Abstract
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. 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. 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%). 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.
Highlights
BACKGROUND & AIMSMETHODS: RESULTS: CONCLUSIONS: dysphagia is common, there is limited information about the prevalence and burden of illness of dysphagia in the United States
In a large population-based survey, we found that dysphagia is common; 1 of 6 adults reported experiencing difficulty swallowing
Of the 62 individuals who prepared it themselves, 20 (32.3%) said that it was inconvenient, 19 (30.6%) reported that it was either somewhat convenient or convenient, and 23 (37.1%) rated it as very or extremely convenient. For those following the elimination diet and who knew how much they spent at the grocery store (n 1⁄4 121), 59 (48.8%) stated that they were spending more money on food compared with their previous diet, 31 (25.6%) spent approximately the same, 29 (24.0%) were spending less, and 2 (1.7%) were unsure. In this population-based survey of more than 31,000 Americans we found that dysphagia is common, affecting 16.1% of adults at some point during their lives
Summary
METHODS: RESULTS: CONCLUSIONS: 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. 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. Respondents who selected dysphagia continued the remaining survey, which included questions about dysphagia severity, use of compensatory maneuvers, health care seeking, and esophageal comorbidities.
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