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Swallowing Disorders: Causes, Diagnosis, and Treatment

Published on Jan 25, 2018 and last reviewed on Jul 21, 2022   -  4 min read

Abstract

Swallowing disorders present with difficulty swallowing or pain during swallowing. The following article explains swallowing disorders in detail.

Contents
Swallowing Disorders: Causes, Diagnosis, and Treatment

Introduction:

Swallowing refers to muscular movements controlling the mouth, the back of the throat (pharynx), and the food tube (esophagus). Swallowing occurs involuntarily without even thinking about it. Yet it is a complex and vital function, as it is very important for eating and social interaction. Swallowing happens in three phases.

What Is Meant by Swallowing Difficulty?

The medical term used for difficulty in swallowing is dysphagia. A patient may also complain of trouble in moving food through the mouth, pharynx, and food pipe. Sometimes, the patient might pinpoint the level of sticking of food. If it is said to be above the suprasternal notch, then the site of obstruction is the oropharynx. Pointing to the level of the chest might indicate food pipe obstruction. The condition is more common in the elderly.

What Are the Types of Swallowing Disorders?

There are two terms that explain the problems with swallowing,

Dysphagia: A sense of discomfort with choking or coughing during swallowing.

Odynophagia: Pain during swallowing.

Often both the conditions are presented together and addressed as dysphagia.

What Are the Symptoms of Swallowing Disorder?

Associated symptoms relevant to dysphagia are:

What Are the Causes of Swallowing Disorders?

Dysphagia can be due to mechanical reasons or due to abnormalities in the muscles controlling the action of swallowing.

1. Mechanical Causes:

2. Abnormalities of Muscles Controlling Swallowing Can Lead To Trouble Swallowing:

How Swallowing Disorders Are Diagnosed?

Diagnosis of swallowing problems is suspected from history. Difficulty in swallowing solids can indicate mechanical while liquid can indicate neurological disorders.

Initial consultation with a family doctor and referral to an ENT (ear, nose, throat) specialist might be needed. The ENT doctor starts with the examination of the inside of the throat and then proceeds with an indirect laryngoscopic examination of the throat. This test involves placing a mirror inside the mouth after pulling your tongue and holding it with cotton. The patient is asked to breathe/say 'Aaa' or 'Eee' for visualization of the food pipe area. This test usually is well tolerated by most patients after proper explanation and reassurance before the test.

Investigations relevant to dysphagia are barium swallow (a type of X-ray test), and endoscopic examination of the food pipe if mechanical causes are suspected.

Endoscopy:

An endoscopy is a procedure to visualize the upper digestive tract using a tiny camera with a light inserted through the mouth into the esophagus.

In endoscopy,

Barium Esophagram:

Swallowing disorders can be assessed well in barium esophagram. The structure and the function of the gastrointestinal tract can be better viewed. Barium is a radiocontrast material used to highlight the body parts in the radiograph.

In barium esophagram,

Esophageal Manometry:

Pressure is usually generated inside the esophagus during swallowing. The changes in the pressure can be measured in esophageal manometry.

In esophageal manometry,

pH Testing:

The acidic pH in the lower esophagus is checked to evaluate the acid reflux symptoms like heartburn and irritation during swallowing. A ph sensor chip is introduced into the digestive tract and left in place for two days, that records the data and transmits the information.

How Swallowing Disorders Are Treated?

The treatment of swallowing problems depends on the cause. Sometimes, they go away on their own, while at other times, treatment by a specialist may be necessary. Meanwhile, it is good to follow some lifestyle modifications like eating soft food, chewing very little food at a time, taking syrup or crushed forms of medication, etc.

The treatment option includes,

Conclusion:

The swallowing disorder can deprive the person of getting proper nutrition and energy. The patient should understand the underlying cause of swallowing problems and try to avoid the triggering factors. Lifestyle modifications and exercises can help in most cases. When swallowing difficulties are not addressed properly, it may lead to complications like severe cough, dehydration, malnutrition, and pulmonary complications.

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Last reviewed at:
21 Jul 2022  -  4 min read

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