Swallowing difficulties, medically known as dysphagia, can significantly impact one’s quality of life. Swallowing is a complex process that involves the coordinated action of muscles and nerves in three distinct stages: the oral phase, the pharyngeal phase, and the esophageal phase. Problems can occur at any of these stages, leading to dysphagia. This article will provide an overview of these stages and focus on the types of dysphagia affecting the oral and pharyngeal phases, which are treated by Mr Wale Olarinde, an ENT specialist.
Stages of swallowing
- Oral phase: This is the first stage of swallowing where food is chewed and mixed with saliva to form a bolus (a soft mass of chewed food). The tongue then pushes the bolus to the back of the mouth, preparing it for the next stage.
- Pharyngeal phase: The second stage begins when the bolus reaches the throat (pharynx). The swallow reflex is triggered, and the food is pushed down the throat. This stage is crucial as it involves closing the airway to prevent food or liquid from entering the lungs, directing it safely into the oesophagus.
- Esophageal phase: The final stage involves moving the bolus down the oesophagus to the stomach through a series of muscle contractions called peristalsis.
Swallowing is a smooth and efficient process when all three stages work correctly. However, issues in any stage can lead to dysphagia, causing discomfort and potential health risks.
While dysphagia can occur at any of these stages, this article will focus on issues in the oral and pharyngeal phases, which are the areas treated by Mr Wale Olarinde.
Oral dysphagia: challenges in the mouth
Oral dysphagia occurs when there are problems in the mouth that make it difficult to chew food or move it to the back of the throat. This can be caused by neurological disorders, muscle weakness, or structural issues.
Symptoms
- Trouble chewing food
- Food or liquid spilling from the mouth
- Difficulty moving food to the back of the mouth
- Feeling like food is stuck in the mouth
Treatment
Diagnosing oral dysphagia involves a careful examination and may include tests like a modified barium swallow study. Treatment might include swallowing therapy with a speech and language therapist, changes in diet, and dental treatments.
Pharyngeal dysphagia: issues in the throat
Pharyngeal dysphagia happens when there are problems in the throat affecting the movement of food from the mouth to the oesophagus. This phase is important for ensuring food and liquid go down the right way without entering the airway. Causes include neurological disorders, structural problems, and muscle issues e.g. pharyngeal pouch, throat (laryngeal, hypopharyngeal, tongue base cancer). Cricopharyngeal dysfunction (when the muscle at the top of the oesophagus (food pipe/gullet) does not relax to allow food to enter the oesophagus), cervical osteophytes (bony prominences from the spine) and pharyngeal strictures are conditions in the pharynx that may also cause dysphagia.
Symptoms
- Coughing or choking while eating or drinking
- Feeling like food is stuck in the throat
- Food or liquid coming out of the nose
- Frequent pneumonia due to food entering the airway
- Difficulty starting to swallow
Treatment
Diagnosing pharyngeal dysphagia requires a thorough examination and might involve tests like a modified barium swallow study. Treatment can include swallowing therapy, changes in diet, and sometimes surgery to remove blockages or correct problems.
When to seek medical attention
You should seek medical attention if swallowing difficulties are linked with breathing issues, weight loss, a neck lump, voice changes, a constant sore throat, choking, ear pain, or regurgitating food or drink. These symptoms could indicate a more serious problem that needs prompt care.
Understanding the stages of swallowing and the types of dysphagia is important for getting the right treatment. Early diagnosis and intervention can greatly improve quality of life. If you or someone you know has trouble swallowing, book an appointment with Mr Wale Olarinde to explore the best treatment options.