Surgery & Treatment
Investigation of Swallowing Difficulties (Dysphagia)
Difficulty swallowing, known as dysphagia, can be worrying and uncomfortable. It may present as food “sticking,” coughing or choking when eating or drinking, or discomfort when swallowing. Dysphagia can result from a wide range of causes — from minor throat irritation to muscle or nerve problems, or narrowing in the oesophagus.
Our clinic provides a thorough and supportive pathway to investigate the cause of dysphagia and plan the right treatment for you.
1. Booking Your Appointment with the Team
Booking an appointment is simple. Contact our team and we’ll arrange a consultation at a time that works for you. Because swallowing difficulties can have many different causes, we aim to see you promptly to provide reassurance and start investigations without delay.
2. What the Consultation Will Involve
At your first visit, our specialist will:
- Take a detailed history of your symptoms (when they occur, what foods are difficult, whether you’ve had weight loss or pain).
- Ask about your general health, medical history, and lifestyle.
- Perform an initial examination of your mouth, throat, and neck.
This initial step helps guide the choice of further investigations.
3. Diagnostic Investigations
Depending on your symptoms, we may recommend one or more of the following:
- Flexible nasendoscopy a small camera passed gently through the nose to look at your throat and voice box.
- Videofluoroscopy (swallow X-ray) a moving X-ray taken while you swallow a contrast liquid or food.
- Fibreoptic Endoscopic Evaluation of Swallowing (FEES) a small scope to watch swallowing in real time.
- Barium swallow an X-ray study to check how food and drink move down the oesophagus.
- Endoscopy (oesophagoscopy/gastroscopy) a camera test to look inside the oesophagus and stomach.
- High-Resolution Manometry (HRM) a specialist test that measures the pressure and coordination of the muscles in your oesophagus to detect motility disorders such as achalasia or spasm.
- Imaging (CT, MRI, or ultrasound) — if further detail is needed.
These tests help us identify whether dysphagia is caused by structural narrowing, reflux, neurological conditions, or problems with oesophageal movement.
4. Involvement of Other Professionals
You may also be supported by a wider multidisciplinary team, which can include:
- Speech and language therapists experts in swallowing rehabilitation and safe eating strategies.
- Dietitians to ensure you maintain proper nutrition and hydration.
- Physiotherapists or osteopaths if posture or muscle tension is contributing.
- Gastroenterologists if investigation of the stomach is needed.
- Upper GI Surgeons in the rare instance of surgery of the oesophagus being required.
This team-based approach ensures both safety and comfort during eating and drinking.
5. Surgery If Required and What It Would Involve
If investigations reveal a narrowing, growth, or structural problem, surgery may be recommended. Options can include:
- Endoscopic dilatation gently stretching the oesophagus.
- Removal of growths or scar tissue using minimally invasive techniques.
- Anti-reflux surgery if severe reflux is contributing.
All surgical decisions are carefully explained, with your safety and comfort as the highest priorities.
6. Post-Operative Aftercare
After surgery, our team will support your recovery with:
- Dietary guidance to help you safely reintroduce foods.
- Swallowing therapy to rebuild strength and coordination.
- Follow-up appointments to monitor healing and progress.
Our aim is to help you return to eating and drinking with confidence and comfort.
When to Seek Urgent Medical Attention
While many causes of dysphagia are not serious, some symptoms require urgent review. According to NICE (National Institute for Health and Care Excellence) guidelines, you should see a doctor straight away (within two weeks under the urgent referral pathway) if you have:
- Progressive difficulty swallowing (getting steadily worse)
- Unexplained weight loss
- A persistent lump in the neck
- Pain when swallowing (odynophagia)
- Regurgitation of food or choking episodes
- Persistent hoarseness or voice changes alongside swallowing problems
If food becomes completely stuck or you are unable to swallow fluids, attend the nearest emergency department immediately.
Early investigation is key to identifying the cause of swallowing problems. If you’re concerned about dysphagia, our team is here to provide reassurance, clarity, and the right care for you.