What it means
Dysphagia is difficulty swallowing — from the Greek dys, difficult, and phagein, to eat. It is distinct from odynophagia, which is painful swallowing, and from globus, the sensation of a lump in the throat with normal swallowing.
Two patterns:
- Difficulty initiating a swallow, with coughing or choking — usually neurological, as after a stroke
- Food sticking after swallowing — usually an obstruction or motility problem in the oesophagus
Progression from solids to soft foods to liquids over weeks strongly suggests a narrowing that is getting worse, and is the pattern that matters most.
In practice
Investigated by endoscopy rather than by scan, since endoscopy allows both direct inspection and biopsy.
Causes include benign strictures from acid reflux, eosinophilic oesophagitis, achalasia and oesophageal cancer.
Why it matters
Persistent difficulty swallowing is an urgent suspected cancer referral symptom in NICE guidance, at any age. It should be assessed within two weeks, not managed with acid-suppressing medication and review.
This is a specific instance of a general rule on this site: we will not treat reflux remotely in anyone whose main problem is that food is sticking. That needs a camera.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 30, 2026