Swallowing is an essential function that is necessary for properly digesting food and liquid which sustains the body. Difficulties with swallowing, referred to as dysphagia, is often a symptom of an underlying health concern. Numerous factors can contribute to dysphagia which means that you experience challenges with swallowing. If swallowing is challenging on a consistent basis, you should consult with an ENT (ear, nose, throat) specialist – or an otolaryngologist. ENT specialists are specifically trained to diagnose and treat conditions related to the throat and voice so they are equipped to diagnose and treat issues with swallowing. 

The Process of Swallowing

There are four main components or stages of swallowing, which include: 

  • Oral Preparation Stage: this initial stage occurs in the mouth and prepares the foods and liquid for swallowing by chewing and breaking down the food.
  • Oral Stage: the tongue pushes the food or liquid to the back of the mouth, which activates the swallowing response.
  • Pharyngeal Stage: this third stage involves the food and liquid going from the mouth and passing through the pharynx, throat, and esophagus. 
  • Esophageal Stage: this final stage is when the food and liquid pass from the esophagus and enter the stomach. 

Difficulties swallowing can occur at different stages of this process, requiring a thorough examination by an ENT specialist. 

Symptoms & Causes

Difficulty swallowing produces various symptoms, including the following: 

  • Coughing or choking on small pieces of food or liquid 
  • Food is not easily moving through the throat and esophagus
  • Drooling 
  • Changes with voice 
  • Coughing up blood 
  • Sensing lump in the throat 
  • Lung infections 
  • Weight loss  

In addition to these symptoms, there is a range of causes that can lead to dysphagia including: 

  • throat infections like tonsillitis (bacterial or viral infection of the tonsils)
  • acid reflux
  • muscle weakness that becomes more common with aging 
  • food or other substances that get stuck in the throat 
  • impact of medications
  • tumors in the throat, lungs, or esophagus 
  • vocal fold paralysis 
  • medical conditions, including Parkinson’s disease, multiple sclerosis, Gravis disease, strokes etc. 

Difficulty swallowing can impact overall health and wellness, so seeing an ENT specialist as early as possible is important. 


There are various tests that ENT specialists use to identify and diagnose swallowing disorders. In addition to running these tests, ENT specialists may work with other healthcare experts – neurologist, gastroenterologist, speech-language pathologist etc. – to comprehensively assess and treat the root of the issue. 

An ENT specialist will likely approach treatment by discussing your experience with the specific difficulties you are having around swallowing. They will also examine the mouth and throat, and could conduct the following tests: 

  • FEES (flexible endoscopic evaluation of swallowing) involves inserting a small tube – known as a laryngoscope- through your nose to assess the throat. The specialist may ask you to consume food or liquids with the scope in place so they can observe the swallowing process. This allows them to get a thorough look at the back of the tongue, throat, and voice box. 
  • Barium Swallow – this is another way to examine how you swallow. Rather than inserting a tube that allows the specialist to see what is going on, this test involves using X-rays to record how food and liquids are being swallowed. 
  • TNE (trans-nasal esophagoscopy): this test specifically examines the esophagus and stomach with a flexible camera. Similar to the FEES test, this exam takes it further by extending the scope all the way to the stomach. 

The cause of swallowing difficulties will determine the specific treatment that will be most effective. Medication can treat many issues, including acid production in the stomach. Medication can also be in the form of muscle relaxants, antacids etc. Another treatment option is working with a speech-language pathologist (SLP). An SLP can provide therapies for swallowing that could address and alleviate challenges. 

If you experience challenges with swallowing, and if the signs previously listed seem familiar to you, it is important to schedule an appointment with us today. Seeking treatment can improve health outcomes and quality of life!

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