Why Is It Hard to Swallow?

Disorders of the esophagus can make it hard to swallow. Photo © A.D.A.M.

Question: Why Is It Hard to Swallow?

There are actually many conditions that can make it hard to swallow. In general, swallowing difficulties (also called dysphagia) fall into distinct categories based on the part of the swallowing process that has been disrupted. This is because swallowing involves the brain, tongue, pharynx, esophagus, and many other structures and physiological processes.


People may experience difficulty swallowing in many different ways, including: feeling like there's a lump in your throat or chest, choking and/or coughing while trying to swallow, pain when swallowing, sore throat, heartburn, getting food stuck in your throat, a weakened voice (laryngitis), and weight loss. If you are having a hard time swallowing, you should see a doctor right away to avoid complications like aspiration and pneumonia, and reduce to the risk of death by choking.

If this is the first time you've had a hard time swallowing, and no significant event has occurred to cause this problem, it is more likely to be an infection or the progression of a chronic condition you already have -- rather than, say, a neurological problem, such as a stroke. That said, any of the following conditions have been known to cause swallowing difficulties.


  • any infection that has the potential to cause swollen tonsils, a swollen tongue, or swelling of other structures involved in the swallowing process

Disorders That Affect the Esophagus

Neurological or Problems With Weak Muscles

Other Causes

  • Lou Gehrig's disease (ALS)
  • stroke
  • Parkinson's Disease
  • multiple sclerosis
  • achalasia
  • myasthenia gravis
  • muscular dystrophy
  • polymyositis
  • scleroderma
  • cerebral palsy
  • spinal cord injury
  • dementia
  • head and neck cancer
  • head and neck surgery
  • anatomical problems, such as cleft lip palate
  • Zenker's diverticulum
  • motility disorders of the esophagus (disorders that cause a disruption in peristalsis)
  • severe anxiety disorders in which the ability to relax the muscles is affected
  • anaphylactic reaction (a serious allergic reaction which requires immediate medical care)

Treatment of Swallowing Difficulties

Your treatment will depend on what, specifically, is making it hard for you to swallow. For example, anatomical problems, such as cleft lip palate, can be corrected surgically. GERD can be treated with medication.

No matter what is making it hard for you to swallow, the following measures should be taken by anyone with swallowing difficulties in order to prevent serious complications:

  • Chew your food extremely well and take your time when eating
  • Avoid foods that are likely to get stuck in your throat (steak or similar meats, for example).
  • It may be necessary to drink thickened liquids.
  • Make sure you are in an upright position while eating.
  • If you or your child has difficulty swallowing accompanied by a fever, get medical attention.
  • If your child has excessive drooling, get immediate medical attention.
  • If your condition is rapidly getting worse, call 911 or go to your nearest emergency room (this may be a life-threatening anaphylactic reaction).

While dysphagia can be a dangerous condition, many of the things that make it hard to swallow are temporary and/or can be treated.


Medline Plus. Swallowing Difficulty. Accessed: September 7, 2011 from https://www.nlm.nih.gov/medlineplus/swallowingdisorders.html

National Institute on Deafness and Other Communication Disorders. Dysphagia. Accessed: September 7, 2011 from http://www.nidcd.nih.gov/health/voice/pages/dysph.aspx

University of Maryland Medical Center. Dysphagia. Accessed: September 7, 2011 from http://www.umm.edu/altmed/articles/dysphagia-000053.htm

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