Dysphagia Symptoms: Early Signs, Causes & Warning Symptoms

Quick Glance: Common Dysphagia Symptoms

Dysphagia symptoms can differ depending on whether the swallowing problem affects the mouth and throat or the oesophagus.

Common dysphagia symptoms include:

Difficulty swallowing food, liquids or saliva
Feeling that food is stuck in the throat or chest
Coughing or choking while eating or drinking
Taking longer than usual to chew or swallow
Food or liquid coming back through the mouth or nose
Drooling or difficulty managing saliva
A wet or gurgly voice after eating or drinking
Unexplained weight loss or dehydration

Some people may also avoid certain foods, take smaller bites or change food textures because swallowing has become difficult.

Dysphagia Symptoms That Should Not Be Ignored

Persistent swallowing problems can interfere with eating, drinking and affect airway protection. As a result, swallowing symptoms that recur, worsen, or lead to weight loss and chest infections require medical evaluation.

Some dysphagia symptoms that should not be ignored include:

Symptom	What It May Indicate
Recurrent difficulty swallowing	Indicates an ongoing problem affecting the swallowing muscles, nerves or oesophagus
Food repeatedly feeling stuck in the throat or chest	Signals impaired movement or narrowing along the swallowing pathway
Coughing or choking during meals	Suggests food or liquid may be entering the airway
Wet or gurgly voice after swallowing	Points to food, liquid or secretions remaining around the throat or airway
Repeated chest infections	Indicates possible aspiration of food, liquid or saliva
Unexplained weight loss	Reflects reduced food intake due to swallowing difficulties
Signs of dehydration	Points to difficulty drinking enough fluid safely
Painful swallowing (odynophagia)	Indicates inflammation, infection or another underlying disorder

Why Do Dysphagia Symptoms Occur?

Dysphagia symptoms occur when the muscles, nerves or structures involved in swallowing do not move food and liquids safely towards the stomach. Such poor coordination in the mouth or throat can make swallowing difficult and cause coughing, choking, nasal regurgitation or a wet voice.

If the oesophagus is narrowed or its muscle contractions do not work properly, food may feel stuck in the throat or chest or come back up. However, if food, liquid or saliva enters the airway instead, it typically triggers coughing. In some cases, this happens without any coughing or choking, which is a condition known as silent aspiration.

If left unmanaged, persistent swallowing difficulty can also reduce food and fluid intake, leading to weight loss, malnutrition or dehydration.

Dysphagia Symptoms That Require Immediate Medical Attention

Some swallowing problems can obstruct the airway, prevent a person from swallowing normally or indicate a neurological emergency.

Seek immediate medical attention for:

Severe choking or difficulty breathing
Inability to swallow food, liquids or saliva
Food becoming completely stuck with the inability to swallow saliva
Blue or grey lips or skin during choking
Sudden swallowing difficulty with facial drooping, speech problems or weakness in an arm or leg
Severe breathing difficulty after food or liquid enters the airway
Reduced consciousness following choking or aspiration

Sudden dysphagia accompanied by neurological symptoms may indicate a stroke, while severe choking or airway obstruction can immediately interfere with breathing.

Symptoms of Dysphagia Based on Type

Dysphagia is commonly classified based on whether the swallowing problem primarily affects the mouth and throat or the oesophagus. The symptom pattern can help doctors diagnose the condition, although symptoms alone may not always identify the exact location.

A breakdown of dysphagia symptoms based on types is outlined below:

Type of Dysphagia	Common Symptoms
Oropharyngeal dysphagia	Difficulty starting a swallow, coughing or choking during swallowing, drooling, nasal regurgitation, wet or gurgly voice and difficulty controlling food or liquid in the mouth
Oesophageal dysphagia	Sensation of food sticking after swallowing, food or liquid moving slowly through the oesophagus, regurgitation and difficulty swallowing solids or sometimes both solids and liquids

Symptoms of Dysphagia in Children

Dysphagia in infants and children may be noticed during feeding rather than described as difficulty swallowing. Symptoms can vary with the child's age and stage of feeding development.

Symptoms of dysphagia that parents or carers may notice include:

Difficulty sucking, chewing or swallowing
Coughing or choking during feeds
Regurgitating food or liquid through the nose
Drooling excessively or struggling to manage saliva
Developing a wet or gurgly voice during or after feeding
Difficulty coordinating sucking, swallowing and breathing
Taking unusually long to finish meals or feeds
Refusing certain foods or textures
Developing repeated respiratory or chest infections
Gaining weight slowly or showing signs of undernutrition

Can You Have Dysphagia Without Symptoms?

