Swallowing difficulties

Oesophageal disorders may manifest in various ways, with symptoms usually related to swallowing. While swallowing difficulties may in themselves cause significant discomfort to individuals suffering from these disorders, they may also be an indicator of serious, life-threatening problems.

Such symptoms include:

  • Dysphagia (difficulty swallowing)
  • Odynophagia (painful swallowing)
  • Food bolus impaction
  • Chest pain
  • Regurgitation


Causes can be divided into:

  • Inflammation in the oesophagus
  • Physical obstruction
  • Motility disorders


Inflammation of the oesophagus can be caused by infections or non-infectious diseases:

  • Infections
    • e.g. candida, herpes viruses
  • Non-infectious disease
    • e.g. gastro-oesophageal reflux disease, eosinophilic oesophagitis

Physical obstruction can be caused either by a lesion inside the oesophagus or something outside the oesophagus pressing on it. Examples include:

  • Stricture from gastro-oesophageal reflux disease
  • Oesophageal tumours
  • Enlarged heart or chest tumour


Motility disorders are problems with the normal contraction of the oesophageal muscle. Abnormal contractions may be excessive or reduced. Motility disorders may also mimic gastro-oesophageal reflux disease. Examples of oesophageal motility disorders include:

  • Achalasia
  • Oesophageal spasm
  • Absent peristalsis (no contraction of the oesophagus)


Recently there have been significant advances in the investigation and understanding of oesophageal motility disorders. The development of high resolution oesophageal manometry has played a key role in these advances (See High resolution manometry).