Swallowing disorder (dysphagia) involves problems in the passage of food from the oral cavity to the stomach. These problems may occur in the form of a delay in the passage of the food into the stomach, obstruction, or its escape into the windpipe by following a wrong path. If the food goes down to the level of the vocal cords, it is called "penetration", and if it passes below the vocal cords, it is called "aspiration". During aspiration, food reaches the lungs and is a very dangerous situation that can lead to death. Everyone can aspirate swallowed food from time to time, but a healthy person can cough reflexively and clear his throat when the food he eats gets into his windpipe. However, people with decreased reflexes cannot understand that they are aspirating. This can sometimes lead to serious or even fatal problems. Swallowing disorders can occur in patients of all age groups due to nervous (neurogenic), mechanical, psychological reasons and muscle diseases (myogenic).
How Do We Swallow?
Swallowing. Its function has four phases:
1)The first phase is the period when food and drinks are chewed, mixed with saliva and made ready for swallowing.
2) strong>During the mouth phase, the second period in which the created food bite is pushed to the back of the mouth and the swallowing response begins.
3) In the pharynx phase, food and drinks are pushed towards the upper esophageal valve. When this valve opens, food quickly passes from the pharynx to the esophagus.
4)In the last phase, the esophagus phase, food and drinks pass from the esophagus to the stomach.
The first and second phase. While the phases occur under voluntary control, the third and fourth phases occur reflexively.
What are the symptoms of difficulty swallowing?
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Long effort and time spent on chewing and swallowing
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Coughing and vomiting during or after eating and drinking
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Wet, wheezing voice during or after eating and drinking
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Food flowing out of the mouth, spilling or accumulating in the mouth
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Not being able to breathe after eating or developing pneumonia
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Weight loss or dehydration
What are the Causes of Swallowing Diseases?
Improper dentures, missing teeth, decreased saliva flow, valve problems at the entrance to the esophagus or stomach, paralysis, progressive neurological disease (Parkinson, Multiple Sclerosis, cerebral palsy). (Alzheimer, dementia), presence of a tracheostomy tube, immobile vocal cords, mouth, larynx or esophagus tumors, and surgical operations, radiation treatments or chemotherapy applied to the head and neck area.
Who Evaluates Swallowing Diseases and How is treatment done?
In the treatment of swallowing disorder, ENT specialist, neurologist and language and speech therapist play a role as a team.
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Positions that will ensure strengthening and coordinated movements of the muscles responsible for swallowing are selected and exercises are performed in this position. This treatment is also called positional swallowing treatment.
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Sensory Stimulation Techniques and customized exercises are performed to stimulate the nerves that can activate the swallowing reflex.
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Diet modification is made to determine the consistency that the patient can swallow without aspirating and to ensure that the patient swallows safely without aspirating.
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