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Swallowing Disorders

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					Swallowing Disorders




Introduction                                     	 There	are	two	types	of	problems	that	
	 Occasional	difficulty	swallowing	              can	make	it	hard	for	food	and	liquids	to	
(dysphagia)	usually	isn’t	cause	for	concern,	    travel	down	your	esophagus:	Something is
and	may	simply	occur	when	you	eat	too	fast	      blocking your throat or esophagus. This
or	don’t	chew	your	food	well	enough.	But	        may happen if you have:
persistent	difficulty	swallowing	may	indicate	      · Gastroesophageal reflux disease
a	serious	medical	condition	requiring	                 (GERD).	When	stomach	acid	backs		
treatment.                                          	 up	regularly	into	your	esophagus,	it		
	 Dysphagia	is	usually	a	sign	of	a	problem	         	 can	cause	scars	to	form.	These	scars		
with	your	esophagus—the	muscular	tube	              	 can	make	your	esophagus	narrower.
that	moves	food	and	liquids	from	the	back	          · Esophagitis.	This	is	inflammation	of
of	your	mouth	to	your	stomach.	Although	            		 the	esophagus.	This	can	be	caused	by		
dysphagia	can	happen	to	anyone,	it	is	most	         	 different	problems,	such	as	having	an		
common	in	older	adults,	premature	babies,	          	 infection	or	getting	a	pill	stuck	in	the		
and	people	with	problems	of	the	brain	or	           	 esophagus.	It	can	also	be	caused	by	an		
nervous	system.                                     	 allergic	reaction	to	food	or	things	in	the		
	 There	are	many	different	problems	that	           	 air.
can	prevent	the	esophagus	from	working	             · Esophageal webs.	These	occur	when
properly.	Some	of	these	are	minor,	while	           	 thin	pieces	of	tissue	stick	out	from	the		
others	are	more	serious.	If	you	have	a	hard	        	 walls	of	the	esophagus.	
time	swallowing	once	or	twice,	you	probably	        · Diverticula.	These	are	small	sacs	in	the
do	not	have	a	medical	problem.	But	if	you	          	 walls	of	the	esophagus	or	the	throat.	
have	trouble	swallowing	on	a	regular	basis,	        · Esophageal tumors.	These	growths	in
you	may	have	a	more	serious	problem	that	           	 the	esophagus	may	be	cancerous	or		
needs	treatment.                                    	 not	cancerous.
                                                    · Some type of food or object stuck in
Causes of Dysphagia                                    your throat or esophagus.	Older
	 Normally,	the	muscles	in	your	esophagus	          	 people	with	dentures	may	have
contract	to	move	food	and	liquids	from	your	        	 problems	chewing	food	properly
mouth	to	your	stomach	without	problems.	            	 before	they	swallow.	Young	children	will
Sometimes,	though,	food	and	liquids	have	           	 sometimes	swallow	small	objects	that
trouble	getting	to	your	stomach.	                   	 can	get	stuck	in	the	esophagus.
    · Masses outside the esophagus,	such              · Sensation of food getting stuck in
    	 as	lymph	nodes	or	tumors,	that	press		            your throat or chest, or behind your
    	 on	your	esophagus.                                breastbone (sternum)
	 The muscles and nerves that help move               · Pressure or pain in your chest
food from the throat down the esophagus               · Bringing food back up (regurgitation)
are not working right. This can happen if             · Frequent heartburn
you have:                                             · Food or stomach acid backing up into
    · Had a stroke or a brain or spinal cord            your throat
      injury.                                         · Gurgling sound in your throat
    · Certain problems with your nervous              · Unexpected weight loss
      system,	such	as	achalasia,	post-polio		          In infants and children, signs and
    	 syndrome,	multiple	sclerosis,	muscular		    symptoms of swallowing difficulties may
    	 dystrophy,	or	Parkinson’s	disease.          include:
    · An immune system problem that                   · Lack of attention during feeding
      causes swelling and weakness,	such                or meals
    	 as	polymyositis	or	dermatomyositis.             · Tensing of the body during feeding
    · Esophageal spasm.	This	means	that               · Refusing to eat foods of different
    	 the	muscles	of	the	esophagus	suddenly		           textures
    	 squeeze.	Sometimes	this	can	prevent		           · Lengthy feeding or eating times
    	 food	from	reaching	the	stomach.                   (30 minutes or longer)
    · Scleroderma.	In	this	condition,	tissues         · Food or liquid leaking from the mouth
    	 of	the	esophagus	become	hard	and		              · Coughing or gagging during feeding
    	 narrow.	Scleroderma	can	also	make		               or meals
    	 the	lower	esophageal	muscle	weak,		             · Spitting up or vomiting during
    	 which	may	cause	food	and	stomach		                feeding or meals
    	 acid	to	come	back	up	into	your	throat		         · Inability to coordinate breathing with
    	 and	mouth.                                        eating and drinking
	 Sometimes	doctors	can	find	no	reason                · Poor weight gain or growth
for	dysphagia,	even	though	it	can	have	many	      	 If	you	have	problems	breathing	because	
causes.	In	some	people,	dysphagia	is	just	        something	is	stuck	in	your	throat	or	chest,	
a	result	of	aging.	As	people	get	older,	all	of	   call	911	immediately.	If	you	have	had	
their	muscles	can	get	weaker,	including	the	      difficulty	swallowing	for	more	than	1	week,	
esophagus.                                        call	your	doctor.

