Dysphagia is the medical term for swallowing problems. Swallowing is only something which occurs for most people without needing to consider it, but dysphagia can influence all individuals of all ages, from newborn infants to elderly people.

In the back of the mouth is your pharynx. Just below the pharynx we've got two passages, one for atmosphere (the trachea) and one for fluid and food (the oesophagus). Only one is supposed to be open at a time, so that we stop breathing briefly when we consume and then begin breathing immediately after.

Swallowing is really one of the most complicated actions that our body must do. First, the brain has to plan out the whole activity then tell at least thirty pairs of muscles what to do. This is called a motor program or motor plan.
Food is processed in the mouth to the point it is safe to swallow, and for most food this includes chewing. Food or fluid requires manoeuvring to the rear of the mouth and into the pharynx, ready to go into the oesophagus. This prompts the area around the larynx (the'voice box') to be dragged up. It is all linked and protected by muscles and ligaments.

If you want to appreciate this motion, feel that your larynx as you take a swallow.

Since the larynx is pulled up, it warms up a small flap of skin called the epiglottis which covers the airway. The tooth can also be protected by the vocal cords which shut, and the false vocal cords them above, so that normally you'll find 3 layers of protection for your airway.

As the airway is coated, the entrance to the oesophagus (the sphincter) opens and food is quickly manoeuvred to the opening. From there, the oesophagus moves the food down to the stomach, at a movement over that we have no hands, by gravity.

The oesophageal sphincter then shuts and the airway opens - and breathing continues.

Everybody knows the feeling of something going down the wrong way. Usually we are able to cough and splutter until we get rid of whatever it had been. This is lucky, since food going down the wrong way can lead to choking, and fluid at the lungs or airway may lead to chest infections and even pneumonia. If food or fluid penetrates the larynx and enters the tooth then this is called aspiration.

All kinds of things can go wrong with swallowing. Because it is a complex and finely tuned action, even a little bit of coordination problem can cause a problem. Other issues arise when the swallow isn't initiated (started), or when the airway isn't insured, or if it is not covered quickly and completely. If residue of food or fluid is left in the pharynx following the consume it can slide into the airway seconds after if we breathe or talk.

Occasionally infants may have a difficulty consuming from arrival. Or they may get an illness of some kind that needs another method of consuming, and swallowing then may be established later if at all possible. For the majority of the life span swallowing difficulties occur due to accident or disease, such as traumatic brain injury or thyroid deficiency). In elderly people swallowing is more widespread, particularly when a disorder is present or individuals are unwell.

Often after operation, like a fracture fix, older men and women are particularly vulnerable. In'the olden days' most people used to die following a hip fracture, for example, since they aspirated fluid which led to pneumonia. In addition to coping with the pain, and with poor freedom, being not able to sit straight, people tend to be well-medicated now and this makes the brain less able to generate a engine program and take it out correctly.

Elderly people who are unwell are at high risk for dysphagia. The elderly in residential facilities or nursing homes, as an example, who have limited freedom and communication abilities, have to be tracked closely for swallowing problems.

The clinician responsible for diagnosing and managing dysphagia is a Speech Pathologist. A Speech Pathologist may assess, manage and prevent swallowing.

A Speech Pathologist can use a blend of resources, depending on technology available. In some cases, patients may have access to fibre-endoscopy with an ENT specialist, in which a probe can be inserted to see whether there are physiological difficulties. A video-fluoroscopy can be performed at a hospital or radiography clinic, in which a moving X-ray can be taken while a patient swallows.

More often a Speech Pathologist can perform a bedside examination or even a manual evaluation in a practice, where they can feel and observe swallowing of various consistencies of food and fluid. This can be done with cervical auscultation where the swallow can be listened to using a stethoscope.

Speech Pathologists can give exercises that will strengthen or coordinate a consume. Occasionally the consume is handled by recommending food or fluid that is safe for a individual to consume.