Swallowing Difficulty Treatment in Sharjah

What is swallowing difficulty?

A normal swallow happens in two stages. In the first, the tongue and throat muscles push food from the mouth into the top of the gullet in a fraction of a second. In the second, a wave of muscle contraction carries it down the oesophagus, through a ring of muscle at the bottom and into the stomach. Swallowing difficulty, or dysphagia, means one of these stages is working less smoothly than it should.

Where you feel the problem is a useful clue. Trouble starting a swallow, coughing or choking as you swallow, or food going "down the wrong way" usually points to the throat stage. These throat problems are assessed by the Otolaryngology (E.N.T) team and are described on the voice and throat disorders page. A sensation of food sticking behind the breastbone a few seconds after swallowing points to the gullet itself, and that is where a gastroenterologist leads the investigation at Dar Al Kamal Hospital, Sharjah.

One detail patients rarely guess: people often point to the throat even when the hold-up is lower down in the gullet, so the doctor relies on the whole pattern of symptoms rather than the spot you point to.

Who needs it

An assessment is worthwhile if you notice any of the following for more than a week or two:

• Solid food, such as bread, rice or meat, feeling stuck in the chest
• Needing to drink water to push each mouthful down
• Tablets lodging on the way down
• Pain when swallowing
• Bringing food back up soon after eating
• Long-standing heartburn that has started to affect swallowing

The common causes of gullet-stage difficulty are each treatable once identified:

• Reflux narrowing. Years of acid reflux can leave a tight ring of scar tissue, called a stricture, near the bottom of the gullet. Reflux itself is covered on the acid reflux page.
• Eosinophilic oesophagitis. An allergy-type inflammation of the gullet lining, often seen in younger adults with a history of asthma, eczema or hay fever. Food getting stuck, especially meat, is a typical first sign.
• Motility problems. The muscle wave or the valve at the bottom of the gullet may work out of rhythm, so both solids and liquids feel slow to pass.
• Rarer causes. A growth in the gullet is an uncommon cause, and it is the reason steadily worsening swallowing is always looked into promptly.

What happens

Your first visit is a consultation. The gastroenterologist asks whether solids, liquids or both are affected, whether the problem comes and goes or is getting steadily worse, how your weight has changed, and about reflux, allergies and medicines. Some tablets irritate the gullet if they sit there, so bring a full list.

A gastroscopy is usually the key test. A slim camera passed through the mouth shows the lining of the gullet directly, and small tissue samples are taken and sent to the laboratory, because eosinophilic oesophagitis is confirmed on these samples even when the lining looks almost normal. Sedation options are explained on the anesthesia for endoscopy and sedation for procedures pages.

If a narrowing is found, it can often be stretched during the same endoscopy, using a small balloon or a gently tapered tube. This is called dilatation, and it widens the gullet so food passes more easily. Some narrowings respond best to a series of stretches spaced over weeks.

Treatment then targets the cause: medicine to reduce stomach acid for reflux strictures, anti-inflammatory treatment and sometimes dietary changes for eosinophilic oesophagitis, and further assessment for motility problems. Where the muscle function of the gullet needs measuring, specialist motility tests may be arranged. If the swallow itself needs retraining, speech and language therapy is available by referral.

Preparing for it

For the consultation, keep a short food diary for a week: which foods stick, how often, and whether water helps. You will be given fasting instructions before a gastroscopy, and an empty gullet matters more than usual here, because food can linger above a narrowing for longer than expected.

In the UAE, rice, flatbread and grilled meat are everyday foods and also the ones most likely to stick. Until you are assessed, cut food small, chew thoroughly, eat slowly and sip water between mouthfuls. If you plan to fast during Ramadan, discuss timing with the team, since rushed iftar meals after a long fast are a common moment for food to lodge.

Afterwards

After gastroscopy or dilatation you rest until any sedation wears off, then start with sips of water. A mild sore throat or chest ache for a day is common after stretching. Your gastroenterologist explains what was found, the plan for treatment and whether a repeat stretch or follow-up endoscopy is needed. Biopsy results are discussed at your clinic appointment.

Go to the emergency department straight away if food is stuck and you are unable to swallow your own saliva, or if you develop chest pain, fever, breathlessness or vomit blood after a dilatation. If swallowing is getting steadily harder and you are losing weight, call 06 599 7777 for a prompt review. For other questions, contact the hospital on the same number.

Cost and insurance

Most UAE health insurance plans cover a gastroenterology consultation and a gastroscopy requested for swallowing symptoms. Pre-approval is usually needed before endoscopy or dilatation, and biopsy analysis and sedation may appear as separate items. Dar Al Kamal Hospital, Sharjah can help you check your cover on 06 599 7777.