A patient’s story
Ben, 58, began avoiding meat and bread after repeatedly feeling food stick behind his chest. At first it passed within seconds, but over time swallowing became painful and stressful. A specialist assessment revealed oesophageal narrowing, and targeted treatment restored his ability to eat comfortably again.
What are swallowing problems?
Swallowing problems, medically known as dysphagia, occur when food or liquids do not pass smoothly from the mouth to the stomach. While occasional difficulty can happen, persistent or painful swallowing is not normal and should always be assessed.
Symptoms of dysphagia
Common symptoms include:
Food sticking in the throat or chest
Choking or coughing when eating
Pain when swallowing
Bringing food back up
Excess saliva
Difficulty chewing
Hoarse voice or throat clearing
Left untreated, dysphagia can lead to weight loss, dehydration and chest infections.
What causes swallowing problems?
Dysphagia can result from structural, inflammatory or neurological conditions, including:
Gastro-oesophageal reflux disease (GORD)
Eosinophilic oesophagitis (EoE)
Achalasia
Oesophageal cancer
Oesophageal strictures or scarring
Neurological conditions such as stroke or multiple sclerosis
Identifying the exact cause is essential for safe and effective treatment.
How swallowing problems are diagnosed
Assessment usually starts with a specialist consultation, followed by targeted tests such as:
Gastroscopy
Barium swallow
High-resolution oesophageal manometry
24-hour pH impedance testing
96-hour wireless pH capsule (BRAVO or Alpha)
These tests assess structure, muscle function and reflux activity.
Treatment for dysphagia
Treatment depends on the underlying cause and may include:
Endoscopic treatments
Oesophageal dilation for strictures, EoE or achalasia
Endoscopic resection or ablation for early oesophageal cancer
Medical and dietary treatments
Proton pump inhibitors (PPIs)
Topical swallowed steroids such as budesonide
Six-food elimination diet for EoE
Reflux-focused treatments
Lifestyle and dietary modification
Anti-reflux procedures including Stretta, TIF or LINX
Laparoscopic Nissen fundoplication
Advanced disease may require surgery, chemotherapy or radiotherapy.
When to seek urgent medical advice
Seek urgent care if swallowing problems are accompanied by:
Rapid weight loss
Persistent vomiting
Chest pain
Coughing blood
Recurrent chest infections
Expert swallowing assessment at LSDC Clinic
At LSDC Clinic, swallowing problems are assessed using advanced diagnostics and treated with individualised, evidence-based care, ensuring symptoms are addressed safely and thoroughly.