Esophageal Dysphagia

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Esophageal dysphagia typically results from a motility disorder or a physical obstruction that prevents food and drink from passing easily through the esophagus. Motility disorders and obstructions that lead to esophageal dysphagia include:

Gastroesophageal reflux disease (GERD)
Eosinophilic esophagitis (EoE)
A narrowing of the esophagus (strictures)
Achalasia or other motility disorders such as Jackhammer esophagus
A non-cancerous or cancerous growth or blockage
Zenker’s diverticulum

Esophageal dysphagia is diagnosed with a variety of tests, and can often be alleviated with minimally invasive surgical or endoscopic procedures.

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Diagnostic Tests for Esophageal Dysphagia

If you experience difficulty swallowing, frequent coughing or gagging while eating, or feel like food is stuck in your throat, your doctor may recommend one or more of the following tests to determine the severity of your dysphagia.

Barium Swallow

A barium liquid is swallowed and travels the length of your esophagus. X-ray images show how food and liquid travel through your esophagus.

Upper Endoscopy (EGD)

Your doctor inserts a flexible tube into your mouth to view the inside of your esophagus, stomach, and small intestine.

Esophageal Manometry

A tiny electronic device is inserted into your nose and guided to your esophagus via a thin, flexible tube called a catheter. It evaluates motility by monitoring strength and patterns of muscle function within the esophagus.

EndoFLIP

During endoscopy, your gastroenterologist uses a device to measure pressures inside your esophagus and assess esophageal motility.

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Esophageal Dysphagia Treatments

Medical Management

Medications may be prescribed to reduce acid production and relax the esophageal muscles. Antibiotics may be prescribed for esophageal infections.

Esophageal Dilation

During an endoscopy, a balloon is passed into the esophagus. The balloon is then inflated to stretch narrowed areas that impede swallowing. Another type of dilation procedure uses a dilator passed through the esophagus during an endoscopy. This is performed as an outpatient procedure.

Heller Myotomy

During this minimally invasive procedure, your surgeon makes several small incisions and passes small surgical instruments through a laparoscope to reach the esophagus. Small cuts are made in the esophageal muscle to relieve pressure. If necessary, your surgeon may also wrap part or all of the stomach around the lower esophagus to strengthen the muscle. This is called a fundoplication.

POEM (Per-oral Endoscopic Myotomy)

This minimally invasive procedure helps people with achalasia eat and drink comfortably again. An endoscope is passed through the mouth and into the esophagus. This allows doctors to see and cut the esophageal muscle that cause the swallowing disorder. There are no surgical incisions.

Endoscopic Diverticulotomy

If you have moderate to severe Zenker’s diverticulum, your surgeon may use an endoscope to reach the esophagus and remove or change the position of the pouch that is causing your swallowing discomfort.

Esophageal Stent Placement

If your esophagus is partially blocked or narrowed, your doctor will use a small cylinder called a stent to open the esophagus and ease your symptoms. This procedure is performed through an endoscope.

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Why Choose Duke

Extensive Experience
Our gastroenterologists have completed specialized training and are highly skilled in the use of endoscopy to diagnose dysphagia and other esophageal motility disorders. Our board-certified surgeons have additional fellowship training in thoracic surgery. This includes specialized procedures in and around the esophagus.

A Team of Specialists for Your Condition
Because dysphagia can result from many different conditions, a team of experts from different specialties may be involved in your care. This may include highly trained, board-certified speech pathologists and otolaryngologists as well as gastroenterologists and neurologists. We work together to ensure you receive the best treatment for your condition.

More Complex Procedures
If your condition requires surgery, you may benefit from our use of robot-assisted surgery, which allows our surgeons to visualize the surgical site better. The precision of the robotic tools allows us to do more complex procedures in smaller areas and place sutures with greater accuracy.

Research Advances
Our specialists have made major contributions that have improved treatment and outcomes for people with esophageal dysphagia, and conducted clinical trials to uncover better treatment options. For example, Duke doctors pioneered endoscopic staple diverticulostomy (ESD), the first minimally invasive surgery for Zenker’s diverticulum.

Best Hospital for Gastroenterology and GI Surgery in NC

Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our gastroenterology and GI surgery program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2023–2024.

Related Conditions

Dysphagia

Oropharyngeal Dysphagia

This page was medically reviewed on 06/14/2023