What Is Oropharyngeal Dysphagia?

Oropharyngeal dysphagia is a disorder or impairment in the ability to swallow.

In oropharyngeal dysphagia, swallowing both liquids and solids can be disrupted, which can impact the ability to eat and drink.

If you or a loved one suspects difficulties with swallowing, you should seek care from your healthcare provider as soon as possible. Dysfunctional swallowing caused by dysphagia can have serious consequences, including an increased risk of damage to the lungs, infection, and even malnutrition. Additionally, dysphagia can be a sign of esophageal cancer.

In this article, we review what causes oropharyngeal dysphagia, the common complications, and treatments. 

What Is Oropharyngeal Dysphagia?

Oropharyngeal dysphagia is a medical condition that causes a disruption or delay in swallowing.

The term comes from the oropharynx, the location in the back of the throat, and dysphagia, which means disordered swallowing.

A variety of different conditions, such as esophageal cancer, oropharyngeal cancer, strokes, and Parkinson’s disease, can all contribute to oropharyngeal dysphagia.

Signs

The first signs of a disruption in the ability to swallow can be difficult to fully appreciate.

You may notice coughing more frequently at meals, a sensation that something is stuck in your throat or chest, or even the need to clear your throat after a meal.

Sometimes, you may notice it takes longer to eat and you need to take more time to chew your food.

All of these can be early signs of oropharyngeal dysphagia.

Causes

There are many different potential causes of dysphagia, ranging from aging to neurological disorders and cancers.

Identifying the underlying cause of dysphagia is important as it can lead to better treatment selection. In some cases, there can be multiple causes that combine to cause dysphagia.

Neurological Disorders

Swallowing may seem simple, but it is actually quite complex and requires a carefully orchestrated series of coordinated muscles and nerves.

If there is a disruption in the nervous system, such as an issue in the brain or spinal cord, then the ability to swallow correctly can be disrupted. As a result, any condition that may impact the brain, spinal cord, or nervous system can potentially affect the ability to swallow.

The most common nervous system disorders that are associated with oropharyngeal dysphagia include:

• Stroke
• Brain tumor
• Parkinson’s disease
• Cognitive impairment
• Multiple sclerosis
• Amyotrophic lateral sclerosis (ALS)
• Spinal cord injuries
• Infections in the brain or spinal cord 
  

Cancer

Cancer is a leading cause of oropharyngeal dysphagia.

The most common cancers that cause oropharyngeal dysphagia are ones located in the upper part of the gastrointestinal system, such as the esophagus and stomach, or in the head and neck region.

Cancer can invade the structures that control swallowing and, as a result, disrupt the ability to swallow properly. These cancers include:

• Stomach cancer
• Esophageal cancer
• Oral cancer
• Head and neck cancer
• Brain cancer
• Lymphoma
• Lung cancer

Muscle Weakness

The muscles that control and coordinate swallowing are very precise and finely controlled by the body. If there is a disruption in the ability of the muscles to properly function, then swallowing can be impaired.

The conditions that most frequently impact swallowing and can lead to oropharyngeal dysphagia are:

• Myasthenia gravis
• Muscular dystrophies
• Polymyositis
  

Medications

Some medications are known to have side effects that can result in impaired swallowing.

The exact reasons these medications are causing a problem are not always well understood.

Some medications change the way food and liquids move through the esophagus. In some cases, if the medications themselves are large enough, they can inflame and irritate the esophagus.

The most commonly known medications to lead to oropharyngeal dysphagia are:

• Bisphosphonates
• Calcium channel blockers
• Antipsychotics
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Nitrates
• Immunosuppressants (tacrolimus, cyclosporine) 
• Opioids 
  

Diagnosis

The diagnosis of oropharyngeal dysphagia is made using the assistance of a speech-language pathologist.

Specific tests—such as a swallow test—can evaluate the function of the oropharynx and determine if swallowing is impaired.

In addition, specialized video cameras called endoscopes can be used to examine swallow function. In some cases, imaging tests, such as a barium swallow, are used to fully evaluate the function of the esophagus. 

Treatment

The treatment of oropharyngeal dysphagia varies depending on the specific cause.

In the cases where specific causes are identified, treatment of the underlying cause is the first step.

For example, if cancer is impacting the ability to swallow, then initiating treatment for the cancer is necessary. In addition, certain changes may need to be made to diet and lifestyle to avoid complications from oropharyngeal dysphagia. 

Dietary Changes

Certain foods can exacerbate the symptoms and problems with oropharyngeal dysphagia. For example, large, hard foods that require lots of effort to break down can be significantly more challenging to swallow.

A speech-language pathologist can help evaluate the best foods for you to eat with oropharyngeal dysphagia. Food modifiers, such as thickeners, are often used to make them easier to swallow. 

Dilation

The oropharynx in the throat is a narrow space through which food and liquids need to pass. If there is an obstruction in the esophagus that restricts the flow of food or liquids, then a dilation procedure may be used for treatment.

A dilation procedure widens the esophagus so that food and liquids can pass through the obstruction.

Surgery

Severe oropharyngeal dysphagia can be treated with surgery in some cases.

The surgery usually involves removing obstructions that restrict the passage of food. In the case of achalasia (a motility disorder of the esophagus), surgery can divide muscles that fail to properly relax.

Surgery is invasive and usually reserved for specialized cases of dysphagia that are not amenable to other treatments like those mentioned above.  

Physical Therapy

There are many effective exercises and therapies you can use to retrain your body on how to swallow.

Just like any muscle, repetitive training can help strengthen and reinforce the muscles that control swallowing. There are even specific training programs and physical therapists who can help you improve your ability to swallow. Work with your healthcare provider, speech-language pathologist, or occupational therapist to identify the best exercises that may help you.

Complications

One of the most significant complications from dysphagia is aspiration pneumonia, where abnormal swallowing leads to food or liquid entering the lungs.

The food and liquid can lead to an infection in the lungs, or pneumonia developing, which is a severe medical complication.

Additionally, dysphagia that is ongoing for a long period of time can lead to malnutrition and dehydration as food and nutrients cannot properly move through the digestive system. For these reasons, dysphagia is a serious medical issue that requires urgent treatment.

Summary

Oropharyngeal dysphagia causes you to lose the ability to swallow. This is a serious medical condition that can be treated in numerous ways, depending on the underlying cause.

A Word From Verywell

Losing the ability to swallow properly can make you feel at a loss. Swallowing is something that we don’t often think about but is critical to our well-being. Know there are many treatments, exercises, and lifestyle changes available to help manage dysphagia. With appropriate help, you can look to get past dysphagia and live a healthy, fulfilling life.