Swallowing is considered a natural process of the body when eating. When swallowing, the muscles of the throat make many movements. But sometimes there is a violation of the swallowing reflex. This phenomenon is accompanied by discomfort. Dysphagia is a condition that should be treated. The reasons for this condition and its therapy are described in the article.
Concept
Dysphagia is a difficulty or complete exclusion of the passage of food through the esophagus. Violation of swallowing leads to discomfort and pain in the throat. In this case, the coordination of the muscles of the food tract changes, and the food bolus is not able to move freely through the throat.
Violation of the swallowing reflex appears when swallowing a very large piece of food. It also happens when there is a violation of peristalsis. This leads to complications in the respiratory function, weight loss, exhaustion of the body, so an urgent visit to the doctor is necessary.
Reasons
If the violation of the swallowing reflex is one-time, then it probably happened from a mechanical cause. The piece may be very large or may not fit the esophageal lumen.
With the constant repetition of problems, one should suspect the functional factors of their appearance, which are associated with a violation of peristalsis. Violation of the swallowing reflex occurs due to:
- glossopharyngeal nerve damage;
- tongue paralysis;
- damage to the muscles of the esophagus and pharynx after a stroke;
- damage to the smooth muscles of the esophagus in myopathy, neuropathy, alcoholism and other ailments.
Rarely this problem occurs with narrowing and upset of the esophagus:
- swelling with stomatitis or sore throat;
- pharyngeal or food stenosis;
- scarring after burns, operations, trauma to the esophagus;
- growth of tumors in esophageal cancer;
- damage to the walls of the esophagus.
In isolated cases, when violated, Parkinson's disease, cerebral palsy, systemic scleroderma, chronic pneumonia and other ailments appear. These are all reasons for the violation of the swallowing reflex.
Localization
There are several types of swallowing disorders, depending on the part of the digestive tract where the problem is located, as well as on its severity.
According to localization, pathology happens:
- Oropharyngeal or oropharyngeal, when the food bolus is difficult to move from the pharynx to the esophagus.
- Esophageal or esophageal. In this case, the lumen of the alimentary tract is blocked or there are problems in the work of its muscles.
- Cricopharyngeal discoordination. In this case, there is a failure in the relaxation of the crico-pharyngeal muscle. Esophageal diverticulum and chronic lung pathology may also develop.
Degrees of disease
The severity of the disorder of the act of swallowing is divided into 4 degrees:
- The patient has difficulty swallowing. This feature is not available with some solid foods.
- Difficulty swallowing any solid food, but semi-liquid and soft foods pass easily.
- A person can only eat liquid food.
- Swallowing is impossible completely, no food can pass down the throat, even liquid.
Symptoms
It is not uncommon for the swallowing reflex to become impaired after a stroke. Whatever the cause of this phenomenon, a person feels the following symptoms:
- Unable to swallow solid food. In severe cases, liquid, saliva.
- Reflux is performed, the contents of the stomach flow back into the esophagus and throat.
- There is a sensation of a lump in the throat due to the fact that the sour content penetrates the throat and burns the mucous membrane.
- During swallowing, there is a feeling of lack of air.
- After eating there is a feeling as if it is stuck in the throat.
- There is a sore throat, shortness of breath.
Diagnosis
There is a violation of the swallowing reflex in the elderly and young people. For diagnosis andidentifying the cause, the doctor records complaints, and it is also proposed to undergo tests with swallowing solid food and water.
To fully assess the patient's condition after the test, the doctor prescribes additional hardware examinations, for example, an x-ray of the esophagus with contrast. It is also allowed to perform an ultrasound examination of the thyroid gland, magnetic resonance imaging. Sometimes blood tests for tumor markers and other laboratory tests are prescribed.
Who should I contact?
If you have difficulty swallowing, feeling a lump in your throat and pain, you need to visit a therapist or gastroenterologist.
The doctor performs an initial examination, a treatment is selected. If required, the doctor may prescribe an additional examination by an ENT specialist, surgeon, neurologist or oncologist.
In children
There is a violation of the swallowing reflex in newborns. In this case, you need the help of a pediatrician. Dysphagia in children usually appears due to disorders in the nervous system. This fact is associated with the immaturity of this system or congenital and acquired ailments. Often this pathology appears in children with cerebral palsy.
Increased risk of pathology in children occurs when:
- athetose;
- congenital anomalies in the pharynx and esophagus;
- Rossolimo-Bekhterev syndrome and Arnold-Chiari anomalies.
Parents can identify the course of the disease by the following symptoms:
- Child eats small meals.
- Baby sucks for a long time orpacifier.
- There is a cough and redness of the face after washing or eating.
- Cough and difficulty breathing does not appear if there is feeding in small portions.
- Baby puts head in unusual position before feeding.
- Pour milk or formula into the nose.
Such symptoms appear with frequent bronchitis and pneumonia, as well as bronchial asthma.
Therapy
Treatment of violations of the swallowing reflex should be comprehensive. Therapy is prescribed to alleviate local symptoms and eliminate the underlying ailment. To improve the condition with inflammation of the esophagus, the patient is prescribed a course of treatment with Zantak, Phosphalugel and other antacids. When food particles are thrown into the nasopharynx, the doctor provides immediate assistance and clears the airways.
