Swallowing

Swallowing Problems

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• Swallowing problems overview
• How do I know if I have a swallowing problem?
• How are swallowing problems diagnosed?
• How are swallowing problems treated?
• Things you can do to make eating and drinking easier and safer
  • Positioning while eating
  • Dining environment and minimizing distractions
  • Amount of food and rate of eating
  • Swallow food with frequency
  • Saliva management--drink plenty of fluids
  • Food consistency--eat soft foods
  • Taking medications and swallowing problems

Swallowing problems overview

The swallowing tract extends from the mouth to the stomach. The act of swallowing normally occurs in three phases. In the first phase, food or liquid is contained in the mouth by the tongue and palate (oral cavity). This phase is the only one we can control.

The second phase of swallowing begins when the brain makes the decision to swallow. At this point, a complex series of reflexes begin. The food is thrust from the oral cavity into the throat (pharynx). At the same time, two other events occur: A muscular valve at the bottom of the pharynx opens, allowing food to enter the swallowing tube (esophagus), and other muscles close the airway (trachea) to prevent food from entering the airways. This second phase of swallowing takes less than half a second.

The third phase of swallowing begins when food enters the esophagus. The esophagus, which is about nine inches long, is a muscular tube that produces waves of coordinated contractions (peristalsis). As the esophagus contracts, a muscular valve at the end of the esophagus opens and food is propelled into the stomach. The third phase of swallowing takes six to eight seconds to complete.

Thus, swallowing is a very complex act, requiring the normal function of the brain, several nerves and muscles, and two muscular valves, as well as an open, unconstricted esophagus.

A wide range of diseases can impair swallowing, including:

• Disturbances of the brain, such as Parkinson's disease, multiple sclerosis or ALS (amyotrophic lateral sclerosis, or Lou Gehrig's disease).
• Oral or pharynx muscle dysfunction (such as from a stroke).
• Loss of sphincter muscle relaxation (termed "achalasia").
• Esophageal narrowing (such as from acid reflux or tumors).