Table of ContentsView AllTable of ContentsWhat Is Dysphagia?Functional DysphagiaOropharyngeal Dysphagia

Table of ContentsView All

View All

Table of Contents

What Is Dysphagia?

Functional Dysphagia

Oropharyngeal Dysphagia

The weight loss and malnutrition associated with anorexia can lead todysphagia, which is defined as difficulty swallowing due to physical or mental illness.

Dysphagia can result in additional medical problems that can be dangerous and even fatal. As a result, it’s essential to diagnose and treat dysphagia in a person withanorexia.

How Anorexia Is Treated

Dysphagia is a dysfunction of the swallowing muscles. It can involve any of the apparatuses involved in moving food from the mouth to the stomach. People withanorexiawho develop dysphagia usually experience one of two kinds:

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Functional Dysphagia as a Symptom of Anorexia

There are very few studies about the association between dysphagia and anorexia. One investigation noted people with functional dysphagia are often diagnosed with anorexia because the two conditions share manyclinical characteristics. For example, both conditions include symptoms like reduced appetite, weight loss, changes in food selection, and decreased food intake.

However, researchers found that the answers people with psychogenic functional dysphagia gave on a series of questionnaires were distinct from those of people with anorexia. As a result, they suggested that people with functional dysphagia don’t have eating disorders but suffer from various forms of psychological distress, especiallyanxiety.

Similarly, another study found that functional dysphagia is present in 6% of people witheating disorders, includinganorexia and bulimia.

These studies indicate that even though clinicians may come to the conclusion that functional dysphagia is a symptom of anorexia, this is rarely the case.

Nonetheless, if a doctor suspects someone with anorexia hasfunctional dysphagia, they will likely refer the patient to a speech-language pathologist who will perform an exam that rules out gastroesophageal reflux disorder (GERD) and structural abnormalities or motor disorders in the mouth and throat.

If none of these underlying issues are found but the individual is still complaining of difficulty swallowing, they will be diagnosed with functional dysphagia.

Treatment

Treatment for functional dysphagia can vary, but for people with anorexia they may be likely to include:

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Oropharyngeal Dysphagia as a Symptom of Anorexia

The severe restrictions in food consumption and excessive weight loss characteristic of anorexia often lead to muscle weakness, which can extend to the swallowing muscles, resulting in oropharyngeal dysphagia.

This is especially problematic because oropharyngeal dysphagia can lead to aspiration (i.e., taking in food or liquid into the lungs instead of the stomach), which increases the risk of pneumonia, a possibly life-threatening lung infection.

To determine if a patient has oropharyngeal dysphagia, a speech-language pathologist will take the same steps to diagnose oropharyngeal dysphagia in an individual with anorexia as they would anyone else. These steps are likely to include:

The Likelihood of Developing Oropharyngeal Dysphagia

Oropharyngeal dysphagia may be especially likely in anorexia patients who are severely ill.

For example, an extensive retrospective review of 206 adults with severe anorexia admitted to the hospital over a five-year period found that 42 had oropharyngeal dysphagia. And, this group had significantly lower BMI when they were admitted to the hospital, stayed in the hospital a week longer on average, and were much sicker than anorexia patients without oropharyngeal dysphagia.

The researchers emphasized that these issues demonstrate the need for clinicians to recognize when people with severe anorexia need to be screened for oropharyngeal dysphagia.

In two case studies (one describing three individuals with severe anorexia who had symptoms of oropharyngeal dysphagiaand one describing an individual with severe anorexia and oropharyngeal dysphagia who had developed aspiration pneumonia),speech-language pathologists administered treatment for dysphagia that involved the following:

In both case studies, the treatment improved the patients' ability to swallow, which enabled them to tolerate an oral diet. It also eliminated aspiration.

Of course, any treatment for dysphagia in anorexia patients should be administered in conjunction withtreatment for anorexia, given dysphagia is merely a symptom of theeating disorder.

Because aspiration due to oropharyngeal dysphagia is life-threatening if someone with anorexia is coughing when they consume liquids or finding it takes a lot of effort to swallow food, it’s important to consult an expert and get treatment as soon as possible.

If you or a loved one are coping with an eating disorder, contact theNational Eating Disorders Association (NEDA) Helplinefor support at1-800-931-2237.For more mental health resources, see ourNational Helpline Database.

If you or a loved one are coping with an eating disorder, contact theNational Eating Disorders Association (NEDA) Helplinefor support at1-800-931-2237.

For more mental health resources, see ourNational Helpline Database.

8 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Gaudiani JL.Dysphagia: Why Difficulty Swallowing is a Serious Red Flag in Anorexia Nervosa.Gaudiani Clinic. 2016.Aldridge KJ, Taylor NF.Dysphagia is a common and serious problem for adults with mental illness: a systematic review.Dysphagia. 2012;27(1):124-137.Barofsky I, Fontaine KR.Do psychogenic dysphagia patients have an eating disorder?.Dysphagia. 1998;13(1):24-27. doi:10.1007/PL00009545Wang X, Luscombe GM, Boyd C, Kellow J, Abraham S.Functional gastrointestinal disorders in eating disorder patients: altered distribution and predictors using ROME III compared to ROME II criteria.World J Gastroenterol. 2014;20(43):16293-16299. doi:10.3748/wjg.v20.i43.16293Functional Dysphagia.UCLA Health.Holmes SRM, Sabel AL, Gaudiani JL, Gudridge T, Brinton JT, Mehler PS.Prevalence and management of oropharyngeal dysphagia in patients with severe anorexia nervosa: A large retrospective review: Prevalence and Management of Oropharyngeal Dysphagia.Int J Eat Disord. 2015;49(2):159-166.Holmes SRM, Gudridge TA, Gaudiani JL, Mehler PS.Dysphagia in severe anorexia nervosa and potential therapeutic intervention: a case series.Ann Otol Rhinol Laryngol. 2012;121(7):449-456. doi: 10.1177/000348941212100705Holmes SRM, Gudridge TA, Gaudiani JL, Mehler PS.Dysphagia in severe anorexia nervosa: A case report.Int J Eat Disord. 2012;45(3):463-466.

