September 09, 2013
By Robert H. Shmerling M.D.
Beth Israel Deaconess Medical Center
Imagine you've just seen your doctor because you're having trouble swallowing. Sometimes, food seems to get stuck going down or it hurts. Your doctor listens to the details carefully and then tells you what he thinks.
"I'm not sure yet why you have dysphagia. But we can usually figure it out, so I'm going to order a couple of tests."
Wait a minute. Who said anything about dysphagia? It sure sounds medical. But, is it bad? Should you be worried?
Dysphagia is just "medical-speak" for trouble swallowing. Your doctor forgot that you may have no idea what he is saying.
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Where the Word Comes From
The word dysphagia comes from the Greek"dys," meaning abnormal or bad, and "phagia," which refers to eating. Your doctor would say you had dysphagia if you described foods or drinks sticking in your throat. But if you had sores in your mouth, ill-fitting dentures or indigestion, the term dysphagia would not be used, even though each of these problems might make it difficult to eat.
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Common "Phagia" Terms You May Hear
The act of swallowing requires a well-coordinated series of events within the mouth, esophagus and stomach. When your doctor is describing something abnormal related to swallowing or eating, he may call it:
- Dysphagia - difficulty swallowing
- Odynophagia - painful swallowing
- Polyphagia (or hyperphagia) – overeating, often (but not always) associated with increased appetite
- Hypophagia - undereating
- Aerophagia - swallowing of air, which may cause abdominal bloating or belching. It's well known to any parents of a newborn, but it's also a common cause of excessive belching for adults as well.
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Non-Medical "Phagia Words
The "phagia" suffix is used in several non-medical contexts. For example:
- Hyperphagia - While this refers to overeating, it can also refer to a stage that bears enter in the late summer and fall, just before they start hibernating. You can probably guess what happens during this stage. Bears go on a feeding frenzy, adding two or more pounds a day in anticipation of the long sleep.
- Omophagia - While sushi-lovers embrace the idea of eating certain foods raw, some people will eat raw food exclusively. Omophagia, the eating of raw food, is also part of a lifestyle for people who believe that the more raw food in the diet (including raw meat and unprocessed foods) the better.
- Xylophagous - This term describes insects or larvae that feed on wood. If you've ever had a problem with termites, you're familiar with this concept. Interestingly, termites don't actually digest wood themselves; they depend on microorganisms (called protozoa) within their guts to digest wood into useful nutrients. (Humans get help with digestion from bacteria and enzymes.)
- Macrophage and phagocyte - A macrophage is a type of white blood cell or organism that is capable of ingesting bacteria or other foreign substances. A phagocyte is any cell (including macrophages) that can ingest foreign organisms or material. Phagocytosis is the process of ingestion and plays an important role in the immune (defense) system.
- Bacteriophage - These are viruses that can infect bacteria. In some cases, viral infections of bacteria make them resistant to antibiotics.
The Bottom Line
Now you know more than you'll ever need to know about dysphagia and related terms. If your doctor asks you if you have any problems eating, resist the temptation to use your newly acquired medical fluency. I think it's best for doctors and patients to use plain language to communicate. But, sometimes we doctors have to be reminded.
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Robert H. Shmerling, M.D., is associate physician at Beth Israel Deaconess Medical Center and associate professor at Harvard Medical School. He has been a practicing rheumatologist for over 20 years at Beth Israel Deaconess Medical Center. He is an active teacher in the Internal Medicine Residency Program, serving as the Robinson Firm Chief. He is also a teacher in the Rheumatology Fellowship Program.