Treatment

Treatment for dysphagia depends on the type or cause of your swallowing disorder.

Oropharyngeal dysphagia

For oropharyngeal dysphagia, your health care provider might refer you to a speech or swallowing therapist. Therapy might include:

• Learning exercises. Certain exercises might help coordinate your swallowing muscles or restimulate the nerves that trigger the swallowing reflex.
• Learning swallowing techniques. You might also learn ways to place food in your mouth or position your body and head to help you swallow. Exercises and new swallowing techniques might help if your dysphagia is caused by neurological problems such as Alzheimer's disease or Parkinson's disease.

Esophageal dysphagia

Treatment approaches for esophageal dysphagia might include:

• Esophageal dilation. For a tight esophageal sphincter (achalasia) or an esophageal stricture, your health care provider might use an endoscope with a special balloon attached to gently stretch and expand your esophagus or pass a flexible tube or tubes to stretch the esophagus (dilation).
• Surgery. For an esophageal tumor, achalasia or pharyngoesophageal diverticulum, you might need surgery to clear your esophageal path.

• Medications. Difficulty swallowing associated with GERD can be treated with prescription oral medications to reduce stomach acid. You might need to take these medications for a long time.

  Corticosteroids might be recommended for eosinophilic esophagitis. For esophageal spasm, smooth muscle relaxants might help.

• Diet. Your health care provider might prescribe a special diet to help with your symptoms, depending on the cause of the dysphagia. If you have eosinophilic esophagitis, diet might be used as treatment.

Severe dysphagia

If difficulty swallowing prevents you from eating and drinking enough and treatment doesn't allow you to swallow safely, your health care provider might recommend a feeding tube. A feeding tube provides nutrients without the need to swallow.

Surgery

Surgery might be needed to relieve swallowing problems caused by throat narrowing or blockages, including bony outgrowths, vocal cord paralysis, pharyngoesophageal diverticula, GERD and achalasia, or to treat esophageal cancer. Speech and swallowing therapy is usually helpful after surgery.

The type of surgical treatment depends on the cause of dysphagia. Some examples are:

• Laparoscopic Heller myotomy. This involves cutting the muscle at the lower end of the esophagus (sphincter) when it fails to open and release food into the stomach in people who have achalasia.
• Peroral endoscopic myotomy (POEM). The surgeon or gastroenterologist uses an endoscope inserted through the mouth and down the throat to create an incision in the inside lining of the esophagus to treat achalasia Then, as in a Heller myotomy, the surgeon or gastroenterologist cuts the muscle at the lower end of the esophageal sphincter.
• Esophageal dilation. The health care provider inserts a lighted tube (endoscope) into the esophagus and inflates an attached balloon to stretch it (dilation). This treatment is used for a tight sphincter muscle at the end of the esophagus (achalasia), a narrowing of the esophagus (esophageal stricture), an abnormal ring of tissue located at the junction of the esophagus and stomach (Schatzki's ring), and motility disorders. Long flexible tubes of varying diameter also may be inserted through the mouth into the esophagus to treat strictures and rings.
• Stent placement. The health care provider can also insert a metal or plastic tube (stent) to prop open a narrowing or blocked esophagus. Some stents are permanent, such as those for people with esophageal cancer, while others are removed later.
• OnabotulinumtoxinA. This can be injected into the muscle at the end of the esophagus (sphincter) to cause it to relax, improving swallowing in achalasia. Less invasive than surgery, this technique might require repeat injections. More study is needed.