Physiology of the Swallow & Dysphagia

Physiology of the SwallowPhysiology of the Swallow

Physiology of the Swallow. This part of the swallow is voluntary. It is a mechanical phase that can be by-passed by dropping liquid or food into the back of the throat. … The food and saliva form a bolus of material. Swallowing is basically an involuntary reflex; one cannot swallow unless there is saliva or some substance to be swallowed. Initially, food is voluntarily moved to the rear of the oral cavity, but once food reaches the back of the mouth, the reflex to swallow takes over and cannot be retracted.

What are the 4 stages of swallowing?
  • Oral Preparatory Phase.
  • Oral Transit Phase.
  • Pharyngeal Phase.
  • Esophageal Phase.

Swallowing is commonly divided into the following four phases: Oral Preparatory—voluntary phase during which food or liquid is manipulated in the mouth to form a cohesive bolus—includes sucking liquids, manipulating soft boluses, and chewing solid food.

What is the process of swallowing?
Swallowing is the process by which food is transported from the mouth to the stomach. Functionally, it may be divided into three phases—preparatory, transfer, and transport phases—that follow each other in a sequence. … Anatomically, swallowing has been divided into three phases: oral, pharyngeal, and esophageal.

What is the function of swallowing?

Food passes from the pharynx into the esophagus; the upper esophageal sphincter then immediately closes, preventing the flow of food back into the mouth. Once the food is in the esophagus, the final phase of swallowing begins. The larynx lowers, the glottis opens, and breathing resumes.

How many muscles used swallowing?

Swallowing is a complex process. Some 50 pairs of muscles and many nerves work to receive food into the mouth, prepare it, and move it from the mouth to the stomach. This happens in three stages. During the first stage, called the oral phase, the tongue collects the food or liquid, making it ready for swallowing.

What happens in the swallowing reflex?
Swallowing causes reflex closure of the glottis, elevation of the larynx, and a transient cessation of respiration. These complex motor acts implicate that numerous muscles are activated during the act of swallowing.

What part of the brain is responsible for swallowing?

The medulla oblongata controls breathing, blood pressure, heart rhythms, and swallowing. Messages from the cortex to the spinal cord and nerves that branch from the spinal cord are sent through the pons and the brainstem. Destruction of these regions of the brain will cause “brain death.”

What are the signs of dysphagia?
Other signs of dysphagia include:
  • coughing or choking when eating or drinking.
  • bringing food back up, sometimes through the nose.
  • a sensation that food is stuck in your throat or chest.
  • persistent drooling of saliva.
  • being unable to chew food properly.
  • a ‘gurgly’ wet-sounding voice when eating or drinking.

Dysphagia is the medical term for swallowing difficulties. Some people with dysphagia have problems swallowing certain foods or liquids, while others can’t swallow at all. Other signs of dysphagia include: coughing or choking when eating or drinking. bringing food back up, sometimes through the nose.

Over time, dysphagia can also cause symptoms such as weight loss and repeated chest infections.

How do you fix dysphagia?
Treatment for dysphagia includes:
  1. Exercises for your swallowing muscles. If you have a problem with your brain, nerves, or muscles, you may need to do exercises to train your muscles to work together to help you swallow. …
  2. Changing the foods you eat. …
  3. Dilation. …
  4. Endoscopy. …
  5. Surgery. …
  6. Medicines.
What are three disorders that cause dysphagia?
Neurological conditions that can cause swallowing difficulties are stroke (the most common cause of dysphagia); traumatic brain injury; cerebral palsy; Parkinson’s disease and other degenerative neurological disorders such as amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig’s disease), multiple sclerosis, …
Does dysphagia go away?
Dysphagia is another medical name for difficulty swallowing. This symptom isn’t always indicative of a medical condition. In fact, this condition may be temporary and go away on its own.
What are the stages of dysphagia?
Dysphagia can disrupt this process. Aspiration is serious because it can lead to pneumonia and other problems. Problems with any of the phases of swallowing can cause dysphagia.

