Posts tagged Dysphagia
Dysphagia is a medical condition which is characterized by difficulty with swallowing, wherein much more effort is needed than usual to accomplish the movement of food from mouth to stomach. It is most often caused by nerve or muscle problems, and dysphagia can be uncomfortable at times, or sometimes even painful.
It generally afflicts babies and older people more than any other grouping of people, although it can trouble persons of literally any age group at all. There are a number of causes of dysphagia, and when it only happens occasionally, there usually isn’t any serious problem underlying the swallowing difficulty.
However, when it happens that dysphagia occurs with greater regularity, that’s a situation which should be brought to the attention of the family doctor. Treatments recommended by your doctor will depend on what the underlying cause of the dysphagia is.
What Exactly is Dysphagia?
Whenever you take a swallow, there are several different muscles and nerves which participate in the process, and it is considerably more complex than you might think. Any disruption to the sequence of events which is necessary in the swallowing process can result in dysphagia.
Oral dysphagia is the type which is attributable to a problem situated in the mouth, and that can be triggered by tongue weakness following a stroke event, some kind of difficulty with chewing, or even problems with the transportation of food to the stomach. Pharyngeal dysphagia is characterized by some kind of disruption to the swallowing process which is centered in the throat. This kind of dysphagia is generally caused by some type of neurological problem affecting people’s nerves, and it is very common in conditions like stroke, Parkinson’s disease or amyotrophic lateral sclerosis.
Esophageal dysphagia is the type which is situated somewhere in the esophagus, and it is usually triggered by some kind of irritation or blockage in that area. It happens very frequently that a surgical solution is necessary to resolve esophageal dysphagia.
It should be borne in mind that pain in swallowing, which is known as odynophagia, is a very different problem than dysphagia, although it happens frequently enough that the same person will be afflicted by both at the same time.
Common Causes of Dysphagia
As can be seen below, there are a wide variety of causes for dysphagia, and in some cases, more than one of the conditions described are contributors to the problem:
- myasthenia gravis – voluntary control muscles become weak and tired because of a problem with how nerves produce muscle contraction
- multiple sclerosis – this condition is caused by the central nervous system coming under attack from the immune system
- amyotrophic lateral sclerosis – this is an incurable form of progressive neurodegeneration, in which over a period of time brain and spinal nerves lose function
- cleft lip and palate – these are abnormal facial developments which are caused by incomplete fusion of head bones
- eosinophilic esophagitis – this is characterized by elevated levels of white blood cells in the esophagus, which grow in at uncontrolled rate, and attack the gastrointestinal system
- diffuse spasm – esophagus muscles contract in an eccentric manner
- achalasia – the lower esophageal muscle cannot sufficiently relax to allow the passage of food to stomach
- esophageal ring – some portion of the esophagus narrows down, thus preventing the passage of solid foods
- Parkinson’s disease – a gradually progressive degenerative disorder which degrades a patient’s motor skills
- stroke – in this medical condition, brain cells die off because there is insufficient oxygen supply to the brain
- radiation – patients who have previously undergone radiation treatments in the area of the neck or head will sometimes develop difficulty swallowing.
Treatment for Dysphagia
The treatment for dysphagia will depend on whether it is characterized as high dysphagia or low dysphagia. In the case of high dysphagia, swallowing therapy may be recommended, and this will be carried out with the assistance of a language and speech therapist. The patient is helped to learn alternate ways of proper swallowing, and exercises are engaged in regularly toward that end.
At the same time, the patient is put on a diet which makes swallowing easier, while still providing all the necessary nutritional benefits. In cases where a patient is at risk of malnutrition, dehydration, or pneumonia, they may have to be fed through a nasal tube. In situations where this is the recommended process, the tube will be surgically implanted directly in the stomach, and will be passed through a tiny abdominal incision.
When low dysphagia is diagnosed, it would generally be necessary for some kind of surgical intervention. In cases where the esophagus is constricted for some reason and must be widened, a tiny balloon is slowly inserted and inflated until the passageway has become dilated, after which the balloon would again be extracted.
In cases where the muscles of the esophagus have become stiff, Botox is sometimes recommended because it is a toxin which has the effect of paralyzing the stiff muscle, thereby minimizing any constriction which has taken place.
In the event of dysphagia being caused by cancer, a patient would always be referred to an oncologist, and a program of treatment would generally involve surgical remover removal of the cyst or tumor which has been identified.
Causes of Swallowing Disorders
Trouble swallowing might be because of something blocking the esophagus and this is preventing anything from passing through. Swallowing disorders might stem from any of the following types of blockages:
- Esophagitis – This is where the esophagus becomes inflamed after an infection or perhaps even a pill getting stuck. For some, they also experience some form of reaction to a substance in the air or food they consume.
- Gastroesophegeal Reflux Disease (GERD) – If stomach acid manages to back right up into the esophagus, ulcers can form and this can actually lead to scars; in turn, this narrows the esophagus.