Further treatment depends on the underlying disease causing dysphagia. For example, antibiotics are prescribed for angina. If the walls of the esophagus are affected by benign and malignant neoplasms, their surgical removal and chemotherapy are required.
Eating behavior is also corrected by a doctor. It is advisable to eat often and in small portions. Hard and dry foods, foods that can damage the esophagus are removed from the diet.
Surgical treatment
If medicines are not effective, surgical treatment is used. A plastic fundoplication is performed - acid reflux is eliminated. Tumors, cysts are removedpolyps that interfere with the passage of food. The expansion of the lumen of the esophagus with air balloons is used, using the bougienage method.
Myotomy of the esophagus is performed through punctures of the abdominal wall - laparoscopy or through penetration into the chest - topacotomy. The surgeon excised the sclerotic area, eliminated adhesions or adhesions, lengthened, expanded the lumen of the esophageal tube.
In difficult cases, a gastrostomy is installed. A thin tube is inserted through the anterior abdominal wall. At the tip of the tube there is a cap that is opened to enter food with a special probe. Often, the gastrostomy is the only way to save from starvation.
Home Therapy
It should be done only under medical supervision. The action of medicines is aimed at eliminating inflammation, muscle spasms, calming the nervous system:
- "Atropine" - helps to relax the muscles of the esophagus, eliminates spasm and pain.
- Buscopan is a rectal suppository used to relieve spasms of smooth muscles and reduce the secretion of digestive enzymes.
- "Gastrocepin". The agent temporarily blocks the vagus nerve, eliminates excess secretion of hydrochloric acid.
- Motilium. The drug stimulates the motility of the stomach, with it the passage of the food coma through the digestive tract is accelerated.
- "Platifillin". With it, the nervous system calms down, vascular hypertonicity is eliminated.
- Nikospan. Has a relaxing effect on the cerebral vessels, improves blood circulation in the brain.
Drugs have contraindications and side effects. Therefore, they should be treated only after consulting a doctor.
Folk remedies
Treatment with folk remedies is allowed only with a mild degree of pathology, which is caused by nervous tension, inflammation of the throat or esophagus, hyperacid gastritis.
To relax the muscles, calm the nerves, a collection of sweet clover, oregano, nettle, kelp, hops, mint is used. Dry herbs take 1 tsp. and mix. The mixture (1 tablespoon) is brewed with boiling water (300 ml) in a thermos. After 30 minutes, straining is performed, the agent is taken 100 ml of warm broth 3 times a day.
A general tonic and anti-inflammatory effect has a collection based on rose hips, calendula and chamomile flowers, mint, licorice, sage, rue. Herbal ingredients must be mixed in the same amount. The collection (2 tablespoons) is brewed with boiling water (1 liter) in a thermos and insisted for an hour. Take 40 minutes after eating ½ cup of decoction.
To reduce pressure, normalize the work of the stomach, a collection of motherwort grass, hawthorn flowers, mint leaves, calamus root is used. 1 tsp. each dry raw material is mixed in a glass jar. It will take 1 tbsp. l. mixture, which is brewed with boiling water (500 ml). In the morning, 20 minutes before breakfast, drink 150 ml of decoction, and then repeat before lunch and dinner.
Treatment of peptic ulcer is performed using in complex therapy a medicinal collection from the same parts of fennel fruits, chamomile flowers, rootslicorice and marshmallow, couch grass rhizomes, yarrow herb. The mixture (1 tablespoon) is poured with boiling water (200 ml). Infusion is performed for half an hour, and then you need to take ½ cup 3 times a day.
Treatment with herbal preparations must be performed for 10 days, and then a break of 2 weeks is required. If desired, phytotherapy is resumed by changing the composition of the medicinal collection. If during treatment nausea, headache, skin rashes, stool disorders and other symptoms appear, then the therapy is canceled.
Consequences
When swallowing food is difficult for a long time, you need to see a doctor. In the absence of timely treatment of the cause, complications arise. They appear as:
- Esophagitis is inflammation in the esophagus that causes constant pain.
- Cancer of the esophagus with constant irritation and damage to the mucous membranes.
- Aspiration pneumonia associated with the penetration of food particles, mucus, vomit into the lungs.
- Lung abscesses that are caused by ingestion of food and appear as a complication of pneumonia.
- Pneumosclerosis is a pathological proliferation of connective tissue in the area of the lung. This is due to prolonged inflammation.
Prevention
To reduce the risk of dysphagia, follow these simple guidelines:
- Should stop smoking.
- Requires a balanced diet, avoid roughage whenever possible.
- It is necessary to treat diseases of the esophagus, throat, ENT organs in a timely manner.
- It is important to take regularscheduled check-ups with doctors.
To rule out violations in a child, it is important to keep track of what toys he plays with. They should not contain small parts that can be easily swallowed.
Thus, dysphagia must be treated in a timely manner. Only effective therapy will relieve unpleasant symptoms. And preventive measures will prevent this pathology.
