Swallowing Disorders

Swallowing is a life-sustaining process that, thankfully, most of us don't have to give much thought. If you did stop to think about it, you'd realize just how many steps go into swallowing. A small abnormality can derail the whole process. The medical term for difficulty swallowing is dysphagia. This swallowing disorder can be a symptom and result of numerous medical disorders.

Swallowing occurs in three phases.

  • Phase 1: The Oral Phase - During this phase, sucking and chewing moves food or liquid from the mouth to the throat.
  • Phase 2: The Pharyngeal Phase - In this phase, the airway closes off to prevent choking or coughing. The food or liquid moves from the throat into the esophagus, the feeding tube that leads to the stomach.
  • Phase 3: The Esophageal Phase - Here, the esophagus pushes the food or liquid into the stomach.

How to Tell if You Have a Swallowing Disorder
Symptoms of swallowing disorders may be extremely obvious, but they can also be so subtle that you may not pick up on them. They can occur on a daily basis or appear only when you eat certain foods.

Some common symptoms that may indicate a swallowing disorder include:

  • Coughing while eating and drinking
  • Regurgitation
  • Chest pain after swallowing
  • The need for a conscious effort to swallow
  • Excessive drooling after eating
  • Unintentional weight loss

Swallowing disorders can lead to a variety of serious medical conditions including pneumonia, malnutrition, poor dental condition or dehydration. If you have a swallowing disorders, you may also avoid eating in public out of embarrassment, which can take a huge toll on your social and emotional well-being.

What May Be Causing Your Swallowing Disorder
Many conditions can cause or contribute to problems swallowing.

Factors that can contribute to dysphagia include:

  • Medications that cause dry mouth
  • Inflammation or ulceration in the esophagus
  • Age
  • Head or neck injury
  • Oral or cervical surgery
  • Poor dental arrangement or dentures that don't fit well
  • Cancer in the esophagus, mouth or throat
  • Stress
  • Gastroesophageal reflux disease (GERD)
  • Traumatic brain injury
  • Neurological disorders such as stroke, Parkinson's disease, multiple sclerosis, Lou Gehrig's disease (also called ALS), cerebral palsy and Alzheimer's

How Swallowing Disorders are Diagnosed
When dysphagia is persistent and the cause is not apparent, your medical provider will ask you about the history of your problem and examine your mouth and throat. They may use mirrors or a small tube called a flexible laryngoscope that provides a view of the back of your tongue, throat and larynx, or voice box. If necessary, an otolaryngologist or a gastroenterologist may conduct an examination of the esophagus, stomach and upper small intestine, or duodenum. These specialists may recommend that you see a radiologist to have an x-ray examination called a barium swallow, or upper GI.

In some circumstances, your radiologist may consult with a speech pathologist regarding a modified barium swallow, or videofluoroscopy. During a modified barium swallow, a patient swallows different consistencies of food and liquid in different positions. This will allow your speech pathologist to examine all four stages of the swallowing process. If it is determined that your swallowing disorder stems from the nervous system—perhaps, due to stroke or other neurological disorders, an exam by a neurologist may be recommended.

What Treatments May Be Recommended for Your Swallowing Disorder
The recommended treatment for your swallowing disorder will depend on the cause of your swallowing difficulties. Treatment is tailored to the particular cause of the swallowing disorder. You may be recommended to take drugs that slow stomach acid production, muscle relaxants, or antacids. Often, therapy with a speech pathologist is recommended to retrain the muscles of the neck and throat.

Other strategies that may be helpful include:

  • Eating slowly
  • Eating softer foods
  • Drinking thicker liquids
  • Sitting upright when eating

If you think you or someone you love may be suffering from a swallowing disorder, contact our office for a thorough evaluation and treatment plan. Call us today at 404.257.1589 (Atlanta) or 770.777.1100 (Alpharetta), or book an appointment online now.

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