Also called Dysphagia. Dysphagia is simply defined as a swallowing disorder. It can occur in any of the three phases of swallowing: Oral, Pharyngeal, Esophageal.
Dysphagia is often noted in stroke survivors and can affect the oral and/or pharyngeal phase of swallowing. The patient may cough or choke while attempting to swallow saliva, liquids, or food. A speech-language pathologist often assesses a patient’s ability to swallow in order to determine the risk of aspiration, (food or liquid going into the lungs) which potentially may lead to a lung infection or pneumonia.
Stroke survivors are at risk for silent aspiration. Silent aspiration is when food and liquid enter into the lungs without any coughing or choking. In these patients, there are no outward signs or symptoms of a swallowing problem.
When we swallow, many muscles and nerves work together to get food or drink from our mouths into our stomachs. Trouble with swallowing can originate anywhere in the mouth, throat or esophagus. The esophagus is a muscular tube in your throat that carries food and water to your stomach.
Swallowing problems can be mild or severe. The treatment varies depending on what’s causing the problem. Sometimes, doctors can prescribe medication to help you swallow. If you’re unable to swallow anything at all, you may need a feeding tube to get the nourishment you need.
Many disorders, diseases and conditions can cause trouble swallowing. Doctors separate swallowing problems into three types:
Oral cavity dysphagia: The problem is in the mouth. Typical causes include tongue weakness after stroke, difficulty chewing food or neuromuscular problems
Oropharyngeal dysphagia: The problem is in the throat. This can be a result of a neurological or muscular problem
Esophageal dysphagia: This is a problem of the esophagus. This can be caused when something blocks or compresses the esophagus, there’s a muscular disorder or there are pouches in the esophagus.
Possible causes of swallowing difficulties can include:
Nervous system and brain disorders: Certain conditions affect your brain and nervous system (the network of nerves that controls muscles and organs). Parkinson’s disease, multiple sclerosis, amyotrophic lateral sclerosis (ALS) and stroke can lead to swallowing difficulties.
Muscle disorders: Myasthenia gravis (an autoimmune condition) and muscular dystrophy affect muscles all over the body. Disorders of the esophagus, such as achalasia, systemic sclerosis (scleroderma), cricopharyngeal spasms and esophageal spasms can affect your ability to swallow.
Scarring from acid reflux: Scar tissue can form in your esophagus as a result of GERD (acid reflux disease). GERD can lead to Barrett’s esophagus (irritation in the esophagus lining).
Infection: Tonsillitis (sore throat) causes pain and inflammation. It can make swallowing painful.