Swallowing and dysphagia
SWALLOWING INVOLVES THE COORDINATION OF VARIOUS STRUCTURES AND MUSCLES
Swallowing and dysphagia
Swallowing is the passing of food and drink from the mouth to the oesophagus via the pharynx. The process of swallowing food and drink requires rapid coordination from the muscles and structures involved. When one of the elements involved in this process stops functioning correctly, the patient will suffer a swallowing disorder called dysphagia.
Persons affected by dysphagia will find it difficult or impossible to swallow food or liquids and experience a sensation of food remaining in their mouth or throat.
In many cases, the occurrence and progression of this problem is so slow that some patients do not attach enough importance to this pathology which gets worse over time. It is therefore important to diagnose the disease early and initiate treatment as soon as possible.
What types of dysphagia are there?
Depending on the location of the dysfunction in the swallowing process, we distinguish between:
- Oropharyngeal dysfunction, if it occurs in the area of the pharynx.
- Oesophageal dysfunction, if the difficulty occurs in the area of the oesophagus.
In the case of an oropharyngeal dysfunction, difficulties will occur at the beginning of the swallowing process. This can cause inhalation into the windpipe and lead to coughing, vomiting, pain, sensation of pressure or tightness while swallowing, heartburn and regurgitation.
What are the causes related to swallowing disorders?
Swallowing disorders can occur in connection with different diseases:
- Diseases of the pharynx or the oral cavity (tonsillitis, pharyngitis, or fungal infections as in the case of aphtha).
- Oesophageal diseases: oesophageal diverticulum, achalasia.
- Neurodegenerative diseases: multiple sclerosis, Parkinson's disease.
- Diaphragmatic hernia.
- Inhalation of foreign bodies.
- Other causes: oesophageal neoplasms, oesophageal cancer, neurological diseases or stroke.
How is dysphagia diagnosed?
To begin with, it is essential to analyse the patient's full clinical history. Upon suspicion of dysphagia, the specialist will perform a screening by means of endoscopy which will be completed with a dysphagia test.
During the consultation, the otorhinolaryngologist will ask the patient about their troubles swallowing, their usual diet, when they began to notice the symptoms, and if their symptoms have progressed over time. It is important that the patient discusses all symptoms they experience with the specialist, even if they believe they are not related to the disease.
After a screening of the mouth and pharynx, a so-called Dysphagia Test, also known as Volume-Viscosity Swallow Test (V-VST) is performed. This test allows us to determine the most adequate volumes and consistencies for each patient.
What dysphagia treatments are available?
In all cases of dysphagia, the treatment is personalised depending on the clinical history and the cause of the disease.
The treatment is based on changes to postural manoeuvres and progressive structural training to reduce the discomfort and reinstate reflexes such as the swallowing reflex and the cough reflex.