Functional Dysphagia. Disorders of Gut-brain interaction. picture of brain with half black and white and half multi colored and GI anatomy. Cat Ludwig RD, CLT on teal colored gradient background

What is Functional Dysphagia?

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Brain and gut pictures. Functional Dysphagia. Disorders of Gut-Brain Interaction
Functional Dysphagia – Disorders of Gut-Brain Interaction

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Stephanie Peper, MA, CCC-SLP & Cat Ludwig, RDN, LD

So you’ve been told there is nothing wrong with you, but you still are struggling with swallowing food and liquids. You know something is off. You know this isn’t right. But your (insert healthcare professional here) told you that you are fine.

You’ve gone through a modified barium swallow, and a FEES, and a Manometry, and possibly even an upper GI endoscopy. Maybe even others!

You still are struggling, but they told you your tests are normal. Go home and eat.

But you still can’t…

What do you do now???

First….Let’s Talk Dysphagia

Dysphagia is difficulty swallowing. Often caused by another health problem, a physical abnormality or other random reason. Regardless, it can cause significant problems to your mental, emotional, and physical health.

Traditional Dysphagia is treated by a medical doctor, other specialists AND a Speech Language Pathologist. You may have had a referral to a GI specialist and had a radiologist do your testing. The SLP can read your test results and decide on the right treatment plan. A dietitian should also be part of your treatment plan and can help improve your nutritional status, which will ultimately help you be more successful at gaining (and keeping!) your strength.

So What is Functional Dysphagia?

Functional Dysphagia, also known as functional esophageal disorder, describes the diagnosis given when the symptoms do not match the physical structures. This means you make have heartburn, other chest pain, difficulty swallowing, or a globus sensation but there is not a structural abnormality, GERD, or other motor disorder.

Called functional dysphagia, it is better described as the sensation of food getting stuck on the way down, or a delay in food moving down the esophagus. It can cause frustration, fear, anxiety, and more.

Cause of Functional Dysphagia

Some scientists believe that the cause of such a problem may be related to the brain and how it interprets information. It may either be extremely sensitive to information or it overreacts to the information it is receiving. Both are detrimental to the way your body deals with information, and food.

Symptoms of Functional Dysphagia

The symptoms vary for each person. Before getting a diagnosis of Functional Dysphagia, you must rule out other diagnoses first. You must be negative for GERD, have no structural problems, and have no motility issues.

  • Chest pain or discomfort, especially behind the sternum
  • Heartburn, not improved with antacids or PPIs
  • Reflux
  • Food sticking or feeling stuck
  • Globus – sensation (not painful) of something stuck in the throat

Treatment

Each person is different. Your treatment needs to be tailored to you and your specific situation. It is important to address you as a whole person and not just one aspect of your life.

You may find relief with swallowing therapy from a Speech Therapist, behavioral therapy or hypnosis, meditation, or even acupuncture. Medication may be helpful for treating reflux, anxiety, or pain. A combination of all may be the most beneficial.

The Rome Foundation is an independent group that helps diagnose and treat disorders like Functional Dysphagia. They are working to “the continuous development, legitimization and preservation of the field of DGBIs through science-based activities”.

Conclusion

Knowing what to call your swallowing problem can bring a small amount of clarity. Finding the right support will bring you hope.

Many people are dealing with these issues, you are not alone. You are told that you are fine but you are scared of eating, or continue to have symptoms. If this sounds like you we would love to hear your story.

Please contact us at Dysphagiaduo@gmail.com, or on Facebook or Instagram. We are here to help and want to know what you are going through.

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