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The content on this website is for educational purposes only and should not be used as a substitute for medical advice. Please consult with your healthcare provider prior to initiating any of these treatments. The use of this website does not imply nor establish any type of doctor-client relationship.

Updated 10-06-19

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Dysphagia

The swallowing of food is a complex series of muscle activations starting in the mouth. Food enters the mouth, where salivary glands are activated and mastication or chewing and the mixing of saliva takes place to form a bolus. A bolus is a solid cohesive unit that can be swallowed together. During this time, you breathe through your nose, the nostrils flare open to allow for increased air flow into the body.

Once the food has been adequately chewed, it is positioned by the tongue into position to be swallowed. A series of muscles push the food down the esophagus, the vocal cords relax to allow passage of the food to pass through and the epiglottis closes so it doesn't go through the trachea into the lungs. It goes through the Upper Esophageal Sphincter. The entire passage is lined with moist tissue called Mucosa to help lubricate the passage and allow easier passage of solids through the throat.

The esophagus is positioned behind the trachea closer towards the spine. It is about 8 inches long. It passes through the diaphragm, the muscle below your lungs that helps you breathe. It meets the stomach at the Lower Esophageal Sphincter. The contents pour into the stomach where the solids and liquids are broken down via the rest of the digestive system.

Symptoms of Dysphagia:

Pain in chest

Chronic Heartburn

GERD (Acid Reflux Disease)

Weight Loss

Oral Dysfunction

Periodontal Issues

Throat Cancer

Choking on food and liquids

Tightness in the chest

Vomiting after eating not caused by bulimia

Reoccurring Pneumonia

Drooling

Chronic coughing or gagging while eating

Barium X-ray Study

Dysphagia is the difficulty to swallow solids or liquids. In 2012, a national health survey was done, analyzing adults who complained of having difficulty swallowing in the previous 12 months. The most common cause for the Dysphagia was neurological problems, head and neck cancers, & stroke. There are three types of Dysphagia. They are broken down into two types by the cause and presentation of symptoms.

 

Type I: Oropharyngeal Dysphagia

This type of Dysphagia presents as weakness in the mouth, difficulty chewing, weakness in the tongue, and difficulty moving the bolus (chewed food) into position to swallow. Loss of sensation in the mouth, numbness due to nerve damage or other causes can result in this issue. Not being able to feel the food and liquid in ones mouth makes mastication very challenging. EDS can have an effect because EDS has periodontal effects, that can make teeth brittle.

 

When teeth are brittle, it can make eating painful. Tooth pain has been rated as one of the worst pains a human can endure. And as we all know, dental work can become quite expensive and can take time to complete. Pain can also play a role in this type of Dysphagia. When a person's mouth is in a lot of pain, they are unable to chew, so they are unable to eat adequate amounts of nutrients and if this takes place over a long enough period, it can lead to malnutrition.

Many times, people who suffer from Dysphagia experience a wide variety of symptoms. They are can be as simple as heartburn, to a rarer condition called Pharyngoesophageal Diverticulum. This is the formation of a small pocket or pouch within the esophagus where food collects. This causes a partial obstruction, making swallowing food extremely difficult. This type of pouch or pocket forms just above the esophagus. The symptoms for this specific condition are:

 

Bad breath

Difficulty Swallowing solids and liquids

Coughing

Frequent Heartburn

Chest Pain

Gurgling Sounds

Clearing One's Throat

Malnutrition

Dehydration

 

There are several reasons as stated before that can cause Dysphagia. They can be due to neurological manifestations such as Stroke, Trauma, Huntington's Disease, Parkinson's Disease, Multiple Sclerosis, and Muscular Dystrophy. Other medical conditions that dysphagia is common with are connective tissue disorders and GERD (acid reflux disease), and Cerebral Palsy.

Type II: Esophageal Dysphagia

This type generally is found in the Esophagus. This type of Dysphagia is characterized by difficulties of solids and liquids passing through the upper sections of the esophagus. This can also sometimes be referred to as Upper Dysphagia. This difficulty can be the result of spasms in the esophagus. This can be due to various things. These things may include things such as the timing of contractions, lack of coordination in contractions, and or painful, high-pressure contractions. An obstruction can also be the cause of this type of dysphagia. This obstruction can be the result of a physical item being lodged somewhere in the esophagus or an artifact such as the growth of a mass.

 

The signs of this type are usually more obvious with solids than liquids at first. But over time it can make it difficult to swallow liquids. Many patients report that it feels like food is “stuck” around the lower neck and upper chest area. A condition called Esophagitis can also be a reason for this type of Dysphagia. Esophagitis is the inflammation of the esophagus. Throat cancer can also be a cause for this type of Dysphagia. Radiation treatments to combat cancer can lead to swelling within the esophagus, and over time can lead to scarring. The scarring can cause the contractions of the muscles to perform abnormally resulting in poor performance. And as a result, makes it difficult for solids and liquids to pass through the esophagus into the stomach.