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Some of the common questions that we have received are posted here for your convenience. Many times the question asked by one member, answers the same question pondered by several other members. Feel free to contact edwardsd@childrensdayton.org if you have additional questions that are not answered by our current listing.
 

Common Questions

What is a swallowing disorder?

A swallowing disorder, called dysphagia(dys/pha/juh), is a difficulty or inability to swallow. There are different phases of the swallow. The problem can affect any phase of the swallow. What happens in the mouth is the oral phase. What happens in the throat is the pharyngeal phase. What happens in the esophagus, called the esophageal phase. A person can have difficulty in any or all of the phases of the swallow. If the person can’t eat or drink enough, this will affect their nutrition. 

How does normal swallowing occur?
Swallowing is a very complex process that seems to happen so automatically that we give it little thought. Some 50 pair of muscles and many nerves work together to coordinate all the movements needed to transport a bite of food or sip of liquid from the mouth, through the throat and to the stomach.

What are the different phases of swallowing?
The oral phase of swallow is where the food is chewed and prepared, the liquid is controlled and collected and moved to the back of the mouth. It is formed into a bolus. The pharyngeal phase of swallow is where the food/liquid is transported through the throat as the muscles squeeze and push the food down. A muscle called the upper esophageal sphincter separates the upper throat (hypopharynx) from the esophagus (the feeding tube that leads into the stomach). As part of the swallowing response, the upper esophageal sphincter relaxes and opens to allow the food to pass from the throat into the esophagus. In the esophageal phase of swallow a series of wave- like contractions help carry the bolus downwards towards the stomach. A muscle called the lower esophageal sphincter opens and the bolus passes into the stomach.

What is aspiration?
Aspiration occurs whenever secretions, food or liquid goes down "the wrong pipe” and enters the airway or lungs. This often results in coughing or choking sensation. However, many individuals who aspirate do not sense the material going the wrong way. Aspirating material into the lungs may lead to pulmonary problems such as pneumonia.

What is silent aspiration?
Silent aspiration occurs when food or liquid goes down the wrong pipe into the lungs and the individual does not feel it so does not cough.

What are some signs and symptoms of a swallowing disorder?

  • Coughing or choking while eating or drinking
  • A wet or gurgly vocal quality during or after eating or drinking
  • A feeling like the food is stuck or won’t go down
  • Food that may remain in the mouth or in the checks after the swallow
  • Losing food from the front of the mouth
  • Weight loss or reduced appetite
  • Food or liquid coming out of the nose
  • Sensation of a "lump” in the throat

Why can a swallowing disorder be a serious medical problem?
If a person cannot eat enough, they may become under-nourished. If they don’t drink enough, they may become dehydrated. One of the most serious complications of dysphagia is aspiration pneumonia. Aspiration pneumonia can be caused by food or liquid entering the lungs and causing an infection.

What causes a swallowing disorder in adults?
There are three main causes of swallowing disorders in adults:
  • Neurological 
  • Mechanical 
  • Psychogenic 

Many types of neurological diseases can cause dysphagia. These include stroke, head injury, multiple sclerosis, Parkinson’s Disease, dementia and many others.

Surgery or treatment (such as radiation therapy) to the head, mouth or neck area can result in a change in the anatomy that causes dysphagia. These are called mechanical dysphagia because the parts of the anatomy needed for safe swallowing have been altered and don’t move well.

Sometimes a person becomes afraid to swallow when the swallowing mechanism is actually still working well. These psychogenic swallowing problems do not occur nearly as frequently as neurological or mechanical dysphagia.