Understanding the Different Types of Dysphagia

Brushing your teeth shouldn’t feel like a near-death experience, but for some, just getting through a morning routine without gagging is a challenge. If you’ve ever struggled to swallow pills, gagged during dental visits, or felt like your throat has a mind of its own, dysphagia might be the reason.

This guide will walk you through the main types of dysphagia, how they work, and what signs to watch for, whether you’re dealing with it yourself or treating patients who are.

What is Dysphagia?

Dysphagia is the medical term for difficulty swallowing. In simpler terms, it means that moving food or liquid from your mouth down into your stomach isn’t as smooth as it should be. It can range from mild trouble (like needing to swallow twice) to severe cases where swallowing is painful or even impossible. Everyone might occasionally cough or choke if they eat too fast or don’t chew well, but ongoing dysphagia is more serious and usually points to an underlying issue.

For someone with dysphagia, everyday activities that others take for granted can become challenging or stressful. Here are a few real-life situations and how dysphagia can affect them:

• Eating and Drinking: Meals can be tough. People with dysphagia might feel like food is getting stuck in their throat or chest, or that it’s going down the “wrong pipe.” This can lead to coughing or gagging during meals. They often have to eat slowly, take smaller bites, or avoid certain foods (like dry bread or sticky peanut butter) that are hard to swallow. Sipping water carefully is important because even thin liquids can cause choking if they’re not swallowed properly.

• Brushing Teeth (Oral Care): Something as routine as brushing your teeth or rinsing with water can trigger problems. The act of brushing the back of the tongue or rinsing the throat may set off a strong gag reflex in someone with dysphagia. They might start coughing or even choking on toothpaste or mouthwash if they can’t swallow it quickly. This makes oral hygiene and visiting the dentist more stressful, which is a concern for dental professionals, too. A patient with dysphagia may gag easily during dental exams or when water is sprayed in their mouth.

• Swallowing Pills: Taking medications in pill form is a very common challenge for people, even those without other swallowing issues. For individuals with dysphagia, pills can be especially intimidating. They may feel a pill “stuck” in their throat or fear choking on it. It’s not unusual for them to gag or vomit when trying to swallow pills – in fact, about one in three people (dysphagia or not) have gagged or choked on a pill at some point. Many learn special tricks like using lots of water, swallowing pills with applesauce, or tilting the head in a certain way to make it easier.

Beyond these scenarios, dysphagia can also cause related issues like drooling or a hoarse voice if food regularly goes down the wrong way. It can be frustrating and embarrassing, which is why understanding and empathy are so important.

Types of Dysphagia

Doctors categorize dysphagia based on where the swallowing difficulty is happening. The main types include:

Oropharyngeal Dysphagia

This type is related to problems in the mouth and throat (the oro-pharyngeal region). It means there’s difficulty moving food from the mouth to the throat to start a swallow.

People with oropharyngeal dysphagia often cough, gag, or choke right when they try to swallow, because the food or liquid isn’t moving smoothly into the esophagus. This is sometimes called “high” dysphagia because the trouble is high up, in the throat. Neurological conditions (like a stroke or Parkinson’s disease) are a common cause of this type.

Esophageal Dysphagia

This refers to swallowing trouble that originates in the esophagus (the tube that carries food from your throat down to your stomach). With esophageal dysphagia, you might feel like food gets stuck partway down, as if it won’t go down to your stomach.

People often describe a sensation of something caught in their chest or throat after they swallow. This “lower” dysphagia is usually caused by a problem or blockage in the esophagus itself – for example, a narrowing of the esophagus or an issue with the muscular movement of the food pipe.

Functional Dysphagia

In some cases, people have significant trouble swallowing without an obvious physical cause. All the muscles and structures might look normal upon examination, yet the person feels like food or drink won’t go down properly. This is often termed functional dysphagia, meaning the difficulty is in how the swallowing works (the function) rather than a clear structural problem.

Stress and anxiety can play a role here – for instance, being extremely anxious can literally make your throat muscles tighten up, giving the sensation of a lump in the throat and making swallowing hard. You might have experienced a “lump in your throat” when anxious. That’s a mild example of how emotions can affect swallowing.

Approaches to Diagnosing and Treating Dysphagia

Diagnosing dysphagia usually starts with a conversation. A doctor, or sometimes a dentist or speech-language pathologist, will ask questions about when the swallowing issues happen, what foods or drinks cause problems, and whether there’s been any coughing, choking, or weight loss. Based on your answers, they might do a physical exam and refer you for a few simple tests.

One common test is a barium swallow, where you drink a chalky liquid and get X-rays to see how it moves down your throat. Another is a FEES test (Fiberoptic Endoscopic Evaluation of Swallowing), where a tiny camera goes through your nose to watch how you swallow. It might sound uncomfortable, but it’s quick and super helpful.

As for treatment, it really depends on what’s causing the dysphagia. If it’s muscle or nerve-related, a speech or swallowing therapist can teach exercises that strengthen those areas and improve coordination. If anxiety is playing a role, stress management or behavioral therapy can help ease the mental block around swallowing.

For people struggling with pill swallowing or gagging during brushing, products like NoGag (a natural gag reflex suppressant powder) offer a fast, non-medicated way to calm the reflex and make daily routines easier. In more serious cases, like if there’s a blockage or narrowing of the esophagus, a procedure might be needed to stretch or clear the area. No matter the cause, the key is to get help early so it doesn’t lead to bigger problems like malnutrition or aspiration.

Struggling With a Gag Reflex? Relief for All Types of Dysphagia Starts Here

Understanding the different types of dysphagia is the first step toward making everyday activities, like eating, brushing your teeth, or taking medication, feel a little less stressful. Whether you’re a dental professional looking to better support your patients or someone who struggles with a strong gag reflex, knowing what’s going on beneath the surface can make a big difference.

If gagging is part of your daily routine, you don’t have to just “deal with it.” NoGag is a fast-acting, drug-free powder designed to help calm your gag reflex and make swallowing easier. Experience less stress and order NoGag today!