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Understanding Dysphagia
By Jeri Logemann, Ph.D., Charles A. Stewart, M.D., Jane Hurd, MPA,
Diane J. Aschman, MS, Nancy L. Matthews, MA


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Recognition, Education, Control

Dysphagia has a variety of causes and can manifest in a variety of ways. To identify the problem, the right questions need to be asked in easily understood language. It may also be necessary to eliminate some common myths and misunderstandings. Education, therefore, is a key element in bringing dysphagia under control. This can begin with an understanding of the swallowing process itself.

dysphagia

In Picture A, a morsel of food has been chewed and is ready to enter the throat.

The food then pushed toward the back part of the mouth, against the muscles of the pharyngeal wall as seen in Pictures B and C.

In Pictures D and E, the airway lifts and closes off when the soft pallet closes, protecting the entrance to the nose. Then the entrance to the esophagus opens, allowing food to bypass the airway and enter the esophagus.

Finally, in Picture F the food passes down the esophagus. The airways reopen to allow continued breathing.

When this sequence is disrupted at any point, dysphagia can result. Because individuals may seek to avoid the embarrassment of coughing or choking during meals, they isolate themselves to the extent that early signs go unrecognized. In making the diagnosis, itís important to be aware of conditions such as Parkinsonís or gastro-esophageal reflux (GERD), which can heighten vulnerability. Dysphagia may also arise as a side effect of medication often used for arthritis, Parkinsonís disease, depression and other common conditions.

 

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