It is estimated that one in 25 adults will experience swallowing difficulties each year. As the likelihood of dysphagia increases with age, potentially 50-70 per cent of care home residents may have swallowing difficulties. Dysphagia is also seen in around 5 per cent of adults with a learning disability.^2,3

It is common in neurological disorders such as dementia, Parkinson’s disease, progressive supranuclear palsy and multiple sclerosis. It also occurs in autoimmune diseases such as HIV, Sjögren’s syndrome (characterised by reduced tear and saliva secretions), systemic lupus erythematosus, or rheumatoid arthritis. Scleroderma is an autoimmune disease attacking connective tissue and causing excess collagen production, with the oesophagus sometimes being affected.^2,3,7

Intubation and ventilation often result in dysphagia to some degree, as can trauma or surgery such as tracheostomy or thyroidectomy. More than half of people with head and neck cancer may develop dysphagia due to the disease itself, surgery, or radiological treatment. Up to three quarters of acute stroke patients have dysphagia, with many having some residual dysphagia in the longer term.^2,3,8

Other conditions causing a narrowing or obstruction in the throat or oesophagus include:^8,9,10,11

• pharyngeal pouch or Zenker diverticulum, a rare condition where a weakness in the lower pharynx leads to a hernia-like sac or bulge developing
• eosinophilic oesophagitis, where white blood cells accumulate as a reaction to foods, allergens or gastric reflux, resulting in chronic inflammation and fibrosis
• infections such as tuberculosis or thrush
• scar tissue from gastric reflux
• congestive heart failure if cardiac enlargement means there is pressure on the oesophagus.