Swallowing Disorders

Swallowing happens in three stages, or phases. You can have a problem in one or more of these phases. They include:

  • Oral phase – sucking, chewing, and moving food or liquid into the throat.
  • Pharyngeal phase – starting the swallow and squeezing food down the throat. You need to close off your airway to keep food or liquid out. Food going into the airway can cause coughing and choking.
  • Oesophageal phase – opening and closing the oesophagus, or the tube that goes from the mouth to the stomach. The oesophagus squeezes food down to the stomach. Food can get stuck in the oesophagus. Or, you may throw up a lot if there is a problem with your oesophagus.

Signs of Swallowing Disorders

General signs of a swallowing problem may include:

  • coughing during or right after eating or drinking
  • wet or gurgly sounding voice during or after eating or drinking
  • extra effort or time needed to chew or swallow
  • food or liquid leaking from your mouth
  • food getting stuck in your mouth
  • having a hard time breathing after meals
  • losing weight

As a result, you may have:

  • dehydration or poor nutrition
  • food or liquid going into the airway, called aspiration
  • pneumonia or other lung infections

Causes of Swallowing Disorders

There are many conditions that can cause swallowing problems. Some medications can cause dry mouth, which makes it hard to chew and swallow. Other causes include the following:

  1. Damage to your brain or nerves from a stroke, Parkinson’s disease and many other neurological conditions.
  2. Problems with your head or neck, such as:
  • cancer in your mouth, throat, or oesophagus
  • head or neck injuries
  • mouth or neck surgery
  • bad teeth, missing teeth, or dentures that do not fit well

Testing for Swallowing Disorders

A complete history and physical examination of the head and neck is required. Following this, imaging of the swallowing process may occur via;

    • modified barium swallow – you eat or drink food or liquid with barium in it. Barium shows up on an x-ray so the doctor can see how well it travels through the throat, oesophagus and into the stomach, and whether reflux is present
    • endoscopic assessment – the doctor puts a telescope in your nose. This scope has a camera on it, and the doctor can watch you swallow on a screen.

Treatment for difficulty swallowing largely depends on what the cause is. Your ENT specialist can help you make the right decision regarding any ongoing investigation, speech therapy or procedures you may require.

Reference; ASHA (American Speech Language Hearing Association) available at https://www.asha.org/practice-portal/clinical-topics/adult-dysphagia/