What is Cervical Dysphagia?

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.
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Discussion Comments
I have recently been diagnosed with dysphagia and most likely caused by pretty impression osteophytes in my cervical spine. That is also causing numbness of my fingers, and pain in arm and shoulder. I've had GERD for many years. I'm currently seeing a pulmonologist for sleep apnea and swallowing issues.
I have not started my speech therapy yet. Just given very basic advice, such as take small bites, chew well, and drink thicker liquids. My well meaning friends have unasked for advise on eating. I had gastric bypass surgery six years ago, to add another issue to the mix.
I think one of the most frustrating things is the communication between my internal medicine doctor, my pain management doctor that is doing epidural on the cervical area, my pulmonologist, cardiologist and neuro surgeon. I have signed for and given permission for release for records to go to them, but seems they never have them. I have taken to asking to have a copy of the report before I leave the office. Many days I can spend an hour or more trying to coordinate just records!
I am not holding much hope for speech therapy/swallowing lessons, and know that is not the best way to start this. I do not want a feeding tube. It is already a problem eating with the gastric bypass issues. Plus given the fact that I need high protein, 60 grams and at least 60 0z of fluid a day. It just seems overwhelming to me, when I can't swallow my own spit!
I've always had a problem with food getting stuck in my throat and now after two neck surgeries, it has gotten even worse. I'm embarrassed to eat in front of people and to go out to eat is just stupid to me. I don't want to embarrass my family or my kids, if you can understand that it would be great, plus it's gross trying to get the food either down or back up.
I don't tell my family so when we go out to eat, I get a milkshake or something really soft to eat and they look at me like I'm crazy or something. I just don't want to embarrass them, plus I have to fight to get the air into my lungs. It's the worst and I don't think that there is anything to do about this problem except don't eat.
Thank you for listening to me whine about this problem. I mean, after all, there are more important things to worry about, like cancer and other diseases out there that are a lot more serious than my problem. Thank you. Steve.
@strawCake - You're right, cervical dysphagia does sound pretty terrible. I'm glad there are treatments available for this condition though. At least once the patient is diagnosed there's a light at the end of the tunnel for them!
Having experienced trouble swallowing from being ill, I can't imagine having to deal with dysphagia al the time! No wonder people with this problem lose their appetite. I would lose my appetite too if I couldn't swallow my food comfortably. Plus the possibility of aspiration sounds too scary.
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