This may arise from problems in the throat or sometimes lower down in the gullet. A careful history, examination (and many times some kind of investigation e.g. a special x-ray, scan or detailed examination under anaesthesia) is required to arrive at a cause for this symptom. Prompt medical attention should be sought if the swallowing difficulty is associated with breathing difficulties, weight loss, a neck lump, any voice change, a constant sore throat, choking, earache or regurgitation of food or drink.