Conditions We Treat
An estimated 18 million Americans have discomfort or difficulty while swallowing. Dysphagia is the medical term that refers to difficult swallowing.
Some swallowing disorders are mild and can be readily treated. Others are more severe and/or progressive and require long-term rehabilitation or surgery. Even minor swallowing disorders may affect quality of life, thus requiring immediate attention. If dysphagia is overlooked, it may lead to severe consequences such as malnutrition, dehydration, or aspiration pneumonia (an infection that may result from food or liquid entering the lungs), chronic bronchitis, and pulmonary fibrosis.
Dysphagia and related nutrition problems are often seen in patients with:
- cancers of the head and neck
- side effects of treatments:
- radiotherapy
- combined chemo and radiation therapy
- surgical changes to the anatomy
- trauma to the head and neck
- cerebrovascular accident (CVA or stroke)
- chronic neurologic disorders:
- amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease)
- Parkinson’s disease
- myasthenia gravis
- multiple sclerosis (MS)
- gastroesophageal reflux (GERD)
- tracheostomy
- dry mouth (xerostomia)
- vocal cord paralysis
- disorders related to aging:
- loss of muscle mass
- generalized weakness
- deconditioning
- dementia
- autoimmune disorders:
- scleroderma
- myositis
- rheumatoid arthritis
- post-surgical swallowing disorders from:
- thyroid surgery
- cervical spine surgery
- surgery to the mouth and throat
Understanding the Normal Swallow
Swallowing is life sustaining as well as important to social activity. We swallow 2,000 to 3,000 times every day. Swallowing is a very complex act requiring many muscles coordinated by the brain and brainstem. Swallowing takes place in four stages:
- Oral preparatory phase. This stage takes place in the mouth and involves biting and chewing. During this stage, food is broken down into smaller pieces and mixes with saliva. This preparation stage is where the pleasure of eating is derived.
- Oral phase. In this stage, the tongue pushes the food or liquid to the back of the mouth, where it is positioned to pass into the throat (pharynx). When this stage is completed, there should be no food or liquid remaining in the mouth.
- Pharyngeal phase. During this phase, the palate, the soft structure that hangs in the back of the throat, elevates to prevent food or liquid from entering the nose. The voice box closes to prevent food from entering the windpipe, and a muscle at the low end of the pharynx relaxes to allow food to enter the esophagus.
- Esophageal phase. A series of coordinated muscle contractions pushes the food down the esophagus (food tube) and into the stomach.
Swallowing and Nutrition Concerns During Radiation Therapy for Head and Neck Cancers
Swallowing
Nutrition