Frequency of dysphagia among patients submitted to a rheumatology department: a cross-sectional analysis based on the EAT-10 questionnaire

Rheumatol Int. 2025 Aug 12;45(9):196. doi: 10.1007/s00296-025-05952-x.

Abstract

Symptoms related to difficulty in swallowing and bolus transfer from the oral towards the gastric cavity have been collectively termed "dysphagia". The etiology, gravity and complications of dysphagia warrant a rigorous, often multidisciplinary diagnostic evaluation and individualized management. The present study aimed to evaluate the prevalence of dysphagia among patients with rheumatic and musculoskeletal diseases (RMDs) and identify associated risk factors. This cross-sectional study included 340 consecutive patients diagnosed with RMDs from the Department of Rheumatology and Clinical Immunology situated at the Larissa University General Hospital. Dysphagia was assessed using the Eating Assessment Tool-10 (EAT-10). Univariate and multivariate analyses were performed to explore the associations between dysphagia, specific rheumatic diagnoses, and other contributing clinical and demographic factors. Based on the EAT-10, dysphagia was identified in 35% of the patients, with the most commonly reported issues being difficulty in swallowing solid foods and the sensation of food sticking in the throat. Patients with systemic sclerosis, primary Sjögren's syndrome, and rheumatoid arthritis were significantly more likely to develop swallowing difficulties. Furthermore, low serum albumin levels, increasing age, and the presence of gastroesophageal reflux were identified as independent predictors of dysphagia. Both overweight/obesity and a diagnosis of axial spondyloarthritis were negatively associated with dysphagia. Age and years since diagnosis were positively correlated with an EAT-10 score ≥ 3, while body mass index and body fat percentage showed negative correlations. Swallowing dysfunction is prevalent among patients with RMDs, particularly in those with specific rheumatic diagnoses. Given its impact on nutritional status and overall quality of life, routine dysphagia screening in clinical settings is essential for the timely identification and management of the condition.

Keywords: Deglutition disorders; Esophageal dysphagia; Gastrointestinal; Oropharyngeal; Rheumatoid arthritis; Scleroderma; Swallow.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cross-Sectional Studies
  • Deglutition Disorders* / diagnosis
  • Deglutition Disorders* / epidemiology
  • Deglutition Disorders* / physiopathology
  • Deglutition*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Musculoskeletal Diseases* / complications
  • Musculoskeletal Diseases* / epidemiology
  • Prevalence
  • Rheumatic Diseases* / complications
  • Rheumatic Diseases* / diagnosis
  • Rheumatic Diseases* / epidemiology
  • Rheumatic Diseases* / physiopathology
  • Rheumatology
  • Risk Factors
  • Surveys and Questionnaires