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| Diffuculty swallowing - Dysphagia |
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Last Updated
29th o March, 2008
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Dysphagia is a term that means "difficulty swallowing." It is the
inability of food or liquids to pass easily from the mouth, into the
throat, and down into the oesophagus to the stomach during the process
of swallowing.
To understand dysphagia, we must first understand how we swallow. Swallowing involves three stages. These three stages are controlled by nerves that connect the digestive tract to the brain.
- Oral preparation stage
Food is sucked & chewed and moistened by saliva. The tongue pushes food and
liquids to the back of the mouth towards the throat. (This phase is
voluntary: we have control over chewing and beginning to swallow.)
- Pharyngeal stage
Food enters the pharynx (back of the throat). A flap called the epiglottis closes
off the passage to the windpipe so food cannot get into the lungs. The
muscles in the throat relax. Food and liquid are quickly passed down
the pharynx (throat) into the oesophagus. The epiglottis opens again so
we can breathe. (This phase starts under voluntary control, but then
becomes an involuntary phase that we cannot consciously control.)
- Oesophageal stage
Liquids fall through the oesophagus into the stomach by gravity. Muscles
in the oesophagus push food toward the stomach in wave-like movements
known as peristalsis. A muscular band between the end of the oesophagus
and the upper portion of the oesophagus (known as the lower esophageal
sphincter LES) relaxes in response to swallowing, allowing food and liquids
to enter the stomach. (The events in this phase are involuntary.)
Swallowing disorders occur when one or more of these stages fails to take place properly.
Some children's health problems that can affect swallowing include:
- diseases that affect the nerves and muscles, such
as a stroke, tumor, nerve injury, brain injury, or muscular dystrophy,
and can cause paralysis or poor function of the tongue or the muscles
in the throat and oesophagus
- large tonsils
- irritation or scarring of the oesophagus or vocal cords by acid in gastro-oesophageal reflux disease (GORD)
- compression of the oesophagus by other body parts, such as the heart, thyroid gland, blood vessels, or lymph nodes
- foreign bodies in the oesophagus, such as a swallowed coin
- developmental delays
- prematurity
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