Testing & Diagnosis for Dysphagia in Children

Children with dysphagia usually have trouble eating enough, leading to inadequate nutrition and failure to gain weight or grow properly.

What are the symptoms of dysphagia?

Children with dysphagia may have obvious symptoms or may have have some that are difficult to associate with swallowing trouble. There are many common symptoms of dysphagia, but each individual may experience symptoms differently. Symptoms may include:

  • eating slowly
  • trying to swallow a single mouthful of food several times
  • difficulty coordinating sucking and swallowing
  • gagging during feeding
  • drooling
  • a feeling that food or liquids are sticking in the throat or esophagus, or that there is a lump in these areas
  • discomfort in the throat or chest
  • congestion in the chest after eating or drinking
  • coughing or choking when eating or drinking (or very soon afterwards)
  • wet or raspy sounding voice during or after eating
  • tiredness or shortness of breath while eating or drinking
  • frequent respiratory infections
  • color change during feeding, such as becoming blue or pale
  • spitting up or vomiting frequently
  • food or liquids coming out of the nose during or after a feeding
  • frequent sneezing after eating
  • weight loss

How is dysphagia diagnosed?

Your physician will examine your child and obtain a medical history. You will be asked questions about how your child eats and any problems you notice during feeding.

Imaging tests may also be done to evaluate the mouth, throat, and esophagus. These tests can include:

  • Oral-pharyngeal video swallow. Your child is given small amounts of a liquid containing barium to drink with a bottle, spoon, or cup, or spoon fed a solid food containing barium. Barium shows up well on x-ray. A series of x-rays are taken to evaluate what happens as your child swallows the liquid.
  • Barium swallow/upper GI series. Your child is given a liquid containing barium (a metallic, chemical, chalky, liquid used to coat the inside of organs so that they will show up on an x-ray) to drink, and a series of x-rays are taken. The physician can watch what happens as your child swallows the fluid, and note any problems that may occur in the throat, the esophagus, or the stomach.
  • Endoscopy. This test uses a small, flexible tube with a light and a camera lens at the end (endoscope) to examine the inside of part of your child's digestive tract. An endoscopy is performed under anesthesia. Pictures are taken of the inside of the throat, the esophagus, and the stomach to look for abnormalities. Small tissue samples, called biopsies, can also be taken to look for problems.