Swallowing occurs so naturally and automatically that we don’t often think about it. It is common to experience “food going down the wrong way” and coughing as a result from time to time. But swallowing disorders describe difficulty swallowing that occurs regularly. Known as dysphagia, swallowing challenges can impact health and wellness in everyday life. Figuring out if you experience chronic swallowing issues and seeking treatment can profoundly improve your health, nutrition, and quality of life.
How do we swallow?
Did you know you swallow at least one time per minute? This amounts to 500-700 times per day on average. Though swallowing seems to be an easy and automatic thing that we do, it actually involves a complex process of various muscles working together. This process involves:
- Oral phase: swallowing starts when the mouth chews food and moves the food or liquid to the back of the throat.
- Pharyngeal phase: food/liquid enters the throat and a small flap known as the epiglottis covers the windpipe to prevent food from entering the airways. Food going into the airway is what causes coughing and/or choking.
- Esophageal phase: food then enters the esophagus which is a tube that connects the back of the throat to the stomach. Muscles in the esophagus squeeze food into the stomach.
Issues in any of these areas can disrupt this process and contribute to the development of a swallowing disorder.
What are swallowing disorders?
Dysphagia encompasses different swallowing disorders that are all characterized by difficulty swallowing. The type of swallowing disorder depends on where in the swallowing process the challenges are occurring. This includes:
- Oral dysphagia: this type of swallowing disorder occurs in the mouth and typically involves the movement of the tongue.
- Pharyngeal dysphagia: this type of dysphasia occurs in the throat and involves challenges with food/liquid passing through the throat.
- Esophageal dysphagia: this describes food/liquid getting stuck in the esophagus and being unable to move through the esophagus to the stomach.
These types of swallowing disorders can produce various symptoms that are uncomfortable and even painful. Symptoms include:
– Coughing or clearing your throat after eating/drinking
– Feeling like food is stuck in your throat
– Having a wet voice during or after eating/drinking
– Needing extra time to chew or swallow
– Breathing challenges after meals
– Losing weight
These symptoms can lead to greater effects on health and wellness by contributing to: dehydration, lack of nutrition, pneumonia or other lung infections, and reflux. Also, people with swallowing issues may be embarrassed, causing them to want to eat alone. This contributes to social withdrawal and can affect mental health and relationships.
What causes swallowing disorders?
Swallowing disorders can be caused by several medical conditions and injuries including the following:
– Brain and spinal cord injuries
– Head or neck injuries
– Stroke
– Alzheimer’s and Parkinson’s disease
– Multiple sclerosis
– Cerebral palsy
– Muscular dystrophy
– Cancer in the mouth, throat, or esophagus
– Mouth or neck surgery
– Dental issues
These factors can cause swallowing disorders and affect health as well as nutrition and daily wellness. It is important to be assessed if you experience any swallowing issues.
How are swallowing disorders diagnosed and treated?
Speech-language pathologists (SLPs) are specialists that diagnose and treat issues related to communication and swallowing. Also known as speech therapists, SLPs comprehensively evaluate swallowing disorders and then can tailor treatment depending on the underlying cause. The evaluation process can include the following:
- Discussing your symptoms and swallowing issues with you
- Evaluating how your mouth muscles move
- Observing you eat to see what happens when you swallow
- Conduct the following specialized tests:
- Modified barium swallow: barium is a substance that shows on an x-ray. This test involves eating or drinking liquid with barium in it which so the SLP can watch where the food goes.
- Endoscopic assessment: this test involves placing a tube with a light and camera into your nose. The SLP can then watch you swallow on a screen.
Once the location of where the swallowing challenges are occurring is identified, your SLP can establish treatment. Treatment options include working with your SLP to learn and practice strategies that help you swallow effectively. This involves learning how to use your muscles, sit, position your head etc. in ways to better support swallowing.