Healthy Geezer: Dysphagia
Q. I’ve been having some difficulty swallowing food for the past few weeks. Is this something to worry about or is it just another one of those age things?
You shouldn’t worry about occasional difficulty swallowing. Persistent swallowing problems, though, can be a symptom of a serious condition, so it is something to be concerned about. I’d get it checked out by a physician as soon as possible. And, yes, difficulty swallowing, called “dysphagia,” is one of those age things. As we get older, the esophagus, which is the tube that connects your throat to your stomach, loses its ability to move food downward. So, while difficulty swallowing can happen to anyone, it is most common in older adults.
Swallowing is a three-step process that involves dozens of muscles and nerves to work properly:
1. The tongue gathers the food in your mouth.
2. The tongue pushes the food to the back of the mouth. A swallowing reflex moves the food through the pharynx, a canal linking the mouth and esophagus.
3. The food enters the esophagus. It then takes the esophagus about three seconds for the food to be pushed into the stomach.
There are a variety of causes for dysphagia. Probably the most common causes for occasional problems are chewing improperly or gobbling food. Here are others:
The muscle at the base of the esophagus doesn’t let food enter your stomach.
Narrowing of the esophagus.
Tumors in the esophagus.
Food or foreign objects stuck in your throat.
Stomach acid backing up causing the esophagus to spasm or form scar tissue that narrows this canal. This condition is known as GastroEsophageal Reflux Disease (GERD).
The formation of a small pouch that collects food particles in your throat. This happens more often in older people.
Weakened throat muscles caused by disease, stroke or spinal-cord injury.
Improperly coordinated contractions of the esophagus.
Dysphagia can impede nutrition and hydration. And, if food or drinks get into your windpipe when you’re trying to swallow, you can suffer from respiratory problems, including pneumonia.
Occasional dysphagia can be prevented by chewing thoroughly and slowing down when you eat. Treating GERD can reduce swallowing problems caused by the narrowing of the esophagus.
There are a variety of tests for dysphagia. They include: an X-ray of a barium-coated esophagus; direct examination of the esophagus with an endoscope, a lighted instrument; a test with a pressure recorder to measure muscle contractions of the esophagus; video fluoroscopy and ultrasound, two forms of imaging that record patients swallowing.
Treatments include: exercises to help coordinate swallowing muscles or stimulate nerves responsible for the swallowing reflex; expanding the esophagus with an endoscope and balloon attachment; surgery to remove tumors; drugs to reduce stomach acid; liquid diets or feeding tubes for severe cases.
Some people are taught a different way to eat. For example, they may have to eat with their head turned to one side. Preparing food differently may help others. People with problems swallowing liquids may need thickeners for their drinks.
Avoiding some foods, such as very hot or very cold foods, can help some dysphagia victims.
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