Several diseases, including gastroesophageal reflux disease (GERD) and scleroderma, cause dysphagia, a condition that causes a person to have difficulty swallowing. Neurological conditions such as Parkinson's disease and multiple sclerosis also sometimes cause dysphagia. While some people with dysphagia find swallowing to be painful, others may not be able to swallow at all.
There are two main types of dysphagia. When someone has esophageal dysphagia, it may feel as though food or liquid gets stuck in his esophagus. Tumors in the esophagus can cause dysphagia, as can age-related weakening of the esophageal muscle.
Other causes of esophageal dysphagia include diffuse spasm and achalasia. When someone has diffuse spasms, his esophagus muscles constrict as he tries to swallow, preventing the object from sliding down his throat and into the stomach. Symptoms include a feeling similar to heartburn. Diffuse spasm is a rare disease that sometimes turns into a condition known as achalasia.
Achalasia prevents the esophageal sphincter from opening so food can enter the stomach. It usually feels as if the food is stuck in the area around the heart. Sometimes, the food may come back up the esophagus. The pain from achalasia may cause a person to think he is experiencing a heart attack. Both achalasia and diffuse spasm can be treated with Botox® or medications that help the muscles relax. In severe cases, surgery may be performed to cut the muscles to keep them from contracting irregularly.
GERD also can cause dysphagia. Stomach acid comes up the esophagus when someone suffers from GERD; this can scar the throat, narrow the area inside the esophagus and make the muscles contract irregularly. Scleroderma is a disease that has symptoms similar to GERD. The sphincter can be weakened, which causes stomach acid to wash up the throat, as well. Systemic scleroderma causes the tissue of the esophagus to become fibrous and stiff, so food and liquid do not travel as freely as they should along the path to the stomach.
Neurological conditions usually are to blame for the other type of dysphagia, oropharyngeal. When someone has oropharyngeal dysphagia, he is unable to transfer food from the back part of his mouth down into his esophagus. He may instead gag or choke on the food. The food may also be incorrectly routed into his nasal passages or down his trachea, which can lead to a respiratory infection. Strokes, multiple sclerosis, post-polio syndrome, and Parkinson's disease are examples of neurological conditions that can cause dysphagia.