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Dysphagia 101

Science of swallowing

Did you know that you may swallow more than 600 times per day? Swallowing is a necessary part of everyday life, and problems with this important function can have a significant impact on your health and quality of life.

How do we swallow when we eat?

The swallowing process starts at the lips and ends with foods and liquids passing into the stomach. A normal swallow happens in four stages.

  1. Oral Preparatory Phase: Food or drink is put into the mouth, and the mouth is closed. The food is chewed and mixed with saliva, becoming a small ball of food known as a “bolus.”
  2. Oral Phase: The tongue pushes the bolus of food or drink into the back of the mouth.
  3. Pharyngeal Phase: The bolus passes from the mouth through the throat and into the esophagus. The airway closes as this happens.
  4. Esophageal Phase: The bolus passes through the esophagus and into the stomach.

About dysphagia

“Dysphagia” is the medical term for swallowing difficulties. This condition is often not detected or diagnosed until it begins to cause other problems for the affected person.

What is dysphagia?

Dysphagia is defined as difficulty swallowing. It involves a variety of problems related to consuming both solid food and liquids. While dysphagia is typically more common in the elderly, it has multiple causes that can affect people of all ages. It can occur in varying degrees, from mild difficulties with swallowing certain foods or liquids, to the complete inability to swallow.

People with dysphagia might experience trouble with swallowing, eating, drinking, chewing, sucking, controlling saliva in the mouth, swallowing medication, or protecting the airway.

Dysphagia can make eating and drinking uncomfortable or unsafe and may also lead to serious health issues. Because people with this condition may not seek or receive a diagnosis or treatment immediately, dysphagia can result in eating and drinking less, placing them at higher risk of malnutrition and dehydration. Dysphagia may also lead to respiratory infections. And because dysphagia can make eating in social situations uncomfortable, it can lead to isolation and have an impact on emotional wellbeing. Therefore, it’s important that swallowing problems are diagnosed and managed appropriately.

Can dysphagia be treated or cured?

Dysphagia can vary in terms of severity, underlying cause, and duration of the condition. It may be chronic, progressive, stable or temporary depending on what is causing the swallowing difficulty. In some cases, dysphagia can be managed through changes in diet, changes in posture while swallowing, or other non-invasive methods. Dysphagia can also sometimes be rehabilitated through specific exercises targeting the head and neck muscles under supervision from a healthcare professional. In some individuals, dysphagia may be severe enough to warrant a discussion with healthcare professionals about the potential need for a feeding tube.

Your healthcare professional is the most reliable source of information for your dysphagia management plan.

How common is dysphagia?

Dysphagia is generally estimated to affect around 8% of the total population. This number can vary depending on the setting. For instance, in hospital settings, dysphagia can occur in up to 71% of patients. In long-term care homes, it may range from 55 to 68% of residents. The rate of dysphagia is higher among older adults, and it is estimated that among older adults living in the community, the dysphagia rate is between 11 and 16%.

References: 1. Kawashima K, et al. Prevalence of dysphagia among community-dwelling elderly individuals as estimated using a questionnaire for dysphagia screening. Dysphagia. 2004;19:266-271. 2. O’Donohue G, et al. Oropharyngeal dysphagia—the need for effective management. Irish Medical J. 1994;87(6):180-18. 3. Bloem B, et al. Prevalence of subjective dysphagia in community residents aged over 87. BMJ. 1990;300:721-722. 4. Cabre M, et al. Prevalence and prognostic implications of dysphagia in elderly patients with pneumonia. Age & Ageing. 2010;39:39-45. 5. Cichero J, et al. Triaging dysphagia: nurse screening for dysphagia in an acute hospital. J Clin Nursing. 2009;18:1649-1659. 6. Steele C, et al. Mealtime difficulties in a home for the aged: not just dysphagia. Dysphagia. 1997;12:45-50.

What causes dysphagia?

Dysphagia is often caused by an illness, condition or disease that affects the nerves and muscles in the tongue, mouth and throat, and leads to problems coordinating and/or controlling the swallow. The list below contains some, but not all, possible causes for dysphagia.

Neurological disorders

Stroke, dementia, neuromuscular and neurodegenerative disorders such as Alzheimer’s, ALS, Parkinson’s disease, and multiple sclerosis.

Mechanical causes

Dysphagia may have underlying mechanical causes. For example, abnormal growths or structural changes in the esophagus may cause dysphagia. In some cases, dysphagia can be caused by inflammation or chronic gastric reflux disorders.

Head and neck conditions, including cancer

Head and spinal cord injuries, as well as some head and neck cancers may cause dysphagia. Some people who are undergoing radiation therapy for head and neck cancer may also develop dysphagia.

Age and dysphagia

Causes of dysphagia may also be different for people of different age groups. Children may experience dysphagia if they have cerebral palsy or developmental disabilities. In older adults, swallowing problems may be caused by other issues, such as dry mouth, weakness and general frailty, including changes to nerve and muscle function with age.

Nestlé Health Science has made every effort to include on this website only information that it believes to be accurate and reliable. Information provided on this site is for education purposes. It is not intended to replace the advice or instruction of your healthcare professionals, or to substitute medical care. Contact a qualified healthcare professional if you have questions or issues about what is best for you as you manage your swallowing difficulties at home.

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