Swallowing Disorder (Dysphagia): Symptoms, Complaints, Signs

The following symptoms and complaints may occur together with dysphagia:

Leading symptom

  • Dysphagia (difficulty swallowing) – if this occurs with a feeling of pressure/pain in the thorax (chest) and/or abdomen (stomach), this is known as odynophagia (pain on swallowing).

Associated symptoms

  • “Drooling”: drooling, leakage of saliva (sialorrhea) or food pulp from the mouth.
  • Nasal regurgitation (reflux of ingested food/fluid through the nose).
  • Tracheobronchial aspiration (inhalation of a foreign body into the lungs) → coughing, shortness of breath
  • Hoarseness
  • Clearing throat
  • Regurgitation: choking out food
  • Hiccups (singultus)
  • Wheezing breathing sound

The Dysphagia Working Group of the German Geriatrics Society (DGG) has presented its Dysphagia Screening Tool Geriatrics (DSTG): Dysphagia Screening Tool Geriatrics: DSTGFurthermore, training material on the use of the Dysphagia Screening Tool Geriatrics is available: training on the use of the Dysphagia Screening Tool Geriatrics.

Warning signs (red flags)

  • Anamnestic information
    • Age > 45 years → think of: Esophageal cancer (cancer of the esophagus).
    • Acute onset → think of: Esophageal carcinoma (esophageal cancer).
    • Weight loss → think of: Esophageal cancer, possibly also strictures (high-grade narrowing) in the upper gastrointestinal tract (gastrointestinal tract).
  • Stuck eating, weight loss, and progressive symptoms → think of: Tumor diseaseThe high-risk group includes esp. patients over 50 years who smoke or drink excessively.
  • Supraclavicular lymph node enlargement (Virchow’s gland) → think of: Gastric carcinoma (stomach cancer)
  • Retrosternal (“behind the sternum“) pain and/or intermittent (“intermittent”) dysphagia → think of: Reflux disease (caused by frequent reflux of acidic gastric juice and other gastric contents into the esophagus (food pipe)).