8 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Gaudiani JL.Dysphagia: Why Difficulty Swallowing is a Serious Red Flag in Anorexia Nervosa.Gaudiani Clinic. 2016.Aldridge KJ, Taylor NF.Dysphagia is a common and serious problem for adults with mental illness: a systematic review.Dysphagia. 2012;27(1):124-137.Barofsky I, Fontaine KR.Do psychogenic dysphagia patients have an eating disorder?.Dysphagia. 1998;13(1):24-27. doi:10.1007/PL00009545Wang X, Luscombe GM, Boyd C, Kellow J, Abraham S.Functional gastrointestinal disorders in eating disorder patients: altered distribution and predictors using ROME III compared to ROME II criteria.World J Gastroenterol. 2014;20(43):16293-16299. doi:10.3748/wjg.v20.i43.16293Functional Dysphagia.UCLA Health.Holmes SRM, Sabel AL, Gaudiani JL, Gudridge T, Brinton JT, Mehler PS.Prevalence and management of oropharyngeal dysphagia in patients with severe anorexia nervosa: A large retrospective review: Prevalence and Management of Oropharyngeal Dysphagia.Int J Eat Disord. 2015;49(2):159-166.Holmes SRM, Gudridge TA, Gaudiani JL, Mehler PS.Dysphagia in severe anorexia nervosa and potential therapeutic intervention: a case series.Ann Otol Rhinol Laryngol. 2012;121(7):449-456. doi: 10.1177/000348941212100705Holmes SRM, Gudridge TA, Gaudiani JL, Mehler PS.Dysphagia in severe anorexia nervosa: A case report.Int J Eat Disord. 2012;45(3):463-466.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Gaudiani JL.Dysphagia: Why Difficulty Swallowing is a Serious Red Flag in Anorexia Nervosa.Gaudiani Clinic. 2016.Aldridge KJ, Taylor NF.Dysphagia is a common and serious problem for adults with mental illness: a systematic review.Dysphagia. 2012;27(1):124-137.Barofsky I, Fontaine KR.Do psychogenic dysphagia patients have an eating disorder?.Dysphagia. 1998;13(1):24-27. doi:10.1007/PL00009545Wang X, Luscombe GM, Boyd C, Kellow J, Abraham S.Functional gastrointestinal disorders in eating disorder patients: altered distribution and predictors using ROME III compared to ROME II criteria.World J Gastroenterol. 2014;20(43):16293-16299. doi:10.3748/wjg.v20.i43.16293Functional Dysphagia.UCLA Health.Holmes SRM, Sabel AL, Gaudiani JL, Gudridge T, Brinton JT, Mehler PS.Prevalence and management of oropharyngeal dysphagia in patients with severe anorexia nervosa: A large retrospective review: Prevalence and Management of Oropharyngeal Dysphagia.Int J Eat Disord. 2015;49(2):159-166.Holmes SRM, Gudridge TA, Gaudiani JL, Mehler PS.Dysphagia in severe anorexia nervosa and potential therapeutic intervention: a case series.Ann Otol Rhinol Laryngol. 2012;121(7):449-456. doi: 10.1177/000348941212100705Holmes SRM, Gudridge TA, Gaudiani JL, Mehler PS.Dysphagia in severe anorexia nervosa: A case report.Int J Eat Disord. 2012;45(3):463-466.

Gaudiani JL.Dysphagia: Why Difficulty Swallowing is a Serious Red Flag in Anorexia Nervosa.Gaudiani Clinic. 2016.

Aldridge KJ, Taylor NF.Dysphagia is a common and serious problem for adults with mental illness: a systematic review.Dysphagia. 2012;27(1):124-137.

Barofsky I, Fontaine KR.Do psychogenic dysphagia patients have an eating disorder?.Dysphagia. 1998;13(1):24-27. doi:10.1007/PL00009545

Wang X, Luscombe GM, Boyd C, Kellow J, Abraham S.Functional gastrointestinal disorders in eating disorder patients: altered distribution and predictors using ROME III compared to ROME II criteria.World J Gastroenterol. 2014;20(43):16293-16299. doi:10.3748/wjg.v20.i43.16293

Functional Dysphagia.UCLA Health.

Holmes SRM, Sabel AL, Gaudiani JL, Gudridge T, Brinton JT, Mehler PS.Prevalence and management of oropharyngeal dysphagia in patients with severe anorexia nervosa: A large retrospective review: Prevalence and Management of Oropharyngeal Dysphagia.Int J Eat Disord. 2015;49(2):159-166.

Holmes SRM, Gudridge TA, Gaudiani JL, Mehler PS.Dysphagia in severe anorexia nervosa and potential therapeutic intervention: a case series.Ann Otol Rhinol Laryngol. 2012;121(7):449-456. doi: 10.1177/000348941212100705

Holmes SRM, Gudridge TA, Gaudiani JL, Mehler PS.Dysphagia in severe anorexia nervosa: A case report.Int J Eat Disord. 2012;45(3):463-466.

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