Swallowing Disorders

SWALLOWING DISORDERS

A swallowing disorder (dysphagia) can occur at any stage of the act of swallowing.

The stages of swallowing are:

• Oral phase: difficulty chewing and moving food and drink from the mouth toward the throat
• Pharyngeal phase: difficulty starting a swallow, sending food and drink into the esophagus and closing off the windpipe
• Esophageal phase: difficulty with the contraction and relaxation movements of the esophagus and stomach and with moving food and drink down through the esophagus.

What causes swallowing disorders?

• Diseases affecting oral and dental health
• Problems, injuries or surgery involving the head and neck region
• Cancers of the mouth, larynx and esophagus
• Oral hygiene problems, tooth decay, missing teeth and ill-fitting dentures
• Inflammatory diseases
• Congenital diseases
• Thyroid gland diseases
• Salivary gland diseases
• Diseases of the nervous system involved in swallowing
• Psychological conditions (such as panic attacks)
• Nervous system damage (stroke, brain injury, spinal cord injury, Parkinson’s disease, MS, ALS, cerebral palsy, Alzheimer’s disease …)
• Swelling and injuries resulting from trauma
• Tumors
• Certain medications

What are the symptoms of swallowing disorders?

• Drooling
• Food and drink collecting in the mouth, or running or spilling out of the mouth
• A feeling of something getting stuck in the throat or chest when swallowing saliva, solid foods or liquids
• A feeling of a foreign body or lump in the throat
• Burning in the throat and chest
• Vomiting up what cannot be swallowed
• Coughing during or after eating and drinking
• A wet, gurgling voice during or after eating and drinking
• Hoarseness, shortness of breath
• Malnutrition and weight loss
• Liquids and solid foods going down the windpipe, with coughing and a choking sensation
• Spending a lot of effort and time chewing and swallowing
• Embarrassment, discomfort and withdrawal in social situations involving eating and drinking
• Chest tightness after meals or the development of pneumonia

1. Be alert to the risk of aspiration (food and drink entering the windpipe), which can lead to pneumonia and chronic lung disease!

How should swallowing disorders be treated?

Treatment includes lifestyle changes, medication, swallowing therapy and surgery. A speech and language therapist who specializes in this area can evaluate swallowing-related health and provide the necessary treatment.

The speech and language therapist:

• Listens to the patient’s complaints,
• Evaluates the muscle strength and mobility of the organs involved in swallowing,
• Orders the tests needed to evaluate swallowing problems,
• Recommends exercises to make swallowing easier,
• Suggests foods and drinks that are easier and safer to swallow,
• Family members also have a role to play here; they should help patients so that the treatment program can be carried out.

Recommendations for swallowing disorders related to reflux:

• Eat small amounts of soft food frequently
• Avoid alcohol, caffeine and very fatty foods
• Lose weight
• Try to keep stress under control
• Do not eat anything for 3 hours before going to bed
• Raise the head of the bed