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Throat and Swallowing Problems

Swallowing of food occurs in three phases. The oral phase, pharyngeal phase and the oesophageal phase.

The oral phase

The oral phase is where food is in the mouth. Food in the mouth is chewed by the teeth to make it smaller. This also releases the taste of the food into the mouth, where the taste buds detect the taste quality. It is in the mouth, that the food mixes with saliva to lubricate it and determine its volume, texture, temperature and taste. It is the oral phase of taste that determines whether the food is liked, or whether it is dis-pleasing. It is this phase that makes or breaks a restaurant by the food critics. 

 

The pharyngeal phase

The pharyngeal phase occurs whether food leaves the mouth and passes down the back of the throat to the gullet (Oesophagus). The tongue pushes the food backwards while the nose and larynx (airway) are momentarily closed. The food therefore passes into the gullet (Oesophagus). This requires a co-ordination of muscles which is controlled by nerves. After a stroke or in elderly patients, this swallowing mechanism may be affected.

 

The Oesophageal phase

The Oesophageal phase is where food enters the gullet (Oesophagus) and travels down to the stomach. The Oesophagus is basically a tube from the back of the throat to the stomach. Food, once in the Oesophagus (gullet), does not pass to the stomach by gravity, as it is possible to swallow by standing on your head. The Oesophagus has a graded squeezing mechanism that allows food to pass to the stomach and this is called Peristalsis.

 

Dysphagia

Difficulties in swallowing is called Dysphagia. Odynophagia is pain on swallowing. These may occur in both the Oral, Pharyngeal and Oesophageal phases of swallowing. Patients may feel problems in starting the swallowing of food. They feel that the food sticks within the mouth, or in the upper throat. In children, drooling of saliva is the most common symptom. There may be a wet pillow in the morning, where the child has been drooling their own saliva.

When there is an Oesophageal cause of swallowing problem, the patient often reports a sticking sensation in the lower part of the throat or the upper chest.

Some patients report a burning sensation in their throat or upper chest (heartburn). Other people report that something is in the back of their throat and no matter what they do to clear it, they cannot clear the sensation. 

 

Causes of Dysphagia (Troubles with Swallowing)

  • Inflammatory/infective
  • Trauma/foreign body
  • Neo-plastic (cancer)
  • Neurological/Neuromuscular
  • Reflux Oesophagitis (Heartburn)
  • Structure/anatomical problems
  • Post operative problems 
  • Psychological

Please refer to my handout for further information.

 

Click here to download a PDF Fact Sheet  

THROAT and SWALLOWING PROBLEMS

A Guide for Mr Watson’s Patients
  Click to download this PDF

 

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