Transfer (Oropharyngeal) Dysphagia

What is transfer dysphagia?

Transfer dysphagia or oropharyngeal dysphagia is a disorder pertaining to the swallowing mechanism of the mouth and upper esophagus. Patients have trouble transferring food from the mouth to the upper esophagus and completing a swallow. Symptoms are noted immediately upon swallowing and may include coughing, choking, regurgitation of food back into the mouth, and prolonged or difficult swallowing.

What causes transfer dysphagia?

This problem can be caused by muscle or nerve changes in the mouth and upper esophagus. An ENT (Ear, Nose & Throat) or neurology evaluation may be necessary to define the cause.

How is transfer dysphagia diagnosed?

  • Barium swallow studies (thick barium contrast solution is swallowed to see esophagus structures by x-ray).
  • Videofluoroscopy (swallowing action is evaluated by video).
  • Upper endoscopy (EGD is a camera scope placed in the esophagus for direct visualization of the upper GI tract).
  • Fiberoptic nasopharyngeal laryngoscopy (a scope test performed by Ear, Nose & Throat (ENT) specialists evaluating the upper esophagus and voice box).
  • Esophageal manometry (measures esophageal pressures and swallowing ability).
  • These are all tests to help diagnose transfer dysphagia. Tests may identify if esophageal contents are being aspirated (breathed into lungs) and aid in planning the best treatment options.

What are the treatments for transfer dysphagia?

Diet modification through small bites, eating slowly, and altering food consistencies may reduce difficulties. Swallow therapy may help by maneuvering the head and body and strengthen muscles to aid in swallowing. A speech pathologist can offer additional help.

When to seek medical advice for transfer dysphagia?

If painful swallowing, inability to complete swallow or food becomes stuck (impacted), or if choking occurs seek medical advice. If significant weight loss has occurred medical attention should be sought.