The phenomenon in which a person experiences discomfort during the act of swallowing or cannot swallow anything at all (food, water, saliva) is called dysphagia. A single manifestation of such a condition can alert a person, and if such a phenomenon has been observed repeatedly, then it is necessary to consult a doctor and treat dysphagia.
Don't confuse true dysphagia with pseudodysphagia. With the latter, a “lump” is felt in the esophagus or behind the sternum, and the swallowing process itself remains normal. The phenomenon of dysphagia most often accompanies reversible mental disorders, accompanied by violent emotional reactions (loud laughter, tears, screaming), clouding of consciousness, convulsions, as well as diseases of the thyroid gland and heart.
Symptoms of esophageal dysphagia
Treatment will be discussed in detail below. In the meantime, let's describe the symptoms of this disease.
Violation of the movement of a lump of food from the oral cavity into the esophagus or, as we have already calledthis phenomenon, true dysphagia, occurs as a result of damage to the nerve centers that control the process of swallowing, which leads to an imbalance in this complex process. As a result, when you try to swallow a food bolus, its contents enter the respiratory tract (nasopharynx, larynx, trachea) and not the esophagus. This causes airway spasm, choking and a strong reflex cough.
Nervous system disorders such as hyperexcitability or neuroses can cause functional dysphagia. Its symptoms appear sporadically, patients associate them with the intake of a certain type of food (for example, solid, spicy, liquid, and so on). Food does not enter the respiratory tract, but the process of swallowing is difficult, and moving along the esophagus is associated with painful and unpleasant sensations. Treatment of dysphagia should be comprehensive.
Causes of dysphagia
The swallowing process can be divided into 3 phases:
- oral (arbitrary) when a person controls the sip on their own;
- pharyngeal (quick involuntary), when a quick sip is uncontrolled by a person;
- esophageal (slow involuntary) with slow uncontrolled movement of food through the esophagus.
In case of nervous dysphagia, treatment is aimed at correcting the human psyche. The act of swallowing food with dysphagia of the esophagus is not disturbed, but moving along it causes pain in the upper abdomen, heartburn, and belching. There is also regurgitation, where the contents of the stomach are thrown up the pharynx and mouth, causing an unpleasant taste in the mouth. Increased regurgitationcan occur when the body is tilted, including during sleep, if dinner was less than two hours before the night's rest.
Dysphagia can be accompanied by symptoms such as hoarseness, excessive salivation and choking. Most often, esophageal dysphagia provokes solid food. Patients note that when drinking water or taking mushy or liquid food, it becomes easier to swallow. Although there are cases where liquid food has caused dysphagia, symptoms and treatment are of paramount importance.
Disease forms
Depending on the location of the process, the following forms of dysphagia are distinguished:
- oropharyngeal (it is difficult to move food into the esophagus, the voluntary phase of swallowing is disturbed);
- pharyngeal-esophageal (complicated entry of food into the esophagus, impaired rapid involuntary phase of swallowing);
- esophageal (complicated passage of food through the esophagus, disrupted slow involuntary phase of swallowing).
Dysphagia is also subdivided into:
- organic (the cause of its occurrence is the pathology of the upper gastrointestinal tract);
- functional. It is observed in the case of a CNS disorder, provided that there are no mechanical barriers to the passage of food.
Treatment of functional dysphagia is carried out by a psychotherapist or neuropathologist together with a gastroenterologist.
Causes of the pathological condition
Often the development of dysphagia is a symptom of diseases of the esophagus. Among them are:
- Esophagitis is an inflammation of the lining of the esophagus.
- Gastroesophageal reflux disease (GERD). In this disease, the contents of the stomach splashes into the esophagus, irritating its walls.
- Protrusion of the walls of the esophagus (diverticula).
- Cicatricial narrowing of the esophagus that occurs after the healing of chemical burns caused by the ingestion of acid or alkali. After such exposure, the elastic tissue of the esophagus is replaced by a connective tissue that is poorly stretched and does not contribute to the movement of food through the esophagus.
- Malignant tumors of the esophagus and stomach. As a rule, these are fast-growing tumors that invade neighboring organs.
- Achalasia of the cardia. The passage of the food bolus from the esophagus to the stomach is disrupted, the reason lies in a chronic neuromuscular disease of the esophagus.
Also, dysphagia can develop on the background of:
- impaired outflow of venous blood from the liver (portal hypertension), dilated esophageal veins and liver failure (the liver ceases to perform its functions due to the acute or chronic process of destruction of its cells);
- trauma of the esophagus (damage to the inside of the esophagus, for example, when swallowing a sharp object, a knife or bullet wound to the chest, etc.);
- external narrowing of the esophagus, which can be caused by an aortic aneurysm (aortic dilation), an enlarged heart, a tumor of the mediastinum - a section of the chest, limited to the left and right by the lungs, in front of the sternum, and behind the spinal column. It passesesophagus, trachea, heart and thymus gland (an organ of the immune system).
Treatment for dysphagia after a stroke is often required.
Pathological lesions of the oropharynx can also cause dysphagia:
- tumor;
- Quincke's edema (a severe allergic reaction with the development of extensive edema of the larynx and pharynx);
- angina (inflammation of the tonsils);
- foreign bodies (bones, pieces of food, etc.);
- paralysis of the pharyngeal muscles. It occurs, as a rule, after cerebrovascular accident (stroke), which develops against the background of atherosclerosis (clogging of cerebral vessels with atherosclerotic plaques). It may be a consequence of a brain tumor, as well as trauma to the cervical spine. All this causes dysphagia of the esophagus. Treatment and its success depend on correct diagnosis.
