Swallowing difficulties can be caused by CVA, Parkinson's disease, muscle weakness, ALS , etc.
It is then quite a job to be able to eat and drink easily, without needing the help of someone else. Another word for swallowing difficulties is also called dysphagia and when swallowing is impossible, this is called afagie .
Swallowing difficulties can be life-threatening as they can choke in such a way that they can suffocate. People with swallowing difficulties eat very slowly, can cough and sometimes drool.
In this category you will find custom cups that facilitate drinking and adjustments that make drinking through a straw safer.
Swallowing problems (or dysphagia) is a general term for problems with the passage of solid or liquid components from the mouth to the stomach. That can even be saliva. In principle, breathing and swallowing is impossible at the same time. When we swallow something, our trachea is always closed. The respiratory and digestive routes cross each other at the height of the pharynx (the pharynx), but when everything goes well, that does not pose a problem. Without thinking about it, we block our breathing the moment we swallow: the palate closes the nasal cavity (and thus prevents a nasal reflux), the epiglottis tilts to block access to the trachea and close the vocal cords in order to create a double safety. This way all access roads to the lungs are closed. The food is safely led to the esophagus and from there to the stomach.
Swallow we do hundreds, no thousands of times a day: every time we swallow saliva, eat, drink. Chronologically, this process takes place in three phases:
- the oral phase. We put the food or drink in our mouths, where the lips, the teeth and the tongue play an active role. We chew and mix the food with saliva.
- the throat phase. When the tongue pushes the food back into the mouth, our body sends stimuli to the brain to close the airways. Everything happens automatically.
- the esophagus phase. Once passing the intersection between the respiratory and digestive routes, the upper part of the esophagus opens and the food slides into the esophagus.
An uncontrollable coughing fit
Esophagus problems manifest themselves in different ways: there may be difficulties in chewing and swallowing, there may be an accumulation of saliva, an overproduction of mucus, but it can also be simply a ... mistake. It may happen that the food or drink goes wrong. Part of what we had in the mouth then enters the lungs and that causes a coughing, which causes the food to be removed again. But it sometimes happens that we inhale a larger lump that can block the airways, causing suffocation. The only thing we can do at that moment is to cough as hard as possible so that the food is coughed out. And if there is someone in the neighborhood, he can apply the Heimlichmaneuvre.
The possible consequences of these disorders are numerous. Because swallowing is painful, because of a feeling of blocking food in the throat or because food is always accompanied by coughing, some people eat less and lose weight, often without realizing it. Usually they think they eat enough and do not understand why they lose weight.
Another consequence is of a social nature. Eating together fulfills an important social role . However, people with swallowing problems are no longer inclined to go to a restaurant or visit family, afraid they are going to choke in public. They will isolate themselves little by little, which can sometimes lead to depression.
Others will repeatedly experience problems with the airways without the cause being discovered. For example, they will be treated every once in a while for bronchitis while the real cause is their swallowing problem.
The real causes
Swallowing problems can occur very suddenly: after a stroke or a cerebral haemorrhage, after a skull fracture or in people who have been intubated for some time for some medical reason. In other cases, the problem occurs much more gradually. Often it is associated with neurological problems, for example in people who have Parkinson's or multiple sclerosis. In this case, someone may have to cope with swallowing problems for several months, sometimes up to one or two years. If we tell such a person that he can be helped, then he regrets not having visited us before.
Swallowing problems can also occur with age because the sensitivity of the mouth and muscle strength decreases. But also because the teeth no longer function as well or a dental prosthesis is not well tolerated. Then the natural swallowing technique is disturbed.
Speech therapy can also play an important role. With other stimuli (tones, sounds, ...) the problem is approached in a different way, complementary to ours. That the different disciplines work together more and more intensively benefits the patient.
Dieticians are also involved in the rehabilitation process. If the patient is emaciated, sometimes undernourished, he will receive advice to enrich his diet in a natural way. It is mainly daily products that are recommended, to avoid the patient having to resort to food supplements that are often very expensive.
But whatever remedies are used during rehabilitation, it is always the intention to give the patient as soon as possible his self-confidence and let him enjoy eating together with others again. Something that benefits both his health and his social life.