Dysphagia Causes and Complications

Dysphagia is difficulty swallowing or the inability to swallow. It is one of the common problems encountered by stroke survivors. If you are experiencing trouble swallowing food, drinks, or even noticing that saliva builds up in your mouth while you are not eating, you might have dysphagia.

Some people with dysphagia have trouble swallowing everything, while some people with dysphagia may only notice the problem when trying to swallow something such as a thin liquid or large chunks of food.

If you notice any dysphagia at all, you should discuss this problem with your medical team, because there are complications of dysphagia, and there are treatments for it as well.

What Are the Causes of Dysphasia?

Swallowing requires muscle strength and nerve and muscle coordination. The muscles involved in swallowing are located in the face, the mouth, the tongue and the throat. Dysphagia most often results from an injury or disease affecting the areas of the brain that control swallowing or from an injury to the nerves or muscles that carry out the act of swallowing.

A number of medical problems may cause dysphagia, and a stroke is one of the medical conditions most commonly associated with dysphagia. There is not just one particular type of stroke that causes dysphagia, as the function of swallowing is controlled by several regions of the brain that work together.

Most strokes can cause at least some degree of dysphagia for stroke survivors, but large strokes are more likely to cause dysphagia.

Ischemic (caused by an interruption of blood flow) or hemorrhagic strokes  (caused by bleeding in the brain) that affect areas of the cerebral cortex, the white matter, the brainstem or the cerebellum are common causes of dysphagia.

Other causes of brain disease can causes dysphagia, including dementia, severe forms of Parkinson's disease, multiple sclerosis, brain cancers, Lou Gehrig's disease and the Guillain-Barre syndrome.

Dysphagia can also occur when there is damage to muscles or nerves in the mouth, face, head or neck after trauma, cancer, surgery or radiation therapy.

If you have dysphagia, you should expect it to be worse whenever you are tired, sleepy or if you have a medical illness such as an infection.

What Are the Complications of Having Dysphasia?

Dysphagia interferes with swallowing. This can produce a variety of short term and long term consequences that can impact your lifestyle as well as your overall health and safety.

Dysphagia can result in longer hospital stays and a prolonged recovery after a stroke. This is often due to the lack of independence in eating, lung infections, fevers and a slower overall recovery. In some cases, dysphagia is so severe that you might not be able to get enough calories by eating food. In such situations, the medical team must place a feeding tube so that you can get much-needed nutrients and medications delivered through the feeding tube instead of through swallowing.

After leaving the hospital, dysphagia can interfere with home life. Because people need to swallow in order to eat and drink, dysphagia can cause you to avoid eating or drinking if the experience is too difficult, too time consuming or too distressing. This can ultimately result in severe malnutrition, muscle atrophy, weakness and depression. 

If a person with dysphagia chokes while eating food or drinking liquids, this can cause coughing, spitting up, or vomiting.

When dysphagia results in small food or debris getting trapped in the 'wrong pipe,'  it can cause infections such as aspiration pneumonia, an infection that frequently affects recovering stroke survivors. Aspiration pneumonia takes time to resolve and may require a hospital stay, medication and treatment with IV fluids.

Sometimes, when food gets lodged in the wrong pipe, it may be so severe that it can interfere with proper respiration, which can cause a passing out and may even result in death if a person suffers from a prolonged lack of oxygen.

A Word From Verywell

If you or a loved one thinks you might have some of the signs of dysphagia, it is essential to have a medical evaluation, which includes a speech and swallow evaluation, and a plan for therapy. This is the best way to prevent the complications of dysphagia.

Edited by Heidi Moawad MD


Nursing management of post-stroke dysphagia in a tertiary hospital: a best practice implementation project, Liu H, Shi Y, Shi Y, Hu R, Jiang H. JBI Database System Rev Implement Rep. 2016 Jul;14(7):266-74

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