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Dysphagia in the Elderly

  • Intractable Disease in the Elderly: When Conventional Therapy Fails (S Katz, Section Editor)
  • Published:
Current Treatment Options in Gastroenterology Aims and scope Submit manuscript

Opinion Statement

Dysphagia is a common problem in the elderly population with an especially high prevalence in hospitalized and institutionalized patients. If inadequately addressed, dysphagia leads to significant morbidity and contributes to decreased quality of life. Dysphagia can be categorized as emanating from either an oropharyngeal or esophageal process. A disproportionate number of elderly patients suffer from oropharyngeal dysphagia with a multifactorial etiology. Historically, treatment options have been limited and included mostly supportive care with a focus on dietary modification, food avoidance, and swallow rehabilitation. Nascent technologies such as the functional luminal imaging probe (FLIP) and advances in esophageal manometry are improving our understanding of the pathophysiology of oropharyngeal dysphagia. Recent developments in the treatment of specific causes of oropharyngeal dysphagia, including endoscopic balloon dilations for upper esophageal sphincter (UES) dysfunction, show promise and are expected to enhance with further research. Esophageal dysphagia is also common in the elderly and more commonly due to an identifiable cause. The full breadth of treatment options is frequently unavailable to elderly patients due to comorbidities and overall functional status. However, the increasing availability of less invasive solutions to specific esophageal pathologies has augmented the number of treatment options available to this population, where an individualized approach to patient care is paramount. This review focuses on the evaluation and management of dysphagia in the elderly and delineates how standard and novel therapeutics are contributing to more nuanced and personalized management.

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Authors and Affiliations

  1. Department of Gastroenterology, Center for Esophageal Disease, NYU School of Medicine, 240 East 38th St., 23rd Floor, New York, NY, 10016, USA

    Scott M. Smukalla MD & Abraham Khan MD

  2. Department of Medicine, NYU School of Medicine, New York, NY, USA

    Irina Dimitrova MD

  3. NYU School of Medicine, New York, NY, USA

    Jeremy M. Feintuch BA

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  1. Scott M. Smukalla MD
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  2. Irina Dimitrova MD
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  3. Jeremy M. Feintuch BA
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  4. Abraham Khan MD
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Correspondence to Abraham Khan MD.

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Conflict of Interest

Scott M. Smukalla, Irina Dimitrova, and Jeremy M. Feintuch declare that they have no conflict of interest.

Abraham Khan is on the speaker bureau for EndoGastric Solutions in 2017. This company does work with GERD, which is a topic covered in minor detail in this paper.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Intractable Disease in the Elderly: When Conventional Therapy Fails

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Smukalla, S.M., Dimitrova, I., Feintuch, J.M. et al. Dysphagia in the Elderly. Curr Treat Options Gastro 15, 382–396 (2017). https://doi.org/10.1007/s11938-017-0144-0

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