Have you ever wondered how many times you swallow in a day? According to studies, you could be swallowing around 500 to 700 times per day. This also includes the swallows you do when you sleep.
Swallowing, like breathing, is an important bodily function for life sustenance. It is an act of taking in food/water from your mouth, which is then mixed with saliva and chewed with the help of teeth and tongue , and made into a fine paste. It is then passed on to a narrow passage called Pharynx and as it passes further, there is a leaf-shaped structure called Epiglottis that closes off the Trachea (windpipe) and prevents the food substances entering the windpipe. The food then finally passes through Oesophagus (food pipe) and enters the stomach.
Dysphagia (difficulty swallowing) is a condition that can severely impact a person’s quality of life and overall health. In this blog, we’ll explore the importance of dysphagia awareness, by highlighting its causes, signs and symptoms, and what happens when you lose the ability to swallow.
Dysphagia Causes
Dysphagia can arise from various underlying causes, including:
- Structural abnormalities in the throat or esophagus, including strictures, tumors, or inflammation
- Neurological disorders such as stroke, Parkinson’s disease, multiple sclerosis, ALS (amyotrophic lateral sclerosis), and dementia
- Respiratory conditions such as chronic obstructive pulmonary disease (COPD) or pneumonia
- Psychological factors such as anxiety or depression affecting swallowing function
- Gastroesophageal reflux disease (GERD) leading to esophageal irritation or narrowing
- Head and neck cancer or radiation therapy affecting swallowing function
- Muscular disorders such as myasthenia gravis or muscular dystrophy
- Traumatic injuries to the head, neck, or chest
- Aging-related changes in swallowing function
Medications with side-effects like dry mouth or impaired muscle coordination can also cause dysphagia.
Signs and Symptoms of Dysphagia
Recognising the signs and symptoms of dysphagia is crucial for early detection and intervention. These include:
- Difficulty in initiating swallowing
- Coughing or choking while eating or drinking
- Sensation of food getting stuck in the throat or chest
- Change in voice quality after eating or drinking
- Prolonged meal times or difficulty finishing meals
- Recurrent throat clearing or throat discomfort
- Recurrent respiratory infections, such as pneumonia
- Avoidance of certain foods or liquids due to swallowing difficulties
- Unexplained weight loss or malnutrition
- Regurgitation or aspiration of food or liquid
What Happens When You Lose the Ability to Swallow?
When an individual loses the ability to swallow, they are faced with significant challenges and complications associated with dysphagia. Losing this fundamental function can impact various aspects of daily life. Let’s take a look at what happens when you lose the ability to swallow:
Nutritional Deficiencies
The inability to swallow properly can lead to inadequate intake of food and fluids. This eventually results in malnutrition, dehydration, and weight loss.
Choking Hazard
Dysphagia increases the risk of choking on food or liquids.
Aspiration
Food or liquid may enter the airway instead of the esophagus. This increases the risk of aspiration pneumonia.
Speech and Communication Issues
Vocal function may be severely impacted by dysphagia. This leads to changes in voice quality and difficulty speaking clearly, especially after eating or drinking (following an act of swallowing).
Dental Issues
Individuals who have difficulty swallowing are at risk of dental decay, gum disease, and oral infections.
Impact on Mental Health
The inability to swallow can have psychological effects, including depression, anxiety, and decreased self-esteem.
Loss of Autonomy
Dysphagia typically leads to dependence on others for feeding assistance. This loss of independence impacts overall quality of life too.
Reduced Quality of Life
Dysphagia can seriously lower the enjoyment of meals and social interactions. This causes feelings of frustration, embarrassment, and even isolation.
Dysphagia Management
At Plexus, our Speech and Language Therapists help in identifying the root cause of dysphagia and plan appropriate therapy techniques to enable them to eat/drink safely. Some of these techniques include:
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- Mealtime supplementation and modified diet
- Altering the consistency of food or thickness of liquid to a more easier-to-swallow texture will reduce the amount of energy spent on feeding, chewing and swallowing.
- Some foods can be moistened with sauces and/or gravies. These work like a lubricant and case help ease the passage of food through the throat, into the esophagus, and eventually into the stomach. These foods are also less likely to leave any residue in the soft palate or throat.
- Smaller bites of food and sips of liquid can make it easier to control the food while swallowing.
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- Thickeners
- Thickening agents can make liquids more viscous and slow the rate of flow during swallowing. This can significantly reduce the risk of choking and aspiration.
- Other suggestions –
- Soften foods that need a lot of chewing and end up using a lot of energy. Use a blender or food processor to blend foods to a desirable consistency.
- Minimize fatigue at mealtimes by prepping small meals and snacks for the day.
- Keep reinforcing safe swallow strategies as recommended by the SLP and nutritionist.
By increasing awareness, recognising the signs and symptoms, understanding the underlying causes, and promoting early intervention and support, we can make a positive impact on the lives of individuals living with dysphagia. To know more about our Swallowing Therapy programs, reach out to our teams in Bangalore and Hyderabad today.
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FAQs
How do you deal with dysphagia?
A multidisciplinary approach is the best strategy to deal with dysphagia. This includes swallowing exercises, dietary modifications, positioning techniques, as well as the use of assistive devices or feeding tubes. At Plexus, our speech-language pathologists develop personalized treatment plans tailored to the individual’s needs and underlying causes of dysphagia.
What are the 4 stages of swallowing?
The four stages of swallowing include:
Stage 1: Oral Preparatory Stage – A hand-to-mouth transfer of food from a plate and into the mouth, or from a cup that is placed at the lips to drink from. Typically, this process can have a transfer aid like cutlery, cup, straw, etc.
Stage 2: Oral Stage – Chewing and grinding of food happens at this stage. Food is processed into smaller participles by the muscles inside the mouth, tongue and saliva. Once broken down, the food is formed into a cohesive bolus that is soft enough to swallow. The muscles in the tongue push the food/liquid
Stage 3: Pharyngeal Stage – Once the food passes down the throat and past the tonsils the process becomes involuntary. The throat muscles squeeze the food from the upper throat through the sphincter muscle and into the esophagus. The epiglottis prevents the food from entering the trachea.
Stage 4: Esophageal Stage – The sphincter muscle shuts off the entry to the food pipe at this time in order to prevent a) air from entering the stomach and b) reflux or regurgitation of previously ingested food back up into the throat. Once the food has entered the food pipe, the muscles contract to push the food further down and into the stomach.
These stages describe the chronological movements and coordination required for safe and efficient swallowing, from chewing and manipulating food in the mouth to its passage through the throat and into the stomach.
What are 5 signs of swallowing difficulty?
Signs of swallowing difficulty include:
- Coughing or choking while eating or drinking
- Recurrent pneumonia or respiratory infections
- Unexplained weight loss
- Prolonged meal times
- A gurgling sound in the throat after swallowing
Do people recover from dysphagia?
Recovery from dysphagia depends on the underlying cause, the severity of symptoms as well as other individual factors. Early intervention and appropriate treatment has helped people experience improvement in swallowing function and quality of life. There are also some cases of dysphagia that may be chronic or progressive. These require ongoing management and support to optimize swallowing safety as well as nutrition.