Author: Alicia Lasek
Common causes of swallowing problems may differ significantly between older men and women, according to physician researchers.
In a two-year swallowing clinic study, neuromuscular and esophageal problems were the most frequent causes of dysphagia among 109 study participants, reported Jeremy Applebaum, M.D., from Johns Hopkins University. Many patients (16%) had either diverticula (a soft pouch in the esophagus that can collect food particles), reflux (14%) or scarring caused by radiation treatment (8%). These problems also were associated with significant quality-of-life burden, the researchers added.
Causal differences were also found between the sexes. Men were more likely to have oropharyngeal dysphagia, a difficulty with initiating swallowing as food is introduced to the pharynx and esophagus from the mouth. In contrast, women were more likely to present with esophageal dysphagia, which can have several causes and is typically associated with the sensation of food sticking in the throat or chest after starting to swallow.
Higher rates of smoking and head and neck cancer may explain the prevalence of oropharyngeal problems found in male participants, whereas the esophageal problems in women likely were due to the high prevalence of reflux disease among that cohort, the authors surmised. They did not find significant differences in cause between older age cohorts.
Up to 33% of people age 65 and older are known to have swallowing problems due to physical changes, yet dysphasia also may be the result of underlying disease, the investigators said.
“A complaint of dysphagia in older adults should therefore be regarded as pathologic, especially given the wide spectrum of neuromuscular and structural disorders that increase in prevalence with age,” wrote Applebaum and colleagues. “We hope to inform more nuanced, patient-based approaches to this increasingly important topic,” they concluded.
The study was published in OTO Open: The Official Open Access Journal of the American Academy of Otolaryngology–Head and Neck Surgery Foundation.