Symptoms of Dysphagia                             Treatment
    Signs and symptoms sometimes                      Treatment	for	swallowing	difficulties	is	
associated with dysphagia may include:            often	tailored	to	the	particular	type	or	cause	
   · Pain while swallowing (odynophagia)          of	your	swallowing	disorder.
   · Not being able to swallow at all             Esophageal dysphagia—This	is	the	most	
   · Choking or coughing while eating             common	type	of	swallowing	difficulties.	
It	refers	to	the	sensation	of	food	sticking	or	    Oropharyngeal dysphagia—Certain	
getting	hung	up	in	the	base	of	your	throat	        neuromuscular	problems	can	weaken	your	
or	chest.	                                         throat	muscles,	making	it	difficult	to	move	
    · For a tight esophageal sphincter             food	from	your	mouth	into	your	throat	
      (achalasia)	or	an	esophageal	stricture,      and	esophagus.	You	may	choke	or	cough	
    	 your	doctor	may	use	an	endoscope		           when	you	attempt	to	swallow,	or	have	the	
    	 with	a	special	balloon	attached	to           sensation	of	food	or	fluids	going	down	your	
    	 gently	stretch	and	expand	the	width          windpipe	or	up	your	nose.	
    	 of	your	esophagus	(dilatation).	             		 · For oropharyngeal dysphagia, your
    · For an esophageal tumor or                      	 doctor	will	most	likely	refer	you	to
      pharyngeal diverticula, you	may	need            	 a	throat	specialist	or	neurologist	for
    	 surgery	to	clear	your	esophageal	path.          	 further	diagnostic	testing	and	to	a
                                                      	 speech	or	swallowing	specialist	for
    · Difficulty swallowing associated with
                                                      	 therapy.	Certain	exercises	may	help
      GERD can	be	treated	with	prescription
                                                      	 coordinate	your	swallowing	muscles
    	 oral	medications	to	reduce	stomach
                                                      	 or	restimulate	the	nerves	that	trigger
    	 acid	after	a	stricture	is	dilated.	You		
                                                      	 the	swallowing	reflex.	You	may	also
    	 may	need	to	take	these	medications
                                                      	 learn	simple	ways	to	place	food	in	
    	 for	an	extended	period	of	time.	
                                                      	 your	mouth	or	to	position	your
    · If you have esophageal spasm but                	 body	and	head	to	help	you	swallow
      your esophagus appears normal and               	 successfully.
      without GERD, you	may	be	treated
    	 with	medications	to	relax	your
    	 esophagus	and	reduce	discomfort.             Sources:	Webmd	&	Mayo	Clinic




                                                                      “If you have dysphagia, a certified
                                                                speech-language pathologist can help you by
                                                               providing many services to diagnose and treat
                                                                  this potentially life-threatening disorder.”
                                                                             Kristin Johnson,
                                                                   Memorial Speech-Language Pathologist




         The information provided is not meant to diagnose or treat a possible health problem.
         For more information about swallowing disorders, contact your health care provider.
                To	find	a	physician,	please	call:
          Memorial Physician Referral Service
             (228) 865-3627 or (228) 867-4022




 Memorial Neurosciences & Rehabilitation
                           (228) 865-3030




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