Swallowing is an essential process that is integral to nutrition and hydration. Difficulties with swallowing is known as dysphagia which can impact everyday life in significant ways. Swallowing disorders can contribute to health issues, social withdrawal, and affect quality of life. Fortunately, there are effective treatment options that support
On average, we swallow between 500-700 times per day, or once per minute. This process happens so naturally that we don’t seem to think much about it. But swallowing involves a complex process of various muscles working together to perform this vital function. Swallowing involves the following steps:
- The mouth chews and sucks food or liquids and moves substances to the back of the throat.
- Food enters the throat and the epiglottis – a small flap – closes off the airways to prevent food and liquids from being inhaled. Food going into the airways is what causes coughing and choking which you’ve likely experienced before.
- Food/liquids then enter the esophagus which is the tube connecting the throat to the stomach. The esophageal muscles are then able to push food down into the stomach.
- Muscles at the bottom portion of the esophagus open to then squeeze food into the stomach.
Any disruptions, damage, or problems with any of these areas can cause swallowing disorders.
Swallowing Disorders & Symptoms
Dysphagia is an umbrella term that describes difficulty swallowing. It can be used to reference several types of swallowing disorders. It is important to note that experiencing challenges with swallowing from time to time, like when you take large bites, is relatively normal. What distinguishes a swallowing disorder is that it occurs on an ongoing basis. Swallowing disorders can occur at different stages of the swallowing process including:
- Oral dysphagia: this means that the issue is occurring in the mouth and can be an issue with the tongue.
- Pharyngeal dysphagia: difficulty swallowing in happening with food passing through the throat.
- Esophageal dysphagia: this describes food being unable to move through the esophagus, preventing it from reaching the stomach.
These types of swallowing disorders can result in various symptoms and health issues. Common symptoms include the following:
- Coughing during or right after eating/drinking
- Having to frequently clear your throat after eating/drinking
- Feeling like food is getting stuck in your esophagus
- Experiencing pain while swallowing
- Regurgitation, reflux
- Needing more time to chew or swallow
- Breathing difficulties after eating
- Weight loss
In addition to these symptoms, swallowing disorders can also contribute to dehydration, poor nutrition, and pneumonia or other lung infections.
There are several factors that can cause swallowing disorders. This includes the following:
- Brain injuries
- Spinal cord injuries
- Parkinson’s and Alzheimer’s disease
- Muscular dystrophy
- Cerebral palsy
Other causes of swallowing disorders can be caused by head, neck, or mouth issues including:
- Head or neck injuries
- Mouth or neck surgery
- Cancer in the mouth, throat, or esophagus
- Missing teeth or dentures that fit poorly
These factors can produce challenges with swallowing that affect everyday life by causing health issues and social withdrawal. It is common to stop sharing meals with others which is another symptom.
If you experience issues with swallowing, the first step is to schedule an appointment with a Speech-Language-Pathologist (SPL) who can evaluate how you eat and drink. The SLP will likely do the following to assess your swallowing challenges:
- Talk to you about your health history, symptoms, and swallowing issues.
- See how your mouth muscles move and work.
- Evaluate you as you eat to see what happens when you swallow.
- Conduct the following assessments to evaluate swallowing:
- Modified barium swallow: barium is a substance that is used during a swallowing test to help make certain areas of the body show up clearly on an x-ray. This test involves eating or drinking food/liquid with barium in it which allows the SLP to see where the food goes via x-ray.
- Endoscopic test: this test involves putting a tube with a light on the end into your nose. The tube has a camera and this allows the SLP to watch you swallow.
Once swallowing issues are located (mouth, throat, esophagus), the best course of treatment can be identified. Treatment can include medications to help with reflux as well as working with an SLP in the following ways:
- Learning how to use muscles to chew and swallow more effectively
- Learning how to sit and position your head when eating
- Learning strategies to swallow safely