Difficulty in swallowing (Dysphagia) is common in all age groups, especially in the elderly. Dysphagia is the feeling of difficulty passing food and liquids from the mouth to the stomach. This condition can be caused by many factors, most of which are non-dangerous and temporary. Difficulty swallowing rarely indicates more significant pathology, such as a tumor or progressive neurological disease. If difficulty in swallowing does not improve on its own in a short time, it should be evaluated by an ear, nose and throat specialist.
How does the swallowing process occur?
People eat solid foods, drink liquids and the saliva produced by the body and They perform the swallowing function hundreds of times a day to swallow mucus. The swallowing function has four phases:
1) The first phase is the period when food and drinks are chewed and made ready for swallowing.
2) During the oral phase, the tongue initiates the swallowing response by pushing food and drinks to the back of the mouth.
br /> 3) In the pharyngeal phase, food and drinks pass quickly from the pharynx to the esophagus.
4) In the last phase, the esophageal phase, food and drinks pass from the esophagus to the stomach.
While the first and second phases occur under voluntary control, the third phase occurs under voluntary control. and the fourth phases occur spontaneously.
What are the Causes of Swallowing Diseases?
Any interruption during the swallowing function may cause difficulty in swallowing. Difficulty swallowing may be due to simple causes such as unhealthy teeth, ill-fitting dentures or a cold. One of the most common causes of difficulty swallowing is reflux from the stomach into the esophagus. This condition occurs as a result of the upward movement of stomach acid from the esophagus to the pharynx. Other causes include stroke, progressive neurological disease, presence of a tracheostomy tube, immobile vocal cords, mouth, larynx or esophagus tumors, and surgical operations performed on the head and neck region.
Who Evaluates and Treats Swallowing Diseases? ?
If the difficulty in swallowing is persistent and the cause is unknown, an ear, nose and throat specialist will examine the patient by taking the history of the patient in question.
This examination is carried out using endoscopes that provide imaging with mirrors or special optical systems. Examine the back of the tongue, throat and larynx using It is done through stroke. If necessary, examination of the esophagus, stomach and duodenum is performed by an ear, nose and throat specialist or a stomach and intestinal diseases specialist.
According to the results, it may be necessary to evaluate the swallowing mechanism functions with a barium esophageal transition film.
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If there are special pathologies, the radiologist may be contacted with an upper gastrointestinal system film or videofluoroscopy. Thus, all four phases of swallowing are evaluated. Swallowing ability can be evaluated by using food and drinks of different consistency and having the patient assume different positions. If difficulty in swallowing is due to stroke or progressive neurological diseases, it should be evaluated by a neurologist.
What are the symptoms?
1. Increased saliva in the mouth
2. Feeling of food and drinks getting stuck in the throat
3. Feeling of discomfort in the throat and chest (If there is leakage from the stomach to the esophagus - Reflux)
4. Feeling of a foreign object or piece in the throat
5. Prolonged or significant difficulty in swallowing malnutrition and weight loss due to malnutrition
6.Cough and choking sensation that develops due to food particles that do not pass easily during swallowing, liquid and saliva, and their aspiration into the lungs
What are the Possible Treatments?
If the cause can be determined, dysphagia can be treated with medical treatment, swallowing treatment or surgical methods.
Many of these diseases can be treated with medical treatment. Drugs that inhibit stomach acid secretion, muscle relaxants and antacids are some of the available drugs. Treatment is tailored to the cause of the swallowing disease. Leakage from the stomach to the esophagus can often be treated by changing eating and living habits. For example:
* Eating a diet consisting of easy-to-digest foods at frequent intervals and in small amounts
* Staying away from alcohol and caffeine
* Reducing weight and stress
* Three hours before bedtime avoiding eating
* Elevating the head of the bed at night.
* If these do not help, using an antacid between meals and before bedtime may provide relief.
* Many swallowing disorders may benefit from swallowing treatment. Swallowing with muscle Special exercises can be performed that stimulate the nerves that enable the muscles to work together and enable the swallowing reflex to occur. They encounter. The occupational therapist can help the patient and family with feeding techniques. These techniques make the patient as independent as possible. The dietitian or nutritionist determines the amount of food and drink required for the patient and whether additional nutrients are required.
Surgical treatment is used to treat certain problems. In the presence of stenosis or adhesion, it may be necessary to expand the area in question. In the presence of severe muscle contraction, it may be necessary to expand or even release the relevant muscles. This method is called muscle cutting and is performed by an ear, nose and throat specialist.
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