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The secret of choking and coughing: What kind of swallowing problems prevent you from eating normally?
Dysphagia, also known as oropharyngeal dysphagia, is an inability to effectively pass materials from the oropharynx into the esophagus due to dysfunction near the esophagus. Manifestations of this condition vary depending on the underlying pathology and the nature of the symptoms. Many patients experience food getting stuck in their throats, accompanied by coughing and choking, which may even lead to weight loss, recurring lung infections, or vomiting.
According to research, the incidence of oropharyngeal dysphagia in the general population is approximately 2% to 16%. This prompted an in-depth discussion of its symptoms and potential consequences.
Signs and symptoms
Signs and symptoms of dysphagia include:
- Difficulty controlling food in mouth
- Unable to control food or saliva in mouth
- Initial difficulty in swallowing
- Coughing or choking
- Frequent pneumonia
- Unexplained weight loss
- A hoarse or wet sound after swallowing
- Nasal vomiting
- Self-perceived difficulty swallowing (called dysphagia complaint)
When patients answer the question "Where is the food stuck?" they often point to the neck as the location of the obstruction.
Complications
If left untreated, swallowing disorders can lead to significant health problems, including consequences such as aspiration pneumonia, malnutrition, or dehydration.
Diagnostic methods
When diagnosing oropharyngeal dysphagia, doctors often conduct a preliminary analysis based on the patient's self-report. Doctors will suspect dysphagia if the patient answers "Do you feel coughing or choking when eating?" or "Does food often flow back from the nose after swallowing?"
Among the treatment methods, "modified barium swallowing test (MBS)" is commonly used to evaluate the swallowing process.
This test involves mixing food of varying viscosities with barium sulfate and then analyzing it with X-rays to look at the various stages of the swallowing process and whether there are delays or deviations.
Differential diagnosis
Many health conditions can cause difficulty swallowing, including stroke, Parkinson's disease, and other neurological disorders such as amyotrophic lateral sclerosis (ALS). Patients with Parkinson's disease usually develop a variety of esophageal and pharyngeal functional abnormalities, and stroke can cause temporary loss of swallowing function and slow improvement.
In addition, drugs may also cause difficulty in swallowing, especially those that affect the central nervous system, such as sedatives, antihistamines, etc.
Treatment methods
Treatments for oropharyngeal dysphagia range from simple dietary changes to more complex medical devices.
The thickness of some foods using thickening agents can help improve the efficiency of eating in children with dysphagia.
In addition to thickening agents, posture adjustment is also an important strategy. For example, a backward posture of the head can help food slide down smoothly, while a downward posture can reduce the risk of food entering the airway.
In addition, there are many swallowing movement techniques, such as hyperpharyngeal swallowing, effortful swallowing, etc., which can help improve the muscle strength and coordination of swallowing.
Surgery and other treatments
In some cases, surgery may be a last resort to solve the problem, such as tracheotomy, laryngeal reconstruction, etc. For some patients who require long-term nutritional support, a percutaneous endoscopic gastrostomy may be necessary to maintain the body's nutritional levels.
As medicine continues to advance, the options for treating dysphagia may become more diverse, and there may be more solutions to help patients return to a normal eating life in the future.
When facing the problem of dysphagia, how should we understand and deal with these challenges and get our lives back on track?
