{"id":1637,"date":"2024-09-26T18:29:55","date_gmt":"2024-09-26T22:29:55","guid":{"rendered":"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/chapter\/swallowing-and-dysphagia-2\/"},"modified":"2024-10-01T16:16:12","modified_gmt":"2024-10-01T20:16:12","slug":"swallowing-and-dysphagia","status":"publish","type":"chapter","link":"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/chapter\/swallowing-and-dysphagia\/","title":{"raw":"6.2 Swallowing and Dysphagia","rendered":"6.2 Swallowing and Dysphagia"},"content":{"raw":"

Swallowing<\/h1>\r\nBefore discussing how to support clients with their dietary needs, let us review the mechanism of swallowing. [pb_glossary id=\"517\"]Swallowing[\/pb_glossary]\u00a0is the transport of a substance from the mouth to the stomach. It is an important part of eating and drinking. The chewed food or drink that is moved in one swallow is called a [pb_glossary id=\"599\"]bolus[\/pb_glossary]. The most common complications with swallowing are choking and dysphagia (Girdi-Papp, 2022).\r\n\r\n[caption id=\"attachment_1636\" align=\"aligncenter\" width=\"233\"]\"\" Figure 6.2.1<\/strong> Regions of the human respiratory tract.[\/caption]\r\n

The entire swallowing process takes about 4\u20138 seconds for solid food, and about one second for very soft food and liquids. Although this sounds quick and effortless, swallowing is a complex process that involves both the muscles of the tongue and the muscles of the pharynx and esophagus. It is aided by the presence of mucus and saliva. Swallowing consists of three phases \u2014 oral, pharyngeal, and esophageal \u2014 and involves many smooth muscles of the pharynx and esophagus. The oral phase is voluntary and controlled by the cerebral cortex, whereas the pharyngeal and esophageal phases are non-voluntary processes (Girdi-Papp, 2022)<\/span>.<\/p>\r\n\r\n\r\n[caption id=\"attachment_1636\" align=\"aligncenter\" width=\"300\"]\"\" \u0192Figure 6.2.2<\/strong> Swallowing movements during juice drinking filmed in MRI.\u00a0Click to watch.<\/a>[\/caption]\r\n

Dysphagia<\/h1>\r\n[pb_glossary id=\"515\"]Dysphagia[\/pb_glossary] is difficulty in swallowing. It can have various causes and involve different parts of the swallowing mechanism or anatomy. Dysphagia frequently produces coughing, choking, or [pb_glossary id=\"472\"]pulmonary aspiration[\/pb_glossary] and subsequent [pb_glossary id=\"501\"]aspiration pneumonia[\/pb_glossary]. Dysphagia can also lead to dehydration and weight loss (Girdi-Papp, 2022). There are two types of dysphagia: oropharyngeal and esophageal.\r\n

Oropharyngeal dysphagia includes difficulty controlling the position of food in the mouth, difficulty initiating a swallow, nasal regurgitation, and a gurgling voice after swallowing. Clients identify the mouth or neck as the site of the problem. These problems are common among older individuals, and clients who have had strokes, head and neck cancer, and progressive neurologic diseases like Parkinson's disease, Alzheimer\u2019s disease, or multiple sclerosis (Girdi-Papp, 2022)<\/span>.<\/p>\r\n

In esophageal dysphagia, clients indicate an inability to swallow solid food, saying that it is held up or stuck before it reaches the stomach or is regurgitated. Various diseases in or adjacent to the esophagus can result in dysphagia, and the treatment depends on the cause (Girdi-Papp, 2022)<\/span>. There are several triggers that can cause a client to have difficulty swallowing, so it is important to know what the signs of dysphagia are and ask yourself:<\/p>\r\n\r\n