The subtle signs of dysphagia like difficulty swallowing can go unnoticed. In particular, silent aspiration occurs when food, liquid, or saliva enters the airway without triggering natural protective reflexes like coughing or choking. Because obvious signs are absent, recurring chest infections, unexplained weight loss, dehydration, or subtle changes in eating habits may be the only clues to an underlying swallowing problem.

When Can Dysphagia Symptoms Become Life-Threatening?

Dysphagia can become dangerous when swallowing problems interfere with breathing, cause severe aspiration or prevent adequate food and fluid intake.

The table below highlights dysphagia symptoms that may indicate a serious complication:

Symptom	Why It Is Serious
Severe choking with inability to breathe	Food or another substance may be blocking the airway and preventing oxygen from reaching the lungs
Blue or grey lips or skin during choking	May indicate dangerously reduced oxygen levels
Inability to swallow saliva with food completely stuck	May indicate complete oesophageal obstruction requiring urgent assessment
Difficulty breathing after swallowing food or liquid	May indicate significant aspiration into the airway
Fever, breathlessness and worsening cough after repeated aspiration	May indicate aspiration-related lung infection
Very little urine, marked weakness or confusion with poor fluid intake	May indicate severe dehydration
Sudden swallowing difficulty with facial drooping, speech difficulty or limb weakness	May indicate an acute neurological event such as a stroke

How are Dysphagia Symptoms Diagnosed?

Doctors and swallowing specialists select tests according to the symptoms and whether the problem appears to involve the mouth and throat or the oesophagus.

The following assessments may be used by doctors for dysphagia:

Diagnostic Test or Assessment	Purpose
Medical and swallowing history	Reviews when swallowing difficulty occurs, which foods or liquids trigger it and whether coughing, choking or weight loss is present
Clinical swallowing assessment	Assesses oral movements, swallowing function, voice changes and signs of coughing or choking
Videofluoroscopic swallow study (VFSS)	Uses X-ray imaging to assess how food and liquid move through the oral and pharyngeal stages of swallowing
Fibreoptic endoscopic evaluation of swallowing (FEES)	Uses a flexible camera passed through the nose to assess swallowing and airway protection
Barium swallow or oesophagram	Uses contrast and X-rays to assess the structure and movement of the oesophagus
Upper gastrointestinal endoscopy	Examines the oesophagus for inflammation, narrowing, obstruction or other structural abnormalities
Oesophageal manometry	Measures pressure and muscle contractions in the oesophagus to assess motility disorders

FAQs

Q1. What is the first symptom of pulmonary edema?

Ans: Shortness of breath is one of the most common symptoms of pulmonary edema. It may occur during activity or when at rest.
Q2. Can pulmonary edema develop without noticeable symptoms?

Ans: Pulmonary edema is not usually completely silent. When it develops gradually, early symptoms may be subtle.
Q3. Which pulmonary edema symptoms should never be ignored?

Ans: Severe or sudden breathlessness, difficulty breathing at rest, coughing up frothy or pink-tinged sputum, blue or grey lips or skin, chest pain, confusion and inability to speak in full sentences are critical warning signs of pulmonary edema and should never be ignored.
Q4. Is coughing a symptom of pulmonary edema?

Ans: Yes. Coughing can occur when fluid accumulates in the lungs. In more severe cases of pulmonary edema, the cough may produce frothy, pink or blood-tinged sputum.
Q5. Is difficulty breathing when lying down a symptom of pulmonary edema?

Ans: Yes. Difficulty breathing while lying flat, known as orthopnoea, can occur when pulmonary congestion increases, particularly when pulmonary edema is associated with heart problems.
Q6. Are pulmonary edema symptoms different in men and women?

Ans: There is no major clinically recognised difference in the typical symptoms of pulmonary edema based solely on sex. Breathlessness, cough and breathing difficulties can occur in both men and women.
Q7. Can pulmonary edema symptoms vary in intensity?

Ans: Yes. Acute pulmonary edema can cause severe symptoms rapidly. On the other hand, gradual cases may initially cause milder breathlessness.
Q8. Which symptoms indicate a pulmonary edema emergency?

Ans: Sudden severe breathlessness, a feeling of suffocation, coughing up frothy or pink-tinged sputum, blue or grey skin, chest pain, confusion, collapse or inability to speak because of breathlessness are emergency warning signs of pulmonary edema. Seek emergency medical care immediately.

References
- https://www.mayoclinic.org/diseases-conditions/dysphagia/symptoms-causes/syc-20372028
- https://www.asha.org/practice-portal/clinical-topics/pediatric-feeding-and-swallowing/
- https://www.asha.org/practice-portal/clinical-topics/adult-dysphagia/
- https://www.nhs.uk/symptoms/swallowing-problems-dysphagia/
- https://www.mayoclinic.org/diseases-conditions/dysphagia/diagnosis-treatment/drc-20372033