Swallowing Everything
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Swallowing Everything
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Difficulty swallowing (dysphagia) affects your quality of
life and your health. The ability to safely swallow is vital for adequate
nutrition and hydration, and it prevents foods and liquids from entering your
lungs, where they can cause pneumonia.
Swallowing is a complex process that requires multiple muscles to work together. When you swallow:
A problem in one or more of these areas can make it difficult or painful to swallow.
The term dysphagia refers to difficulty swallowing. It is used regarding a variety of swallowing disorders. Not all swallowing problems are dysphagia — it is normal to have occasional difficulty swallowing certain foods or liquids, such as when taking large bites of food. However, ongoing difficulty swallowing could be a cause for concern.
Depending on which part of the swallowing process is affected, dysphagia can be described as:
Swallowing disorders cause a variety of symptoms that include:
While the above symptoms often happen during or after swallowing, some signs of dysphagia can appear independently of eating, drinking or swallowing. Talk to your doctor if you’ve been experiencing:
There are many reasons why swallowing may become difficult.
Esophageal motility is the movement of food through the esophagus. Normally, coordinated muscle contractions in the esophagus move the swallowed food toward the stomach in one direction. At the top and bottom ends of the esophagus are rings of muscles called sphincters that allow the food to enter and exit the esophagus.
If the muscles stop working together or if one of them stops working at all, food can fail to pass into the stomach. This can happen due to issues with the muscles or the nerves that supply the muscles. Events such as previous surgery on the esophagus or having a breathing tube can often lead to difficulties swallowing, but in many cases, the exact cause is unknown.
Problems with mobility in the esophagus include:
There are also other types of motility problems in the esophagus, such as the lower esophageal sphincter being too tight or too loose. If the sphincter is too loose, it can allow the stomach contents to enter back into the esophagus – a condition known as gastroesophageal reflux disease (GERD).
The esophagus is a mostly straight, tube-like structure. If it becomes narrowed or develops pockets, this can lead to swallowing problems. Some people are born with anatomical features that make them prone to swallowing disorders. But more often, structural changes develop over time. They include:
Neurogenic dysphagia is swallowing problems related to the nerves governing function of the mouth, throat and esophagus.
A person experiencing nasal regurgitation is likely to have some form of neurologic disease, and coughing during swallowing is another sign that the dysphagia could be due to a nerve problem. In some cases, if you have these symptoms, your doctor will want to evaluate you to rule out systemic (all-over) nerve disease.
Swallowing issues can accompany conditions associated with muscle weakness or poor coordination such as:
Hyperthyroidism and hypothyroidism can also affect nerve function related to swallowing.
Eosinophilic esophagitis is a chronic condition that can cause swallowing difficulties in infants, children and adults.
An allergic reaction to a food or other environmental factor can trigger inflammation of the esophagus. Over time, the esophagus may tighten and develop abscesses or constricting rings of tissue that can become blocked by swallowed food (impaction), which can cause a medical emergency.
At Another Johns Hopkins Member Hospital:
To diagnose a swallowing disorder, your doctor will start by performing a thorough physical exam and asking you about your symptoms and medical history. As you describe your swallowing difficulties, focus on (or write down beforehand):
In addition to examining the inside of your mouth and throat, your doctor may recommend one or more of the following tests to confirm the diagnosis and the cause of your swallowing problems.
If you are a patient in a hospital when your swallowing problems start, a speech-language pathologist will evaluate your swallowing by performing a bedside swallow exam . It involves a physical exam of your mouth, testing of swallowing reflexes and swallowing test liquids of various thickness.
In some cases, it is possible to remove the cause of a swallowing disorder, such as by relaxing an esophageal sphincter that is too tight. If treating the cause is not possible, then dysphagia treatment focuses on making swallowing safer and on easing the discomfort. Depending on your diagnosis, your doctor may recommend medications, swallowing therapy, surgery, changing your diet or other treatments.
Medications can be effective in relieving specific swallowing symptoms or treating an underlying cause such as an infection or a neurologic condition:
Swallowing therapy focuses on retraining muscles to improve swallowing and to reduce the risk of choking and aspiration. The therapy is performed by speech-language pathologists – specialists trained in swallowing assessments and rehabilitation therapy.
Swallowing exercises include but are not limited to:
Swallowing retraining can be especially helpful for people with dysphagia caused by neurological disorders, as well as those who’ve had surgery on the throat muscles.
Because the organs involved in swallowing are close to the mouth, swallowing problems can often be addressed with an endoscope (a lighted flexible tube) inserted through the mouth. With the endoscopic approach, no incisions are made. However, in some cases, it may be necessary to cut through the skin to treat the cause of a swallowing problem.
Procedures for swallowing disorders include:
If removing the swallowing problem is not possible, changing what and how you eat can help make swallowing safer and more comfortable. Your speech-language pathologist may recommend:
Sometimes, a swallowing disorder may be so severe that it prevents eating enough to maintain weight. Feeding tubes can provide a way for nutrition to bypass the problem area and decrease the risk of coughing and choking. Your doctor may recommend enteral feeding if you have lost a substantial amount of weight or if you keep getting aspiration pneumonia due to the swallowing disorder.
There are several types of feeding tubes based on how they provide nutrition and where in the body they are inserted. Your care team will determine which type of tube is the most appropriate.
A feeding tube does not need to be permanent. As your ability to swallow and absorb nutrients improves, the tube may be removed.
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Swallowing Everything · Helmet
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Released on: 2006-07-18
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2,091 views Feb 22, 2022 Provided to YouTube by CDBaby
Swallowing Everything · Helmet
Monochrome
℗ 2006 Helmet
Released on: 2006-07-18
Auto-generated by YouTube. … ...more
Alice In Chains, Helmet, Faith No More, and more
Alice In Chains, Helmet, Faith No More, and more
Helmet, Faith No More, Rage Against the Machine, and more
Helmet, Faith No More, Rage Against the Machine, and more
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Provided to YouTube by CDBaby
Swallowing Everything · Helmet
Monochrome
℗ 2006 Helmet
Released on: 2006-07-18
Auto-generated by YouTube.
2,091 views Feb 22, 2022 Provided to YouTube by CDBaby
Swallowing Everything · Helmet
Monochrome
℗ 2006 Helmet
Released on: 2006-07-18
Auto-generated by YouTube. … ...more
Alice In Chains, Helmet, Faith No More, and more
Alice In Chains, Helmet, Faith No More, and more
Helmet, Faith No More, Rage Against the Machine, and more
Helmet, Faith No More, Rage Against the Machine, and more
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