<s>[INST] Hello, my nine year old son had recently started complaining of difficulty swallowing, approximately 1.5 to 2 wks. He has always been relatively healthy. Only other history is that of interrmittent constipation some birth. Should I be concerned? What possibilities could be causing this? [/INST] Hi. Difficulty in swallowing can be because of enlarged tonsils or other adenoid gland in that area. Is it associated with pain or is painless. Having enlarged gland at this age is common. Dental infection, ear infection can cause enlarged glands, tonalities will have pain, fever and swallowing issues. Also, simple oral ulcers can make it pain full to swallow. Other causes like retropharyngeal abscess or membrane formation will be associated with a much sicker childishly neurological causes should have other associated issues. Please get a checkup with ENT doctor for proper examination. </s>