If you’re having trouble swallowing, it could be a sign of this devastating disease

Does your lunch break come with a significant amount of coughing and hacking? Do you avoid drinking water, just because you’re afraid to choke on it? Unfortunately, your difficulties swallowing can be an early sign of Parkinson’s disease, a brain disorder with few treatments, and no cure.

What is dysphagia?

Dysphagia is, more simply, a medical term for “difficulty swallowing.” It can occur when the muscles of the esophagus are weakened, too loose, too tight, or one’s diaphragm is atrophied. It can also be a result of brain damage, nerve damage, or just eating too fast or not chewing enough.

Dysphagia can occur in a number of different permutations, namely esophageal dysphagia in your esophagus, or oropharyngeal dysphagia in your mouth and throat. While esophageal dysphagia can be indicative or caused by a number of physical illnesses including scleroderma, in which the dysphagia is caused by hardened tissues in the throat, or GERD, in which the acid from your stomach causes esophageal damage, oropharyngeal dysphagia is more about your neurological health.

Oropharyngeal dysphagia is caused by multiple scleroses, muscular dystrophy, brain damage or spinal cord injury, and is even an early sign of Parkinson’s disease.

Dysphagia is a common symptom of Parkinson’s, as more than 80% of patients will develop it over the course of their disease. If the dysphagia progresses, it can cause complications like malnutrition or aspiration pneumonia, the latter of which constitutes one of the most prevalent causes of death in Parkinson’s disease.

In Parkinson’s specifically, the cause of dysphagia is still being researched. However, research from the University of Muenster notes that “dopaminergic and non-dopaminergic mechanisms are involved in the development of dysphagia,” meaning that a lack of the neurotransmitter dopamine can cause this symptom, as it causes more other symptoms in Parkinson’s disease.

In a 2019 article in the Journal of Movement Disorders, oropharyngeal dysphagia is reportedly underdiagnosed in the early stages of Parkinson’s, “probably due to poor self-awareness of the conditions and the underuse of validated tools and objective instruments for assessment.” The study notes that if detected early, dysphagia is “closely related” to a better prognosis in Parkinson’s, and increased quality of life for the patient.

How do I know if I have it?

If you’re chewing slowly and not eating too quickly, and still find yourself having some trouble swallowing, there are a couple of symptoms of dysphagia that might be good to keep an eye out for.

If you start losing weight without trying, have severe heartburn, a sore throat, or have a sensation that food is often stuck in your throat, those are some common symptoms of dysphagia. You’ll also suffer from frequent coughing while eating or choking, food coming back up (sometimes through your nose), or persistent drooling.

Note that some of these symptoms happen to everyone at some point in their lives – if you notice them happening every time you eat, however, it could be indicative of an underlying illness.

What do I do if I think I have it?

First thing’s first: if you believe that you have dysphagia, make your way to the nearest gastroenterologist. The prognosis for most degenerative conditions is good if they’re caught early, so delaying a doctor’s appointment could, in some situations, mean life or death. To confirm your dysphagia, there are a number of tests like a dynamic swallowing study, x-rays, or a fiber-optic endoscopy.

It’s impossible to self-diagnose with dysphagia, even if you believe you have all the symptoms unless you’re a GI doctor yourself, and even then, you might want some medical confirmation.

If you do have dysphagia, you’ll likely be assigned a speech and language therapist to help learn new swallowing techniques, like exercising your throat and swallowing harder. You can also change the consistency of your food and beverages and cut back on things that are harder to chew.

For more severe cases of dysphagia, your doctor might tell you to try alternative forms of feeding, like a feeding tube. You can also have a stent placed in your throat to widen your esophagus, in the case of esophageal dysphagia.

In the case of your dysphagia indicating Parkinson’s disease, there are other options. Some patients have chosen collagen injections which typically provide temporary relief, and others report that Parkinson’s medications, like Apomorphine, can lend some relief to their difficulty swallowing.