Digestion | June 14, 2018 | Author: Naturopath
The term 'dysphagia' refers to a sign or symptom of swallowing difficulty. People with this condition have trouble moving food solids, liquids and sometimes even saliva, down to the stomach. This condition occurs more often in older people and younger children and is caused by a nervous system disorder, a muscular system disorder or from a blockage in the esophagus.
The anatomy needed to move any product placed in the mouth down to the stomach consist of:
The upper third esophagus and structures consist of skeletal muscle, the lower esophagus and LES consist of smooth muscle.
These components work together as a system to transport material from the mouth to the stomach and prevents its return to back into the esophagus (reflux).
Put simply, when you swallow, the muscles in the throat push food down to the stomach in a wave like motion – called peristalsis. Junctions at the top of the stomach, called the oesophageal sphincter, prevent the products swallowed from returning (refluxing).
Although swallowing seems like a simple process, it does require the brain and nervous system and muscles of the throat working in coordinated fashion. When things go wrong it usually will involve:
Parkinson disease, multiple sclerosis, and amyotrophic lateral sclerosis (ALS) are among some of the diseases that may have swallowing disorders amongst other symptoms.
Disorders that affect the musculature and actions of muscles such as myasthenia gravis, dermatomyositis, and muscular dystrophy will often have swallowing malfunction as one of their symptoms.
Physical blockage can result from:
This is a problem where the stomach pushes up through the diaphragm. Most hernias do not cause symptoms, but an increase of acid reflux may lead gastroesophageal reflux disease (GERD). Gastroesophageal reflux can damage the lining of the wall of the oesophagus and lead to stricturing disease.
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These are diseases that cause changes to the walls of the oesophagus or a narrowing of the lumen often due to gastroesophageal reflux.
Eosinophilic esophagitis develops from reactions as a result of food allergy
This leads to:
Treatment is aimed at identification and elimination of causative foods or medical control of the allergic response.
Other stricturing disorders can result from:
This nervous system oesophageal motility disorder is characterized by impaired oesophageal peristalsis, the wave like movement that push solids and liquid through the digestive canal, and a lack of lower oesophageal sphincter relaxation during swallowing. The symptoms of dysphagia progress slowly and usually involves the swallowing of both liquids and solids and also cause the regurgitation of undigested food. Achalasia is thought to be caused by a denervation of the oesophageal muscle. The reason why is generally unknown, but viral and autoimmune causes are suspected and certain tumours may cause achalasia either by direct obstruction or from the effect on nerves.
This is a disorder where the rhythmic waves of muscular contraction (peristalsis) do not consistently work. Symptoms include difficulty swallowing and chest pain. The cause of this condition is unknown.
This rare, chronic autoimmune rheumatic disorder is characterized by degenerative changes and scarring in the skin, joints, and internal organs and by blood vessel abnormalities.
Dry mouth, a condition where there is not enough saliva to keep the mouth wet.
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If the swallowing problem is from a nervouse or muscular system disorder the disease will usually already be known. Often the diagnosis is based on the patient’s history and will usually require specific test to confirm.
When solids or liquids don’t get swallowing correctly these products may be inhaled into the lung (aspirated) which could result in acute Pneumonia or in chronic conditions, chronic lung conditions may develop. People suffering from chronic dysphagia may develop chronic lung conditions, weight loss and malnutrition.
Anybody could have trouble swallowing some times, but if this is a regular occurrence then it should be checked out by the doctor. Treatment will depend on diagnosis as there are many reasons why dysphagia can occur. Conditions such as gastic reflux disease and food allergies can be controlled to help eleviate symptoms.
Difficulty Swallowing (Dysphagia) By Norton J. Greenberger, MD, Clinical Professor of Medicine, Harvard Medical School; Senior Physician, Brigham and Women's Hospital https://www.merckmanuals.com/home/digestive-disorders/symptoms-of-digestive-disorders/difficulty-swallowing
Approach to the Patient with Dysphagia https://www.amjmed.com/article/S0002-9343(15)00430-1/fulltext