Doctors describe it in three phases:
  • Oral preparatory phase. …
  • Pharyngeal phase. …
  • Esophageal phase.
Does anxiety cause dysphagia?
Anxiety or panic attacks can result in a feeling of tightness or a lump in the throat or even a sensation of choking. This can temporarily make swallowing difficult.
Who can identify signs of dysphagia?
Signs and symptoms associated with dysphagia may include:
  • Having pain while swallowing (odynophagia)
  • Being unable to swallow.
  • Having the sensation of food getting stuck in your throat or chest or behind your breastbone (sternum)
  • Drooling.
  • Being hoarse.
  • Bringing food back up (regurgitation)
  • Having frequent heartburn.
What type of doctor treats dysphagia?
See your doctor if you’re having problems swallowing. Depending on the suspected cause, your doctor may refer you to an ear, nose and throat specialist, a doctor who specializes in treating digestive disorders (gastroenterologist) or a doctor who specializes in diseases of the nervous system (neurologist).
What foods are good for dysphagia?
The following are some of the permitted foods:
  • Pureed bread (also called “pre-gelled” bread)
  • Smooth puddings, custards, yogurts, and pureed desserts.
  • Pureed fruits and well-mashed bananas.
  • Pureed meats.
  • Souffles.
  • Well-moistened mashed potatoes.
  • Pureed soups.
  • Pureed vegetables without lumps, chunks, or seeds.

What are the most common complications of dysphagia?
The most common complications of dysphagia are aspiration pneumonia, malnutrition, and dehydration; other possible complications, such as intellectual and body development deficit in children with dysphagia, or emotional impairment and social restriction have not been studied thoroughly.
Why do I feel like I have mucus stuck in my throat?
When mucus starts to build up or trickle down the back of the throat, the medical name for this is a postnasal drip. Causes of postnasal drip include infections, allergies, and acid reflux. A person may also notice additional symptoms, such as a sore throat.
How does dysphagia start?
How does dysphagia occur? Dysphagia occurs when there is a problem with the neural control or the structures involved in any part of the swallowing process. Weak tongue or cheek muscles may make it hard to move food around in the mouth for chewing.

When to seek medical advice

You should see your GP if you, or someone you care for, have difficulty swallowing or any other signs of dysphagia so you can get treatment to help with your symptoms.

Early investigation can also help to rule out other more serious conditions, such as oesophageal cancer.

Your GP will assess you and may refer you for further tests.

Treating dysphagia

Treatment usually depends on the cause and type of dysphagia.

Many cases of dysphagia can be improved with careful management, but a cure isn’t always possible. Treatments for dysphagia include:

  • speech and language therapy to learn new swallowing techniques
  • changing the consistency of food and liquids to make them safer to swallow
  • other forms of feeding – such as tube feeding through the nose or stomach
  • surgery to widen the esophagus, by stretching it or inserting a plastic or metal tube (stent)

Causes of dysphagia

Dysphagia is usually caused by another health condition, such as:

  • a condition that affects the nervous system, such as a stroke, head injury, multiple sclerosis, or dementia
  • cancer – such as mouth cancer or oesophageal cancer
  • gastro-oesophageal reflux disease (GORD) – where stomach acid leaks back up into the esophagus

Children can also have dysphagia as a result of a developmental or learning disability, such as cerebral palsy.

Complications of dysphagia

Dysphagia can sometimes lead to further problems.

One of the most common problems is coughing or choking, when food goes down the “wrong way” and blocks your airway. This can lead to chest infections, such as aspiration pneumonia, which require urgent medical treatment.

Aspiration pneumonia can develop after accidentally inhaling something, such as a small piece of food.

Warning signs of aspiration pneumonia include:

  • a wet, gurgly voice while eating or drinking
  • coughing while eating or drinking
  • difficulty breathing – breathing may be rapid and shallow

If you, or someone you care for, have been diagnosed with dysphagia and you develop these symptoms.

Dysphagia may mean that you avoid eating and drinking due to a fear of choking, which can lead to malnutrition and dehydration.

Dysphagia can also affect your quality of life because it may prevent you from enjoying meals and social occasions.

Dysphagia in children

If children with long-term dysphagia aren’t eating enough, they may not get the essential nutrients they need for physical and mental development.

Children who have difficulty eating may also find mealtimes stressful, which may lead to behavioral problems.


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