MedCentral offers help with swallowing problems
Imagine waking up to the smell of freshly brewed coffee, cinnamon rolls, and bacon sizzling in a pan and not being able to eat or drink any of it. Or, coughing on every sip or bite while trying to eat.
Unfortunately, that’s what it’s like when you have dysphagia, which means difficulty swallowing. The problem can range in severity from mild difficulty when eating and drinking to not being able to eat anything by mouth and instead, relying on a feeding tube for nutrition. Common causes of dysphagia are sudden illnesses such as stroke, and progressive neurologic diseases such as Parkinson’s, ALS, multiple sclerosis, and dementia. Sometimes the cause is simply not known.
The act of swallowing involves some 50 pairs of muscles and many nerves working together to get food and liquid - or even just saliva - from the mouth to the stomach – everyday, hundreds of times.. Take a sip of water while you’re reading this, and you’ll see just how complicated the simple act of swallowing really is.
If all goes well, you take a sip and the water stays in your mouth instead of dribbling onto your shirt, because your lips stay tightly closed as they are supposed to. Your cheeks stay tight against your teeth, keeping the water in the center of your mouth until your tongue pushes against the roof of your mouth, and, in a perfectly synchronized fashion, moves the water from the front of your mouth to the back. No water comes out your nose because your soft palate rises and closes off your nasal cavity. Then, when the water hits the back of your mouth your brain automatically triggers a swallow reflex, taking the water from your mouth through your throat (also known as your pharynx) into your esophagus and then on to your stomach.
If all does not go well, however – for example, if something has happened to weaken the muscles involved in the process or disrupt nerve function -- swallowing can go badly and make it very difficult and even dangerous to eat.
How can you tell if you have dysphagia? Everyone has a little trouble swallowing or drinking at times. Try talking with your mouth full and you’ll understand. Water or food can go down the wrong way and end up in the airway instead of the esophagus when we’re not paying attention. Those who frequently have the following complaints may have dysphagia:
- difficulty initiating a swallow
- frequent coughing or choking when eating
- loss of food or liquid from the mouth
- the sensation that food is sticking in the throat,
- food or liquid coming out the nose,
- recurrent pneumonia
- difficulty chewing
- food lodging in your cheeks or the space between your teeth and gums
- a dread of eating in public due to embarrassment about eating difficulties
If you think you may have dysphagia, consult your physician. Keep a log of what happens when you are eating that causes you concern. Depending on your complaints, your physician may refer you to an otolaryngologist (ear, nose, and throat doctor) for further evaluation or a speech-language pathologist. A number of tests will provide a clearer picture of what happens when you swallow. If the problem is serious, many treatment techniques are available to make it easier and more enjoyable to eat.
Mary ”Joey” Gillan , is a speech-language pathologist at MedCentral Health System.