Difficulty swallowing (dysphagia)

Dysphagia is difficulty swallowing — food or drink seeming to stick, going down slowly, or needing repeated effort. It splits into two types with different causes. Oropharyngeal dysphagia is trouble starting a swallow, often with coughing, choking or nasal regurgitation, and usually reflects a nerve or muscle problem (such as after a stroke, or in Parkinson's). Oesophageal dysphagia is the sensation of food sticking a few seconds after swallowing, behind the breastbone, and points to the food pipe itself — a narrowing from long-standing acid reflux, a motility disorder, an allergic inflammation (eosinophilic oesophagitis), a large goitre pressing from outside, or, importantly, a tumour. A classic clue pattern is difficulty with solids that progresses to liquids, with weight loss, which raises concern about a stricture or cancer and needs urgent endoscopy. Because of that, new or persistent dysphagia is treated as an alarm symptom.

• Acid reflux (GERD) and its complications — inflammation or a narrowing (stricture) of the food pipe.
• Eosinophilic oesophagitis — an allergic inflammation, often in younger adults with food sticking.
• Oesophageal motility disorders — e.g. achalasia.
• Neurological causes — stroke, Parkinson's, multiple sclerosis (usually oropharyngeal, with coughing).
• A large goitre (enlarged thyroid) — pressing on the food pipe.
• Iron-deficiency (Plummer-Vinson) web — a rare cause linked to long-standing iron deficiency.
• Oesophageal or throat cancer — uncommon but the key reason to investigate promptly.

Dysphagia is diagnosed mainly by direct examination — an endoscopy (camera test) is the priority for persistent or progressive difficulty, particularly with weight loss, to look directly at the food pipe and take biopsies. Blood tests play a supporting role: a full blood count and ferritin (iron deficiency can both cause and result from swallowing problems), TSH (a goitre or hypothyroidism), and CRP if inflammation is suspected. Imaging or a specialised swallow study is used depending on the type. Mediora.AI can surface the iron and thyroid pattern from your results, but the essential step for persistent dysphagia is prompt clinical assessment and endoscopy, not blood tests alone.