DYSPHAGIA
Dysphagia is a condition in which swallowing, even liquids, becomes tiring. Many people underestimate this disorder which, in the most serious cases, can lead to chronic pathologies or even lead to risk of suffocationwith fatal outcomes.
Dysphagia, in fact, exposes a risk of malnutrition, dehydration e respiratory pathology. In the latter case, this can occur due to an incorrect passage of food in the respiratory tract rather than in the digestive tract, giving rise to a aspiration pneumonia.
DYSPHAGIA IN ITALY
Dysphagia in Italy mainly affects elderly peoplebut everyone can suffer from it.
In Italy, about 1 in 5 peopleonce over 50 years old, experience difficulty swallowing solid and liquid foods. But 90 percent of the population affected by this disorder minimizes the pathology, without resorting to remedies.
We need to know that in our country there are different ones hospital outpatient clinics able to treat this pathology and help patients improve swallowing skills.
CAUSE
dysphagia it is a pathology found mainly among the elderly, but it can also arise in younger people since it is a condition that can affect anyone.
It must be considered, in fact, that in some cases, this type of disorder can occur even in the absence of specific diseases.
One of the most accredited causes is advancing age. From the age of 50 onwards, in fact, a condition known as sarcopenia. This is linked to the natural vital development of the individual for which i muscles of our body begin to weakenprogressively and irreversibly.
Before this age, however, the disorder can occur due to problems affecting some organs responsible for digestion, such as the esophagus. But they can also depend on transitory phases due to high stress levels.
ASSOCIATED DISEASES
Those most at risk are also those who have suffered trauma, stroke o tumors involving the nervous system and the anatomical structures directly involved in swallowing.
DIAGNOSIS
To find out if a patient is dysphagic, it is possible to resort to a medical test: the esophageal manometry.
This clinical examination allows you to to measurethanks to sensors, the number of rhythmic muscle contractions that occur in the esophagus right when you eat. This way, you evaluate how the whole process happens, from chewing at the swallowingto understand theefficacy of the motility of food through the esophagus.
The competent physician, usually a otolaryngologist, may also choose to proceed with the study of swallowing. To do this, it coats food with barium, an element visible in X-rays, so as to verify during the chewing process what problems are encountered.
Another option is theesofagogastroduodenoscopia, EGD. This is an endoscopy done in the upper gastrointestinal tract. The doctor inserts a small flexible tube fitted with a camera on the end. By letting the tube flow into the esophagus, he is able to evaluate the symptoms and ascertain, with his hand, what the problem may be.
REMEDIES
The first strategy to implement is to embrace a adequate dietaccompanied by regular exercise, such as the logopedia.
For nutrition, it is recommended to eat following a few simple rules:
- Eat seated
- Back leaning against the backrest
- Try to bring the chin towards the chest when swallowing
- Remain silent while eating and don’t talk, especially while chewing
- Avoid distractions like TVs or smartphones
- Chew slowly
- Only swallow the bite once it has been thoroughly chewed
- Avoid mixed textures (such as soup soup)
- Drink liquids with the help of a straw
In addition, it is possible to associate therapies recommended by the speech therapist to help in re-education to relearn to swallow.
FOODS SUITABLE FOR DYSPHAGIA
There are 3 types of recommended diets:
- fluid
- Chopped
- Thickener
The first is based on the preparation of shakes. All the ingredients are first cooked, to soften them, and then blended.
You can use liquids such as fruit juice, milk or broth to mix it all together. In this case, you can eat more meals a day with less effort.
The diet choppedon the other hand, is ideal for those who have a compromised or absent set of teeth and, therefore, experiment difficulty chewing.
The food is minced and ground to make it easier to swallow. Better soft bread, cooked pasta over the recommended cooking times, with a lot of seasoning, cooked vegetables, puddings e creme.
The thickening dieton the other hand, prefers theaddition of specific thickeners to obtain a consistency similar to that of a pudding and, therefore, easier to swallow. This is quite useful if the patient has difficulty swallowing liquids.
WHAT TO AVOID EATING
Absolutely, they are to be avoided foods that stick to the palate, such as dumplings or chewy bread. Even the spices o powdered foods they can cause many problems when they induce coughing, making it difficult to swallow. You have certainly happened to cough from too much cacao powdered on a tiramisu or the troppa cinnamon on a cake. Alternatively, there are specific foods on the market that allow you to reconstitute the powder making it thicker.
SWALLOWING PHASES
Swallowing is a complex process that is divided into three main phases:
This process involves the oral cavity, pharynx, larynx and esophagus.
The oral phase it is characterized by the insertion of food into the mouth which, thanks to chewing, salivation and the tongue, is transformed into a bolus. This is moved from the tongue downwards, i.e. towards the pharynx, from which the second phase begins.
The pharyngeal stage it is the middle way. When everything goes right, the bolus travels down the pharynx and epiglottis. The valve, which leads to the larynx and further to the lungs, closes and causes what is known as theswallowing apnea.
This is necessary to prevent food from entering the airways and risking suffocation. However, if food enters the respiratory tract, a protective mechanism of reflexes is triggered that cause coughing, saving the lungs.
In the last phase of swallowing, the esophageal stage, the upper valve of the esophagus opens to let the bolus pass, closing following its passage. That’s where let’s start breathing again.
Thanks to the force of gravity and the opening of the lower valve of the esophagus, the bolus completes the swallowing phase, ending up in the stomach.
WHEN TO WORRY ABOUT DYSPHAGIA?
WHO IS THE SPECIALIST TO CURE DYSPHAGIA?
The specialist to contact in case of swallowing disorders is theotolaryngologist. The doctor specializes in the treatment of diseases related to the upper digestive tract, mainly the organs present in the throat, pharynx, larynx and esophagus. But his skills also include the study of ears.
PREVENTION
In most cases, the advice to prevent dysphagia involves the application of remedies mentioned above, with some additional precautions:
- Do some coughingonce the mouthful is down, to check and free the throat from food residues
- Keep one good and adequate oral hygiene
- Eat sitting in a chair with a straight back