When you swallow, you are chewing food and moving it to the esophagus, a tube that connects to the stomach. Dysphagia, the medical term for difficulty swallowing, is characterized by the sensation of food or liquid getting stuck in the throat or chest. There are numerous factors that can cause swallowing difficulty, most of them fairly benign.
The Swallowing Process
Few of us give much thought to the act of swallowing, but it’s actually a complex process that involves around 50 pairs of muscles and nerves.
There are four stages that make up the swallowing process:
- Stage 1: Oral preparation stage. Food is chewed to prepare for swallowing.
- Stage 2: Oral stage. The tongue pushes food or liquid to the back of the mouth.
- Stage 3: Pharyngeal stage. Food or liquid passes through the pharynx into the esophagus.
- Stage 4: Esophageal stage. Food or liquid passes through the esophagus and enters the stomach.
Symptoms & Causes
Swallowing disorders indicate persistent problems with chewing and swallowing. The main symptoms are discomfort when swallowing, chest pain and the feeling that food or liquid is getting stuck in the throat or chest. Additionally, you may experience drooling, heartburn, nausea, wheezing, coughing, regurgitation, sore throat and a sour taste in the mouth.
Causes of dysphagia are diverse. They may originate in the esophagus and include diffuse spasm, an improperly relaxed sphincter, weak esophageal muscles, a narrow esophagus or esophageal ring, the presence of foreign bodies, gastroesophageal reflux disease (GERD), a hardening of the tissues called scleroderma and tumors. In addition, the muscles and nerves responsible for swallowing can weaken as a result of neurological disorders, pharyngeal diverticula or cancer. Children may have difficulty swallowing if they suffer from certain nervous system disorders or a cleft palate.
Treatment for swallowing disorders depends on the underlying cause and where the problem originates. Medication, surgery and swallowing therapy are the most common types of treatments administered. Medications include antacids, muscle relaxants and drugs to limit the amount of stomach acid produced. A surgical procedure to stretch or dilate the esophagus when it is too narrow often helps resolve the issue. Swallowing therapy involving chewing and swallowing techniques can help stimulate the muscles and nerves responsible for swallowing. The most severe cases of dysphagia may require a liquid diet or feeding tube.
Acid reflux, or gastroesophageal reflux disease (GERD), is a chronic digestive condition that causes painful heartburn and regurgitation for millions of Americans every year. It occurs when the contents of the stomach seep backward into the esophagus.
Normally, following a meal, a valve on your esophagus – the sphincter – closes, preventing hydrochloric acid produced in the digestive process from backing up (refluxing) into the esophagus. When reflux occurs, this valve fails to seal properly, and the stomach contents flow freely into the throat and esophagus. This damages the esophageal lining and causes a variety of painful symptoms.
Other risk factors can help to exacerbate the condition. These include eating large meals or lying down afterward, eating certain foods (spicy and fatty foods, citrus, tomato, chocolate, mint, garlic and onions), drinking certain beverages (alcohol, caffeine, carbonated liquids), smoking, obesity and pregnancy.
Heartburn is most commonly associated with GERD. Also known as acid indigestion, this burning pain radiates from the stomach to the abdomen and chest, and may last for up to two hours after a meal. It is frequently accompanied by regurgitation, a sour taste in the mouth, and dyspepsia or general stomach discomfort. Other symptoms often include belching, bloating, coughing, wheezing, hoarseness and nausea.
Symptoms occur most frequently after eating, when lying down or when bending over. They are most common at night. The most common cause of GERD is a hiatal hernia, a stomach abnormality that causes the sphincter valve and upper portion of the stomach to move above the diaphragm, allowing stomach acids to reflux more easily.
An effective way to treat acid reflux is to avoid the triggers that cause painful heartburn and other symptoms. Stay away from those foods and beverages that are likely to cause a negative reaction. Change your eating habits: stick with smaller, more frequent meals, and avoid eating too closely to bedtime. Quit smoking, and ask your doctor if the medications you are taking might be responsible for your symptoms. If you are overweight, exercise to take off excess pounds. Over-the-counter antacids taken immediately after meals will help neutralize stomach acids and can prevent heartburn from occurring, or relieve the symptoms.
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