Dysphagia - Causes of dysphagia

As swallowing is a complex process, there are many reasons why dysphagia can develop.

Some causes of dysphagia are explained below.

Neurological causes

The nervous system is made up of the brain, nerves and spinal cord. Damage to the nervous system can interfere with the nerves responsible for starting and controlling swallowing. This can lead to dysphagia.

Some neurological causes of dysphagia include:

a stroke
neurological conditions that cause damage to the brain and nervous system over time, including Parkinson's disease, multiple sclerosis, dementia, and motor neurone disease
brain tumours
myasthenia gravis – a rare condition that causes your muscles to become weak

Congenital and developmental conditions

The term "congenital" refers to something you're born with. Developmental conditions affect the way you develop.

Congenital or developmental conditions that may cause dysphagia include:

learning disabilities – where learning, understanding, and communicating are difficult
cerebral palsy – a group of neurological conditions that affect movement and co-ordination
a cleft lip and palate – a common birth defect that results in a gap or split in the upper lip or roof of the mouth

Obstruction

Conditions that cause an obstruction in the throat or a narrowing of the oesophagus (the tube that carries food from your mouth to the stomach) can make swallowing difficult.

Some causes of obstruction and narrowing include:

mouth cancer or throat cancer, such as laryngeal cancer or oesophageal cancer – once these cancers are treated, the obstruction may no longer be an issue
pharyngeal (throat) pouches, also known as Zenker diverticulum – where a large sac develops in the upper part of the oesophagus, which reduces the ability to swallow both liquids and solids; it's a rare condition that mainly affects older people
eosinophilic oesophagitis – where a type of white blood cell known as an eosinophil builds up in the lining of the oesophagus as the result of a reaction to foods, allergens, or acid reflux; the build-up damages the lining of the oesophagus and causes swallowing difficulties
radiotherapy treatment – this can cause scar tissue, which narrows the passageway in your throat and oesophagus
gastro-oesophageal reflux disease (GORD) – stomach acid can cause scar tissue to develop, narrowing your oesophagus
infections, such as tuberculosis or thrush – these can lead to inflammation of the oesophagus (oesophagitis)

Muscular conditions

Any condition that affects the muscles used to push food down the oesophagus and into the stomach can cause dysphagia, although such conditions are rare.

Two muscular conditions associated with dysphagia are:

scleroderma – where the immune system (the body's natural defence system) attacks healthy tissue, leading to a stiffening of the throat and oesophagus muscles
achalasia – where muscles in the oesophagus lose their ability to relax and open to allow food or liquid to enter the stomach

Other causes

As you get older, the muscles used for swallowing can become weaker. This may explain why dysphagia is relatively common in elderly people. Treatment is available to help people with age-related dysphagia.

Chronic obstructive pulmonary disease (COPD) is a collection of lung conditions that make it difficult to breathe in and out properly. Breathing difficulties can sometimes affect your ability to swallow.

Dysphagia can also sometimes develop as a complication of head or neck surgery.