Dysphagia

Causes of oropharyngeal dysphagia include:

1. Neurological Disorders
   Patients who have suffered a previous stroke or spinal cord injury can have difficulty swallowing. Other neurological conditions such as Parkinson’s disease, muscular atrophy, multiple sclerosis can cause difficulty in swallowing.
2. Cancer/Tumours
   The presence of certain cancers may cause difficulty in swallowing (e.g. tongue cancer). Additionally, patients who have undergone surgery or radiotherapy to the head and neck region may also develop dysphagia.

Causes of oesophageal dysphagia include:

1. Oesophageal Tumour
   Tumours in the oesophagus can cause obstruction. Dysphagia is usually progressive and usually starts, with solid food and later as the tumour grows larger, liquids.
2. Achalasia
   This is a condition where the lower oesophageal muscle (sphincter) fails to relax adequately to allow food to enter the stomach from the oesophagus.
3. Gastro-oesophageal Reflux Disease
   When the muscle in the lower oesophagus (sphincter) is inappropriately lax, acid from the stomach can reflux back into the oesophagus. This can lead to spasm and even scarring and narrowing of the oesophagus.
4. Oesophageal Stricture
   Narrowing in the oesophagus can be a result of scarring from repeated irritation by acid reflux from the stomach or other caustic substances, previous radiotherapy or previous procedures done.
5. Connective Tissue Disease
   Connective tissue diseases such as scleroderma can sometimes cause hardening of the tissue in the oesophagus and cause it to become stiff. This can in turn cause difficulty in swallowing.
6. Oesophageal Spasm
   In this condition, multiple involuntary poorly co-ordinated contractions of the oesophagus occur after swallowing.
7. Foreign Body
   Objects that get lodged can block the passage of food down the oesophagus. This is seen more commonly in older people who may have difficulty chewing their food well and resultantly swallow a large piece of food bolus that gets lodged in the oesophagus.