Cervical dysphagia is difficulty swallowing because of a problem in the upper part of the esophagus. Patients with this condition will point to their necks when asked to demonstrate where their swallowing problems appear. There are a number of causes for this disorder and treatment options are varied. Patients with this condition may see a gastroenterologist or an ear, nose, and throat physician for initial care, and other specialists such as speech-language pathologists may also become involved after the initial diagnosis.
Neurological damage is one possible cause. Some genetic conditions lead to difficulty swallowing and acquired damage as a result of injury, chronic disease, or degenerative neurological disease can all cause damage in the nerves that control swallowing. Mechanical damage caused by anything from strangulation attempts to infections can also cause cervical dysphagia. Certain cancers can create difficulty swallowing and this condition is also linked with gastroesophageal reflux disorder (GERD).
In a patient with cervical dysphagia, the nature of the difficulty swallowing can vary. Some patients identify a mild hitch as they try to swallow, while others may only be able to eat soft or liquid foods. Painful swallowing is a separate symptom, although it is possible to have trouble swallowing while also experiencing pain. The condition may onset slowly or rapidly. Information about the sensation and when it first started is very helpful for a doctor to have.
During an evaluation for cervical dysphagia, a doctor will discuss the symptoms with the patient and go over the patient's history, looking for clues into the patient's condition. A patient with a history of problems known to be linked to cervical dysphagia, like strokes or injuries to the neck, may be relatively easy to diagnose. A gastroscopy, where a camera is inserted into the esophagus to visualize it, may be recommended to look for any obvious causes of the difficulty. Treatments can include surgery, medications, and dysphagia therapy, where the patient will work with a physical therapist on exercises to improve swallowing.
Having difficulty swallowing can be dangerous, in addition to uncomfortable. There is an increased risk of aspirating food and this can lead to complications like aspiration pneumonia. Patients may also experience decreased appetite, leading to weight loss and other problems, when they have trouble eating. It is important to receive a thorough evaluation and to discuss treatment options thoroughly. Some patients find a second opinion from another practitioner beneficial when making decisions about dysphagia treatment.
