What is dysphagia?

31 May

Dysphagia (dis-fay-juh) // noun
Swallowing disorder

Humans swallow an average of 500-700 times per day. For someone living with dysphagia, this battle can take a huge toll on one’s attitude towards mealtimes.

What happens when we swallow?

So what happens after the food passes our lips? This mystery has been solved through science as various cameras and X-rays look inside the body to explore changes in people’s swallowing conditions. Let me take you on the journey of your swallow.

Anticipatory phase

The way we smell, see, touch and transition food from our plate to our lips. This stimulates our swallowing muscles to prepare for a certain texture so that when it hits our lips, we know how to manage it. It also helps to spark our appetite.

Oral phase

The jaw lowers, opening our mouth, then closes to accept the food. If it is fibrous, our teeth move together to form a bite. Then, our lips close to strip the food from our spoon or fork. The tongue begins moving the food onto our back teeth. Then, in partnership, our jaw moves our teeth up and down (and slightly in rotation) to chew the food. Once it’s ready, our lips close and our tongue wriggles upwards pushing against our palate for the food to move back. As the food travels from your oral cavity, your soft palate moves up to block any food from entering your nasal space. Pretty amazing, right?

Pharyngeal phase

The biggest mystery for many when swallowing is what is happening within the pharynx. Unlike the oral phase, most of the swallowing muscles within the pharynx move automatically with limited volitional control (for example, in contrast, you can lower and raise your jaw willingly).

As the food moves into the pharyngeal phase, your epiglottis lengthens downwards and your vocal folds close to cover your airway (larynx). In fact, swallowing is one of the very few acts that humans perform which requires us to stop breathing. Then, the surrounding muscles of the throat move forwards and upwards to increase the circumference of your food pathway. With a top-to-bottom squeeze of stripping muscles, the food should pass down in a swift action into your oesophagus. Considering the position of your airway, the risk lies in food or drink entering your lungs. This can cause discomfort, choking or the formation of a lung infection known as ‘aspiration pneumonia.’

What are the common signs of swallowing difficulties?

The effectiveness of your swallow relies on the precise timing and coordination of several muscle groups to the absolute millisecond! It’s no wonder that such a complex act can experience difficulty. There are various indicators that food or fluid may not be moving smoothly during a swallow, these include:

+ Difficulty biting through foods
+ Insufficient or prolonged chewing
+ Food or drink falling from the mouth
+ Lots of residue in your mouth after you have swallowed
+ Multiple swallows per mouthful
+ Throat clearing or coughing during or after a swallow
+ The feeling of residue after you have swallowed (that sneaky frog in your throat)
+ Choking incidences or a history of chest infections
+ A wet or gurgly vocal quality during or after intake
+ Raised temperature
+ Fatigue during mealtimes which can result in eating less and unexpected weight loss.

While rare, some people don’t display any signs of difficulty and still have food or fluid moving into their airways. This is known as ‘silent aspiration.’ Therefore, it’s strongly advised that people seek consultation with a Speech Pathologist to assess any swallowing concerns that arise.

Written by Brie Simons
Speech Pathologist