Dysphagia
Introduction[edit | edit source]
Dysphagia is a difficulty in swallowing liquid or solid food due to disruption in swallowing mechanism from mouth to pharynx.[1] Dysphagia leads to severe complications: [1][2]
- Aspiration pneumonia
- Dehydration
- Malnutrition
- Dehydration
Physiology of swallowing[edit | edit source]
Having a thorough knowledge of anatomy and physiology of swallowing and eating is essential while evaluating and treating disorders of eating and swallowing,[3]There are four stages while describing the physiology of swallowing :
- Oral preparatory stage
- Oral propulsive stage
- Pharyngeal stage : Main feature of this stage are: food passage, propelling the food bolus through the pharynx and UES to the esophagus; and airway protection, insulating the larynx and trachea from the pharynx during food passage to prevent the food from entering the airway.
- Esophageal stage
Eating, swallowing and breathing are tightly coordinated during the normal process. Swallowing is dominant to respiration in normal individuals.Breathing ceases briefly during swallowing due to physical closure of the airway by elevation of the soft palate and tilting of the epiglottis and also of neural suppression of respiration in the brainstem. [3]
When drinking a liquid bolus, swallowing usually starts during the expiratory phase of breathing. The respiratory pause continues for 0.5 to 1.5 s during swallowing, and respiration usually resumes with expiration. This resumption is regarded as one of the mechanisms that prevents inhalation of food remaining in the pharynx after swallowing. When performing sequential swallows while drinking from a cup, respiration can resume with inspiration. [3]
Eating solid food also alters the respiratory rhythm. The rhythm is perturbed with onset of mastication. Respiratory cycle duration decreases during mastication, but with swallowing. The “exhale – swallow – exhale” temporal relationship persists during eating. However, respiratory pauses are longer, often beginning substantially before swallow onset.[3]
References[edit | edit source]
- ↑ 1.0 1.1 Balamurali K, Sekar D, Thangaraj M, Kumar MA. Dysphagia in Patients with Stroke: A Prospective Study. available from:https://www.ijcmsr.com/uploads/1/0/2/7/102704056/ijcmsr_96.pdf
- ↑ González-Fernández M, Ottenstein L, Atanelov L, Christian AB. Dysphagia after stroke: an overview. Current physical medicine and rehabilitation reports. 2013 Sep 1;1(3):187-96.
- ↑ 3.0 3.1 3.2 3.3 Matsuo K, Palmer JB. Anatomy and physiology of feeding and swallowing: normal and abnormal. Physical medicine and rehabilitation clinics of North America. 2008 Nov 1;19(4):691-707.
