Dysphagia is the medical term for having trouble swallowing. Swallowing is an intricate procedure that involves a major reflexive action in the pharynx and oesophagus, as well as a substantial involvement of the brain. Swallowing is automatic, in that it happens automatically when food gets to the back of the throat; there isn't any thinking involved in the process once it's started. Hence, a number of causes may lead to swallowing difficulty or dysphagia. Problems with swallowing can occur along with: conscious promotion of swallowing; food moving to the pharynx; the nasal passages being blocked while swallowing; opening of the oesophagus; physical blockages getting in the way of food passing. Or a swallowing issue could be caused by problems that lie in the pharynx or oesophagus itself, and that might be due to diseases in the muscles that control those organs. In order to get a clearer picture, one may distinguish two main categories of swallowing difficulties identified on the basis of their cause, the first being oropharyngeal, which are due to issues related to mouth or pharynx, and the second being oesophageal, related to issues concerning the tube that connects the mouth to the stomach. Among the two distinguishable categories of symptoms of dysphagia, we have one that is linked with swallowing and the other which is not. Swallowing related issues among elderly patients might happen due to dentures and the inability to chew food correctly, that can lead to swallowing big chunks of food that get lodged in the oesophagus. However, this typically happens when there are additional problems with the pharynx or oesophagus, like a possible stricture. However, the most common symptom of dysphagia is the feeling that food is sticking; that can lead to coughing and possibly the regurgitation of food. Additional 'trouble swallowing' manifestations include the lack of ability to control food or saliva in the mouth, trouble swallowing, choking, resultant eating issues and the occasional occurrence of pneumonia. However, one will have to exclude those cases where the affected person has difficulties in swallowing liquid substances in comparison to solid food. This affliction is termed as achalasia, whereby the lower oesophagus suffers a constriction resulting in problems along the entire length of the tube. Aside from dysphagia caused by strokes (which tends to get better), there are several ways that painful swallowing can be treated, and the treatment typically produces steady, progressive improvement. The prognosis for the exact cause of the swallowing problems will impact the method by which it is treated, and therapy will likely respond to the root cause and adapt to the way the individual responds to treatment. Generally speaking, the prognosis is favourable for swallowing problems caused by a non-malignant obstruction in the oesophagus. These normally respond well to treatment. Even swallowing troubles that are the result of a malignant obstruction can be palliated by endoscopic resection of some of the tumour and/or stenting. Treatment of achalasia, trouble swallowing fluids, and other disorders similar to this, is generally very effective. In addition, new light is being shed on the oesophagus and how it works due to recent progress in diagnosis. High resolution and 3D manometry are having a great influence on the field. Patients with dysphagia may often suffer difficulties in swallowing pills. This problem is seen to occur quite frequently and may have multiple causes. Crushing of tablets and dissolving them in water is a common practice among patients with swallowing difficulties, as suggested by statistics. While occasionally this can be a solution, care must be used and patients are asked to consult their doctor before doing this. More often than not, due to the lack of knowledge of all available options, a patient opts for crushing tablets. There exist certain other easier methods for those who find it difficult to swallow pills. First, ask whether there are alternatives available for the drug, such as a liquid type, a dispersible, buccal or an oro-dispersible tablet. Certain medications are only available by a doctor's prescription, as they don't have a license to be marketed by a pharmacist. Ask a pharmacist though, and they'll be able to tell you the information you might require on the subject. Occasionally a doctor or pharmacist will recommend dissolving a pill in water before you put it in your mouth if you have difficulty swallowing whole tablets; as previously stated, follow a professional's advice. If there aren't any oral options, it is sometimes worth asking whether or not there's a patch, cream or inhaled version available. That might not be the case, but it's worth asking the professional about this option if swallowing pills is really hard for you.
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