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. 2020 Aug;18(9):1970-1979.e2.
doi: 10.1016/j.cgh.2019.10.029. Epub 2019 Oct 24.

Prevalence and Characteristics of Dysphagia Based on a Population-Based Survey

Christopher Adkins  1 , Will Takakura  2 , Brennan M R Spiegel  3 , Mei Lu  4 , Montserrat Vera-Llonch  4 , James Williams  5 , Christopher V Almario  6
Affiliations

Prevalence and Characteristics of Dysphagia Based on a Population-Based Survey

Christopher Adkins et al. Clin Gastroenterol Hepatol. 2020 Aug.

Abstract

Background & aims: Although dysphagia is common, there is limited information about the prevalence and burden of illness of dysphagia in the United States. We performed a population-based survey of more than 31,000 adults to evaluate the epidemiology, clinical characteristics, and health care-seeking behavior of individuals with dysphagia.

Methods: We performed a cross-sectional analysis of adults in the United States who completed an online, self-administered health survey from April 4 through April 19, 2018. All respondents were asked which of the following symptoms they had ever experienced (presented in random order): dysphagia, abdominal pain, bloating, bowel incontinence, constipation, diarrhea, heartburn/reflux, nausea/vomiting, or none of the above. Only respondents who selected dysphagia continued the remaining survey, which included questions about dysphagia severity, use of compensatory maneuvers, health care seeking, and esophageal comorbidities. We used multivariable regression methods to adjust for confounding.

Results: Of 31,129 individuals who participated in the survey, 4998 respondents (16.1%) reported experiencing dysphagia; 92.3% of these had symptoms in the previous week. We found that 16.3% of respondents described their dysphagia over the previous 7 days as either quite a bit or very severe. Drinking liquids to help with dysphagia (86.0%) and taking longer to finish eating (76.5%) were the most common compensatory maneuvers. Overall, 51.1% of individuals sought care for their difficulty swallowing; older age, male sex, having a usual source of care and insurance, having comorbidities, and more severe dysphagia symptoms increased the odds for seeking care (P < .05). The most commonly reported esophageal comorbidities were gastroesophageal reflux disease (30.9%), eosinophilic esophagitis (8.0%), and esophageal stricture (4.5%).

Conclusions: In a large population-based survey, we found that dysphagia is common; 1 of 6 adults reported experiencing difficulty swallowing. However, half of individuals have not discussed their symptoms with a clinician and many could have treatable disorders.

Keywords: Difficulty Swallowing; Eosinophilic Esophagitis; Epidemiology; Gastroesophageal Reflux Disease.

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Conflict of interest statement

DISCLOSURES: Mei Lu and James Williams are employees of Shire, a member of the Takeda group of companies, and hold stock in the company. Montserrat Vera-Llonch is an ex-employee of Shire, a member of the Takeda group of companies, and holds stock in the company. Brennan M.R. Spiegel has received grant support from Shire, a member of the Takeda group of companies, and Takeda Pharmaceuticals and has served on advisory panels for Takeda Pharmaceuticals and Salix Pharmaceuticals. Christopher V. Almario has received a speaker’s fee from Takeda Pharmaceuticals. Christopher Adkins and Will Takakura do not have any relevant personal or financial disclosures to declare.

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