Difficulty Swallowing

Swallowing seems like a simple act. But there is really more to it than you think. It requires your brain, a few nerves and muscles, muscular valves and an open esophagus. If not working properly, you might suffer from swallowing problems. Talk to a specialist from OOA today.

What Is Dysphagia?

Difficulty in swallowing is called dysphagia and is common among all age groups, but more specifically the elderly. The term dysphagia refers to the feeling of difficulty passing food or liquid from the mouth to the stomach. This may be caused by many factors, most of which are temporary. Difficulties in swallowing rarely represent a more serious disease, such as a tumor or a progressive neurological disorder. When the difficulty does not clear up by itself in a short period of time, you should see an otolaryngologist, head and neck surgeon. People normally swallow hundreds of times a day to absorb the normal saliva and mucus that the body produces while eating solids and drinking liquids.

The process of swallowing has four stages:

Although the first and second stages have some voluntary control, stages three and four occur involuntarily, without conscious input. If you experience difficulty swallowing, it is important to seek treatment to avoid malnutrition and dehydration.

Symptoms of a swallowing disorder may include:

Seeking Treatment

When dysphagia is persistent and the cause is not apparent, the otolaryngologist will discuss the history of your problem and examine your mouth and throat. This may be done with the aid of mirrors. Sometimes a small tube called a flexible laryngoscope, is placed through the nose and the patient is then given food to eat while the scope is in place in the throat. These procedures provide visualization of the back of the tongue, throat and larynx (voice box). These procedures are called Fiber optic Endoscopic Evaluation of Swallowing (FEES) or Flexible Endoscopic Evaluation of Swallowing with Sensory Testing (FEESST). If necessary, an examination of the esophagus, TransNasal Esophagoscopy (TNE), may be carried out by the otolaryngologist.

Some disorders can be treated with medication, such as drugs that slow stomach acid production, muscle relaxants and antacids are a few of the many medicines available. Treatment will be tailored to the particular cause of the swallowing disorder.

Gastroesophageal reflux can often be treated by changing eating and living habits in these ways:

If the changing of these eating and living habits don’t help, antacids between meals and at bedtime may provide relief.

Many swallowing disorders may can benefit from swallowing therapy where a speech pathologist provide special exercises for coordinating the swallowing muscles and stimulating the nerves that trigger the swallow reflex. Patients may also be taught simple ways to place food in the mouth or position the body and head to help the swallow to occur successfully.

Some patients with swallowing disorders have difficulty feeding themselves. After seeing the Otolaryngologist, he may refer you to an occupational therapist or a speech-language pathologist can aid the patient and family in feeding techniques. These techniques make the patient as independent as possible. He also may refer you to a dietician or nutritional expert, who can determine the amount of food or liquid necessary to sustain an individual and whether supplements are necessary.

Once the cause is determined, swallowing disorders may be treated with medication, swallowing therapy or possibly surgery. Surgery is used to treat only certain problems. For example, if a narrowing exists in the throat or esophagus, the area may need to be stretched or dilated. If a muscle is too tight, it may need to be dilated or released surgically. This procedure is called a myotomy and is performed by the physicians at Oklahoma Otolaryngology Associates, who are licensed otolaryngologists.

Any interruption in the swallowing process can cause difficulties. Eating slowly and chewing thoroughly can help reduce problems with swallowing. However, difficulties may be due to a range of other causes, including something as simple as poor teeth, ill-fitting dentures or a common cold. One of the most common causes of dysphagia is gastroesophageal reflux. This occurs when stomach acid moves up the esophagus to the pharynx, causing discomfort. Other causes may include: hypertension, diabetes, thyroid disease, stroke, progressive neurologic disorder, the presence of a tracheotomy tube, a paralyzed or unmoving vocal cord, a tumor in the mouth, throat, or esophagus, or surgery in the head, neck, or esophageal areas.

Swallowing difficulty can also be connected to medications including:

Many diseases contribute to swallowing disorders. Any interruption in the swallowing process can cause difficulties. If you experience difficulty swallowing, it is important to seek treatment to avoid malnutrition and dehydration. If you have a persistent problem swallowing, call one of the physicians at Oklahoma Otolaryngology Associates, www.okoa.org.

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