Swallowing Disorders

When you swallow, you are chewing food and moving it to the esophagus, a tube that connects to the stomach. Dysphagia, the medical term for difficulty swallowing, is characterized by the sensation of food or liquid getting stuck in the throat or chest. There are numerous factors that can cause swallowing difficulty, most of them fairly benign.

The Swallowing Process

Few of us give much thought to the act of swallowing, but it’s actually a complex process that involves around 50 pairs of muscles and nerves.

There are four stages that make up the swallowing process:

  • Stage 1: Oral preparation stage. Food is chewed to prepare for swallowing.
  • Stage 2: Oral stage. The tongue pushes food or liquid to the back of the mouth.
  • Stage 3: Pharyngeal stage. Food or liquid passes through the pharynx into the esophagus.
  • Stage 4: Esophageal stage. Food or liquid passes through the esophagus and enters the stomach.

Symptoms & Causes

Swallowing disorders indicate persistent problems with chewing and swallowing. The main symptoms are discomfort when swallowing, chest pain and the feeling that food or liquid is getting stuck in the throat or chest. Additionally, you may experience drooling, heartburn, nausea, wheezing, coughing, regurgitation, sore throat and a sour taste in the mouth.

Causes of dysphagia are diverse. They may originate in the esophagus and include diffuse spasm, an improperly relaxed sphincter, weak esophageal muscles, a narrow esophagus or esophageal ring, the presence of foreign bodies, gastroesophageal reflux disease (GERD), a hardening of the tissues called scleroderma and tumors. In addition, the muscles and nerves responsible for swallowing can weaken as a result of neurological disorders, pharyngeal diverticula or cancer. Children may have difficulty swallowing if they suffer from certain nervous system disorders or a cleft palate.


Treatment for swallowing disorders depends on the underlying cause and where the problem originates. Medication, surgery and swallowing therapy are the most common types of treatments administered. Medications include antacids, muscle relaxants and drugs to limit the amount of stomach acid produced. A surgical procedure to stretch or dilate the esophagus when it is too narrow often helps resolve the issue. Swallowing therapy involving chewing and swallowing techniques can help stimulate the muscles and nerves responsible for swallowing. The most severe cases of dysphagia may require a liquid diet or feeding tube.

Call ENT Associates of Santa Barbara at (805) 964-6926 for more information or to schedule an appointment.

Zenker’s Diverticulectomy

A diverticulum is a sac or pocket that forms on a portion of the body. A Zenker’s diverticulum is a pouch that develops on the pharynx, in the upper esophagus of the neck. It may trap food, causing difficulty or pain when swallowing. Other side effects include bad breath, regurgitation, coughing, unexplained weight loss, irritation of the throat and aspiration (the passage of food or liquid into the lungs). Treatment depends on the size of the pouch. Smaller diverticula can often be ignored, so long as they do not cause swallowing problems (dysphagia). Unfortunately, over time swallowing difficulty is likely to increase, leading to the eventual need for treatment. Surgery is the usual treatment method, as no medications currently exist for Zenker’s diverticulum.