Swallowing Disorders

Understanding Dysphagia (Difficulty Swallowing)

Swallowing is something most of us do effortlessly. But for individuals with dysphagia, this seemingly simple act can become difficult, uncomfortable and even dangerous. Occasional difficulty swallowing isn’t a concern, but ongoing difficulty can be a serious medical condition and should be assessed.

Dysphagia, or difficulty swallowing, is a common yet often overlooked medical condition that affects the ability to move food or liquid from the mouth to the stomach. It can impact nutrition, hydration and quality of life. In some cases, it may pose serious health risks.

Swallowing disorders can be caused by a wide range of conditions, including neurological diseases, head and neck cancers, post-surgical changes and gastroesophageal reflux disease (GERD). In some cases, conditions like obstructive sleep apnoea may also be linked, particularly when there is associated structural or muscular dysfunction in the throat.

If left untreated, dysphagia can lead to aspiration pneumonia, malnutrition, dehydration and a significant decline in general health. Fortunately, with proper assessment and treatment through a multidisciplinary team, many people with dysphagia can regain safe and effective swallowing function.

Swallowing Disorders - Complete ENT

Types of Swallowing Disorders

Swallowing disorders can be categorised based on where the problem occurs during the swallowing process.

Types of Swallowing Disorders

Oropharyngeal Dysphagia

This type affects the mouth and throat. It often involves difficulty initiating a swallow or transferring food from the mouth to the oesophagus. Individuals may experience coughing, choking, nasal regurgitation or voice changes after swallowing.

Oral Dysphagia

It is a subset of oropharyngeal dysphagia, specifically referring to difficulty in the oral phase of swallowing when you chew food and move food within the mouth. This condition can result from issues such as tongue weakness, poor lip closure or reduced saliva production.

Oesophageal Dysphagia

This occurs when food has trouble moving down the oesophagus into the stomach. People may feel as though food is getting stuck in their chest or throat.

Dysphagia may also be a symptom of broader medical issues such as neurological conditions (e.g. Parkinson’s disease, stroke), muscle weakness or inflammatory diseases like eosinophilic oesophagitis.

Each type of dysphagia requires different diagnostic and therapeutic approaches. A comprehensive evaluation by an Ear, Nose and Throat specialist, gastroenterologist and Speech-Language Pathologist is essential for accurate diagnosis and treatment planning.

Symptoms of Dysphagia

Symptoms of Dysphagia

The symptoms of dysphagia can vary depending on what causes difficulty in swallowing for you, and whether the issue is in the mouth, throat or oesophagus. Some people may only notice mild discomfort, while others may experience significant trouble swallowing.

Some patients also experience sleep disturbances, especially if dysphagia is associated with obstructive sleep apnoea or nocturnal reflux. When dysphagia is related to head and neck cancers, symptoms may progress gradually, often accompanied by a sore throat, hoarseness, ear pain or a neck mass

Common Signs And Symptoms

  • A sensation that food is stuck in the throat or chest
  • Coughing or choking during or after eating and drinking
  • Throat clearing frequently while eating
  • Gurgly or wet-sounding voice after swallowing
  • Pain while swallowing (odynophagia)
  • Drooling or difficulty managing saliva
  • Unintentional weight loss due to eating less
  • Avoidance of certain foods or liquids
  • Taking longer than usual to eat or drink
  • Frequent heartburn or regurgitation
  • Recurring chest infections or pneumonia (due to aspiration)
  • Feeling tired or exhausted after meals
  • Needing to swallow multiple times to clear food or when having trouble swallowing solids

What Causes Dysphagia?

The causes of dysphagia may be due to various underlying health issues or known risk factors, including:

  • Neurological conditions: Stroke, motor neuron disease, multiple sclerosis, and Alzheimer’s disease can all impair the muscles and nerves involved in swallowing.
  • Head and neck cancers: Tumours or cancer treatments (such as radiation or surgery) can disrupt normal anatomy and impair swallowing function.
  • Neck surgery: Procedures involving the cervical spine, thyroid gland or airway may unintentionally affect nearby swallowing structures.
  • GERD: Gastroesophageal reflux disease, or chronic reflux, is when the lower oesophageal sphincter doesn’t close properly and stomach acid flows back into the oesophagus. This can lead to irritation, inflammation or narrowing of the oesophageal lining (known as strictures), all of which contribute to problems swallowing.
  • Sleep apnoea: Repetitive upper airway collapse during sleep can impact throat muscle tone and structure, potentially contributing to or exacerbating dysphagia.
  • Structural issues: Problems with the soft palate, larynx, or oesophageal sphincter can interfere with the smooth progression of a swallow.
  • Ageing: Increases the risk of dysphagia due to natural muscular weakening and an increased incidence of comorbid conditions.

Dysphagia Treatment Options

Dysphagia Treatment Options

How Is Dysphagia Treated? A Multidisciplinary Approach

Treating dysphagia requires a multidisciplinary approach, often involving ENT specialists, speech language pathologists, dietitians, radiologists and sometimes gastroenterologists or neurologists, depending on the underlying cause. Speech pathologists also manage other communication disorders that may coexist with dysphagia in neurological conditions.

At Complete ENT, we work collaboratively across disciplines to ensure every patient receives an individualised care plan that addresses both the symptoms and root causes of their swallowing difficulties.

The swallowing disorders treatment planned for you will vary depending on the type, severity and cause of dysphagia. From swallowing therapy and dietary adjustments to medical management and surgical interventions, our goal is to restore safe, effective swallowing and support long-term health and quality of life.

