What is a swallowing disorder? Although these issues come in many forms, there are some commonalities between them. In order to better understand swallowing disorders, we can first consider what happens when a person has normal swallowing function. First, your tongue moves liquids or solids to the back of the throat. At that point of the process, a small flap called the epiglottis covers the windpipe so that this substance does not go down toward the lungs. The substance then enters the tube that connects the throat and the stomach, called the esophagus. The esophageal muscles then push the food down the pipe toward the stomach. Finally, a ring of muscles at the bottom of the esophagus opens up to allow the food to enter the stomach. As you can see, many different body parts are included in this process, and a problem at one or more of these stages can be enough to cause a swallowing disorder. With the healthy process in mind, let’s consider the symptoms, causes, and treatments of disorders that affect the swallowing function of the body.
Symptoms of Swallowing Disorders
Swallowing disorders are generally called dysphagia, and many symptoms can signal this type of disorder. Some people have the feeling that food or liquid is not easily going down the esophagus or that it is getting stuck along the way. Some experience pain in the process, either at the back of the throat, on the way down, or at the bottom of the esophagus. Sometimes this sensation feels like heartburn. Coughing while swallowing can be a symptom of dysphagia, and choking is a clear sign of a swallowing disorder. Regurgitation is unlike vomiting, in that it is the sensation of substances coming back up through the esophagus without the retching, nausea, or engagement of the stomach muscles. Regurgitation also tastes like the substance swallowed, without the sour, acidic, or bitter taste of stomach acid. Other symptoms include a persistent sore throat, pain in the chest, and a slow or difficult process of moving food into the esophagus.
Causes and Treatments for Swallowing Disorders
The different causes of swallowing disorders are as varied as the parts of the process that can be affected. Esophageal motility is the term for the mobility of substances through the swallowing process, and motility problems can be the cause of dysphagia. Achalasia refers to a problem with the ring of muscles at the bottom of the esophagus, separating that tube from the stomach. Spasms in the muscles of the esophagus can cause dysphagia, as can severe contractions of these muscles, known as jackhammer esophagus. Treatments for motility issues include muscle relaxers such as Botulinum toxin injections. Infections can also cause swallowing disorders, and antibiotics may be prescribed when this is the case. Dysphagia can be caused by an allergic reaction, and Corticosteroids are one possible treatment. Neurological problems can cause dysphagia, as well, such as a stroke, Amyotrophic Lateral Sclerosis (ALS), or a traumatic brain injury. These conditions can require occupational therapy and other forms of swallowing support to retrain the muscles of the throat to respond to the presence of a substance. Larynx strengthening exercise, tongue strengthening exercises, and lip closure exercises can all be used to help the process of swallowing. In some cases, surgery may be necessary to rebuild the elements of the swallowing process, such as a Peroral Endoscopic Myotomy (POEM) procedure. Diet modification and behavioral changes can assist with this process, as well. Finally, some people require a feeding tube to be able to process food and liquid.
If you have trouble swallowing or any of the other symptoms mentioned, the first step is to seek out a diagnosis from your physician. The diagnostic process can take many forms, and you may need to temporarily adjust your diet to ease the swallowing process. When your physician has reached a diagnosis of the cause of your swallowing disorder, then you will be able to begin a course of treatment. Don’t hesitate to contact your physician if you are experiencing swallowing difficulty. Although some causes are easily remediable over time, some cases can be acute, such as an allergic reaction. Getting help right away can make a difference in the quality of your recovery.