Swallowing

Dysphagia is characterized by difficulty with swallowing. Children may demonstrate dysphagia due to prematurity, developmental delay, craniofacial disorders, cerebral palsy, and other etiologies. Adults may demonstrate dysphagia following neurological injury (strokes, head injury), degenerative diseases (i.e., Parkinson's disease, Multiple Sclerosis), cancer, and other etiologies.

Dysphagia can affect people in varying degrees; some patients may experience a mild discomfort while others experience a complete inability to swallow. The problem can arise anywhere from the mouth to the stomach: it may be due to impaired function of the tongue, palate, pharynx, upper esophageal sphincter or esophagus, since all are involved in the swallowing mechanism.

Swallowing disorders are common and may occur through a wide variety of structural or functional conditions.

Acute dysphagia may be the result of inflammatory conditions such as pharyngitis, tonsillitis, or aphthous ulceration of the mouth.

Chronic dysphagia is most commonly the result of neurological disorders such as Parkinson’s disease, motor neuron disease, neuromuscular disease, multiple sclerosis, and Alzheimer’s disease. Among patients who have had a stroke, as many as 30% suffer from dysphagia [Barer 1989].

Other causes of chronic dysphagia include:

• Structural abnormalities such as head and neck tumors, thyroid enlargement, benign strictures
• Infections such as HIV, candida or herpes
• Latrogenic causes such as performation of the esphagus during intubation
• Gastro-esophageal reflux disease (GERD), in which stomach acid irritates and damages the lining of the esophagus
• Poisoning and/or burns that result from, for instance, swallowing household cleaning agents

Therapy for swallowing disorders may include use of different postures during swallowing, use of swallowing maneuvers, sensory awareness training, and varying food and liquid consistency to maximize swallowing function.