Diagnostic Methods
Diagnosis of the disease includes the following activities:
- Collection of complaints and anamnesis of the disease with the following information: the timing of the onset of symptoms, whether swallowing is disturbed all the time, whether it hurts when swallowing, whether there is a feeling of discomfort behind the sternum during eating, what the patient associates with their occurrence, whether there were difficulties during swallowing only solid food, and now liquid or something else.
- Analysis of life history: what diseases the patient had, whether there were operations, burns of the esophagus, inflammation of the stomach (gastritis), diseases of the gastrointestinal tract.
- Analysis of hereditary history (whether there wereclose relatives of diseases of the gastrointestinal tract, in particular diseases of the esophagus).
- Examination of the patient, a thorough examination of the oral cavity, palpation (palpation) of the lymph nodes of the neck to detect dysphagia syndrome. Diagnosis and treatment of this disease should be timely.
- General and biochemical blood tests - to determine the level of hemoglobin (oxygen-carrying protein), erythrocytes, leukocytes (their increase indicates the presence of an inflammatory process), as well as monitoring the functioning of the kidneys, pancreas and liver.
- Coprogram - microscopic analysis of feces (the study reveals undigested food fragments, coarse dietary fiber, fat).
- Laryngoscopy: An endoscope is used to visually examine the back of the throat.
- Esophagogastroduodenoscopy (EGDS) - an examination using a gastroscope device of the duodenum, stomach and esophagus, with this study it is possible to take a piece of mucous for a biopsy.
- Ultrasound examination (ultrasound). Allows you to assess the condition of the abdominal organs (intestines, gallbladder, kidneys, bile ducts, stomach, pancreas) and find out the possible causes of dysphagia.
- X-ray examination of the esophagus. It also provides an opportunity to identify certain diseases or conditions that may have caused difficulty swallowing.
- Irrigoscopy is an x-ray examination of the esophagus with the introduction of a contrast agent, which is clearly visible in the picture. Allows you to detect narrowing or obstruction of substancesthrough the esophagus.
- MRI (magnetic resonance imaging) of the brain and electroencephalography of the brain are performed to detect the pathology of the nervous system, if the examination of a patient with dysphagia did not reveal any mechanical obstacle that prevents the food bolus from moving through the esophagus and oropharynx.
A patient with swallowing problems needs to get a consultation from doctors: an otolaryngologist, a neurologist, a gastroenterologist.
Drug treatment of dysphagia
Drug therapy (with the help of medicines) consists in taking medicines. Most often, inhibitors are prescribed to reduce the acidity of the stomach contents if this is the cause of dysphagia. Antibacterial therapy of inflammatory processes of the pharynx and esophagus, which led to swallowing disorders, will also be required. Drugs to treat dysphagia should be prescribed by a doctor.
Surgical treatment
It is necessary to remove by operation the consequences of burns of the esophagus that caused its narrowing, inflammation, tumors. There is no other way to remove these obstacles that interfere with swallowing.
If the patient's condition during the recovery period after a stroke does not allow for surgical treatment to eliminate the cause of dysphagia (for example, with a tumor of the esophagus), then temporary measures are taken to make the patient feel better.
Is it possible to treat folk remedies for dysphagia? More on that later.
Folk treatments
Phytotherapy will help to cope with the unpleasant symptoms of dysphagia. Before eating, you should drink a decoction of herbs, which has a calming effect:
- Hop cones - 25g
- Peppermint Leaves - 25g
- Rosemary leaves - 20g
- Valerian Root - 30g
- St. John's wort - 20 g.
- Melissa leaves - 25g
The collection should be thoroughly mixed, scoop 1 tablespoon and pour 1 cup of boiling water, leave for two hours. Then the infusion needs to be filtered. Take a quarter cup three times a day half an hour before meals.
Belladonna tincture has antispasmodic properties. Required to take 5 drops three times a day 5 minutes before meals.
There is another remedy with similar properties:
- Root and rhizome of broad-leaved ragwort, 15 g.
- Ephedra Herb, 20g
- Motherwort Grass, 20 g.
The crushed collection is poured with a liter of cold water for four hours, after which it is boiled over a fire for two minutes, cooled, filtered. Two tablespoons of the resulting composition is required to be taken ten minutes before meals.
With dysphagia, alternative treatment does not always help, so a specialist consultation is required.
What does the diet include?
The treatment of dysphagia is complex, therefore, to alleviate the physical condition, certain dietary rules must be followed.
- Fractional food intakein small portions.
- Thoroughly grinding or chewing food.
- Increase fluid intake.
- Rejection of foods that irritate the esophageal mucosa (spicy, s alty, spicy, too cold or hot), dry food, strong coffee and tea, fizzy drinks and alcohol.
Bougienage may be required - multiple expansion of the lumen of the esophagus with a bougie, a special dilator. Here's the treatment for dysphagia.
Consequences and complications
- Persistent respiratory failure, sometimes to a complete stop, caused by a tumor of the esophagus, squeezing the trachea (the organ that conducts air to the lungs).
- Inflammation of the esophagus (esophagitis).
- Malignant tumors (rapidly growing and spreading throughout the body) of the esophagus or the beginning of the stomach.
- Aspiration pneumonia, when, in violation of the swallowing function, the contents of the oropharynx are thrown through the nose into the lungs and trachea, and the outcome is the development of pneumonia, pneumonia.
- Lung abscesses (pustules surrounded by a protective capsule) that occur when the contents of the stomach are thrown into the respiratory tract and contribute to the development of inflammation.
- Pneumosclerosis, which is a violation of the structure of the lung tissue due to damage to the contents of the stomach (it is acidic), which got there after casting due to impaired swallowing.
- Weight loss due to low nutrient intake.
- Water loss or dehydration.
We have considered such a disease as dysphagia. Diagnosis, symptoms, treatment are described in detail in this article.