Swallowing therapy is a cornerstone of dysphagia management and is typically led by a qualified speech pathologist. Therapy is personalised and designed to retrain and strengthen the muscles involved in swallowing. Common components of swallowing therapy may include:

  • Swallowing exercises to improve swallowing muscle coordination and strength
  • Postural strategies, such as chin tuck or head tilt, to make swallowing safer and more effective
  • New swallowing techniques, including effortful swallows or supraglottic swallows, to help protect the airway during meals
  • Education and training on pacing, bolus size and food preparation

Therapy sessions are often guided by findings from a video fluoroscopic swallow study (VFSS) or fibreoptic endoscopic evaluation of swallowing (FEES), which help tailor the intervention to the patient’s specific needs.

For many people with swallowing dysphagia, adjusting the texture and consistency of foods and drinks can significantly reduce the risk of aspiration (when food or liquid enters the airway). The dietary modifications to your eating habits may include:

  • Thickened fluids that are easier to control in the mouth and throat
  • Soft or pureed foods that require less chewing and are easier to swallow
  • Avoidance of dry, crumbly or mixed-texture foods that increase choking risk
  • Smaller portion sizes and slower eating pace to help with control

In some cases, swallowing difficulties are linked to underlying medical conditions such as gastroesophageal reflux disease (GERD), oesophageal inflammation or muscle dysfunction. Medical management may include:

  • Proton pump inhibitors (PPIs) or H2 blockers to reduce acid reflux
  • Anti-inflammatory medications to address conditions like eosinophilic oesophagitis
  • Botox injections to relax tight oesophageal spasms or muscles in certain conditions
  • Neurological medications when dysphagia is caused by nerve or muscle disorders

Medical treatment is often used in combination with therapy and dietary changes to address both symptoms and their root cause.

When swallowing is unsafe or severely impaired, enteral feeding may be necessary to maintain nutrition and hydration. Feeding tubes can be used on a short-term or long-term basis and may include:

  • Nasogastric (NG) tubes, inserted through the nose into the stomach, are used temporarily
  • Percutaneous endoscopic gastrostomy (PEG) tubes, surgically placed through the abdomen for longer-term nutrition
  • Jejunostomy tubes (J-tubes) for direct intestinal feeding, if needed

 

Feeding tubes can prevent complications such as malnutrition, dehydration and aspiration pneumonia in patients who are unable to meet their nutritional needs by mouth. At Complete ENT, decisions around feeding support are made collaboratively with patients, families and the multidisciplinary team to ensure comfort, dignity and quality of life.

When Is Surgery For Swallowing Disorders Necessary?

Surgery for dysphagia may be recommended when the swallowing disorder is caused by structural abnormalities or blockages that cannot be managed conservatively. Swallowing disorders surgery may include procedures such as:

  • Dilation of a narrowed oesophagus (stricture)
  • Removal of tumours or growths that interfere with swallowing
  • Reconstructive surgery following head and neck cancer treatment
  • Cricopharyngeal myotomy, a procedure to cut a tight muscle at the top of the oesophagus
  • Tracheoesophageal puncture or other reconstructive techniques in post-laryngectomy patients
When Is Surgery For Swallowing Disorders Necessary

Potential Complications Of Dysphagia

Potential Complications Of Dysphagia

Aspiration And Aspiration Pneumonia

When food, drink or saliva enters the airway instead of the oesophagus (known as aspiration), it can introduce bacteria into the lungs and lead to aspiration pneumonia. This condition is particularly dangerous in older adults and those with weakened immune systems, often requiring hospitalisation.

Repeated aspiration can result in recurrent chest infections, which may present as coughing, wheezing, or shortness of breath. Over time, this can lead to chronic lung damage or aspiration pneumonia, especially in vulnerable individuals.

People with dysphagia may avoid eating or drinking due to fear of choking or discomfort, which can result in inadequate nutrition and fluid intake. Over time, this can lead to weight loss, fatigue and weakened immunity, further compromising overall health.

Severe dysphagia can pose an immediate risk of choking, especially with solid foods or thin liquids. This can lead to medical emergencies requiring urgent intervention.

In rare but severe cases, repeated aspiration can trigger a life-threatening lung condition called acute respiratory distress syndrome (ARDS). ARDS involves significant fluid build-up in the lungs, making it extremely difficult to breathe and requiring intensive care.

ENT For Dysphagia Brisbane & Cairns

If you’re experiencing ongoing or worsening swallowing problems, it’s important to seek specialist care. An ENT (Ear, Nose and Throat) is trained to evaluate the structures of the throat, voice box and oesophagus. A comprehensive swallowing evaluation using tools like FEES or VFSS helps identify the safest and most effective treatment path. Complete ENT’s team can identify both common and complex causes of dysphagia.


You should consider seeing an ENT if you experience:

  • Frequent coughing or choking while eating or drinking
  • Food sticking in your throat or chest, especially solids
  • Changes in your voice, particularly after swallowing
  • Recurring chest infections or aspiration pneumonia
  • Painful swallowing (odynophagia)
  • A history of head or neck cancer, surgery or radiation
  • Swallowing issues accompanied by sleep apnoea or snoring

 

At Complete ENT, we work in collaboration with speech pathologists, gastroenterologists and radiologists. Early diagnosis and treatment can help prevent complications and significantly improve your quality of life.

Discuss Your Options with our Swallowing Disorders Specialists at Complete ENT

Head And Neck Cancer Specialists Brisbane & Cairns

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