, nose and throat doctor for initial care, and other specialists such as speech and language pathologists may also be involved after the initial diagnosis.
Neurological damage is a possible cause. Some genetic conditions lead to swallowing difficulties, and damage acquired due to injury, chronic disease, or degenerative neurological disease can cause damage to the nerves that control swallowing. Mechanical damage caused by anything from strangulation attempts to infections can also cause cervical dysphagia. Certain types of cancer can make it difficult to swallow, and this condition is also linked to gastroesophageal reflux disorder (GERD).
In a patient with cervical dysphagia, the nature of the swallowing difficulty can vary. Some patients identify a slight hitch while trying to swallow, while others may be able to eat only soft foods or liquids. Painful swallowing is a separate symptom, although it is possible to have trouble swallowing while also feeling pain. The condition can come on slowly or quickly. Information about sensation and when it first started is very helpful to a doctor.
During an evaluation for cervical dysphagia, a doctor will discuss symptoms with the patient and review the patient’s history, looking for clues about the patient’s condition. A patient with a history of problems known to be related to cervical dysphagia, such as stroke or neck injury, may be relatively easy to diagnose. A gastroscopy, in which a camera is inserted into the esophagus to view it, may be recommended to look for any obvious causes of the difficulty. Treatments may include surgery, medications, and dysphagia therapy, where the patient will work with a physical therapist on exercises to improve swallowing.
Having trouble swallowing can be dangerous, as well as uncomfortable. There is an increased risk of food aspiration and this can lead to complications such as aspiration pneumonia. Patients may also experience a decreased appetite, leading to weight loss and other problems, when they have difficulty eating. It is important to receive a thorough evaluation and discuss treatment options thoroughly. Some patients find a second opinion from another doctor helpful when making decisions about treating dysphagia.
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