Swallowing Therapy
Swallowing difficulty (Dysphagia)
The technical term for swallowing difficulty is “Dysphagia”. Swallowing problems can vary - it could be difficulty in chewing food, swallowing food and / or tolerating fluids. Dysphagia can occur in both children and adults due to various medical conditions. Warning signs of swallowing problems include choking, drooling and coughing during feeding. (See other
signs of swallowing problems ) Swallowing difficulty can result in dehydration, weight lost, and chest infection.
Treatment for swallowing problems include
In adults, causes of swallowing difficulties include stroke, traumatic brain injury, head and neck cancers, surgical excisions, progressive degenerative diseases (Parkinsons, Alzheimers), the aging process and many other medical conditions.
For children, feeding and swallowing difficulties can be caused by prematurity, Gastroesophageal reflux disease, cerebral palsy, head injury, congenital conditions and many other medical conditions.
(Go to Feeding and Swallowing Problems in Children )
Complications of dysphagia
People who have difficulty swallowing cannot enjoy the act of eating as we normally do. They may have difficulty retaining the food inside their mouth. Drooling is common in these individuals. They may also need a longer time to swallow the food or they may have choking or coughing during feeding. They may not be able to enjoy a certain kinds of food as we do. Some of them may lose weight because they are unable to eat/drink enough to meet their nutritional needs because of the swallowing difficulty. Swallowing difficulty can also be life threatening to these individuals as they may end up having a chest infection (aspiration pneumonia) if food goes into the wrong tract (the airway) during feeding.
Normal swallowing function
We always take eating for granted. How much time does it take for us to swallow a spoonful of ice-cream or soup? It usually takes us no more than 2-5 seconds! The time taken to manipulate the food to swallow may vary depending on what we eat. For example, we may have to chew the steak well before swallowing it while we just need to munch and swallow down a spoonful of porridge. The act of swallowing involves the movement and coordination of various muscles of the mouth and face (oro-motor muscles). It is far more complicated than what we have imagined!
What happens when we swallow? Let’s imagine we are now eating a spoonful of delicious creamy soup. When we put the spoonful of creamy soup in our mouth, our brain will send signals to our lips so that they come together to prevent food from leaking out of the mouth. The tongue will then push the bolus back to our throat. When the bolus reaches the back of our mouth, a small cartilage called the epiglottis will move down to cover our airway. Our voice box moves up and we stop breathing at that time. The muscles around our throat would then come together to push the bolus into our esophagus. If any of these oromotor muscles are weak or if our sensation is impaired, the process of swallowing will be affected. We may not be able to enjoy the taste of the soup. We may not be able to hold the soup inside the mouth. We may even choke or cough if the soup goes into our airway (aspiration)!
Swigert, N.B. (2000).
The Source for Dysphagia – Updated & Expanded. US: LinguiSystems, Inc.
Warning Signs of Swallowing Difficulties