- Other Issues – Although these are the two main issues, you could also have cancerous or benign tumors within the esophagus or small sacs that form on the walls of your throat (diverticula). Finally, lymph nodes can appear on the vertebrae and push into the esophagus from the outside.
Secondly, the muscles and/or nerves might not be working correctly and this may come from brain injuries, stroke, orsome other health concerns.
- Nervous System – With muscular dystrophy, post-polio syndrome, Parkinson’s disease, and multiple sclerosis, these can affect the muscles and nerves.
Esophageal Spasm – At random intervals, the muscles will squeeze together and this prevents food from reaching the stomach.
- Scleroderma – With the esophagus tissue, this can become hard as well as narrow. In some cases, it can also weaken the lower esophageal muscles which, in turn, causes a backup of stomach acid in the throat.
- Immune System – Finally, an issue in the immune system can cause weakness and swelling in the area.
Now we know the issues that exist, how do professionals treat these swallowing disorders so you can return to your normal self? Firstly, they’ll try to locate the problem using an x-ray and various other procedures they have. If necessary, they’ll use a small camera to see the extent of the damage or even a small pressure gauge to measure your ability to swallow. Once they’ve found the cause, they can get to work on treatment and there are many different solutions depending on the cause.
- Dilation – If your esophagus has narrowed, this treatment will see a small device expand the area; this may require several sessions.
- Diet – If your diet is causing the problem, your doctor will recommend changing the foods you eat to identify the problematic ingredient.
- Exercise – As strange as It sounds, you can actually complete swallowing exercises to strengthen the muscles and allow for better swallowing.
- Endoscopy – In some situations, a blockage might cause the problem and an endoscopy can be used to remove any objects.
- Medicines – If the issue is related to heartburn, GERD, or esophagitis, some prescription medicines might be able to prevent stomach acid from getting into the esophagus. With infections, antibiotic medicines will also help the problem.
- Surgery – Finally, and this will only be done if completely necessary, surgery can remove blockages or anything else affecting the lower esophageal muscle.
Strep versus Sore Throat: Learn the Difference Here
When school is in session, outbreaks of strep throat can be common. Determining whether this common childhood infection is actually strep or just a sore throat can be challenging. Some parents may not be sure what the differences are or how to determine when to take a child to the doctor for treatment. Here are some things to keep in mind when weighing the differences between strep versus sore throat.
To start, a sore throat is generally caused by a virus. Usually, it will manifest along with other symptoms such as sneezing and a runny nose. There is no medicine that will cure a viral infection, so it generally just has to run its course. While they may be similar, there are marked variations between a strep and a virally induced sore throat.
Strep throat is caused by a bacterial infection. It is contagious, and this is one reason it spreads so quickly, particularly among little ones. Sneezing, coughing, and inadequate handwashing are some ways the infection can be spread. Generally, an infection leading to strep throat is treated with antibiotics. Symptoms may include fever, swollen tonsils, nausea, difficulty swallowing, and white and red patches on the throat. When these symptoms present themselves, it is a good idea to call the pediatrician. A swab test can be done to determine if there is in fact a strep infection. Plenty of rest, fluids, and a course of antibiotics are generally all that is needed to have children back to a normal routine.
The question often arises as to whether a child should have their tonsils removed in cases of frequent strep infection. Research has shown that this may be advisable when infections occur more than seven times in one year, or several times in two consecutive years. Talking to your pediatrician is best when making such a decision.
Knowing the differences between strep versus sore throat can save parents an emergency visit expense, but when in doubt always consult a medical professional.
If you are experiencing increasing difficulty in swallowing, it could be the symptom of a more serious condition. Dysphagia is the technical term for chronic swallowing problems. It can take a person who once loved food, and cause them to dread meal time. If you are experiencing dysphagia, you need to seek treatment. Sometimes even speech therapy is a part of the treatment for this affliction.
One type of dysphagia involves the esophagus. This is the tube that connects the mouth to the stomach. When a person suffers from this type of dysphagia, they may become malnourished since eating becomes difficult. The sufferer may lose weight and seem to have less interest in food than they did before. When a person with esophageal dysphagia tries to swallow, it can cause extreme discomfort in the chest. It may result in a cough that wakes the person up from sleep. It can also result in a person not being able to keep food down.
The other type of dysphagia is known as oropharyngeal dysphagia. While this type of swallowing disorder has many of the same symptoms, it will not cause pain in the chest since the problem is usually more in the mouth or upper throat area. Other symptoms may include drooling, food getting caught in throat frequently, frequent clearing of the throat and an excessive amount of time being spent chewing. This is often an effort on the part of the sufferer to make the food as easy to swallow as possible so as to prevent choking.
There are many different conditions that can cause dysphagia, and treatment will often depend on the underlying cause. Swallowing problems can be caused by muscle disorders, a tumor, dementia, a stroke, acid reflux, an infection, cancer or several other conditions. Surgery and muscle therapy are often needed to counteract many of these different causes for dysphagia.