Swallowing Disorders

Overview

What Happens When You Swallow?

Swallowing is a complex activity that needs precise control and coordination of the muscles in the mouth, throat and food pipe [oesophagus].

Swallowing can be divided into three phases:

  • Oral phase - mouth

    It involves chewing and moving food or fluid using the teeth, jaw and tongue to form a soft mass that is ready to be swallowed.

  • Pharyngeal phase - throat

    Food or fluid is pushed from the back of the tongue into the food pipe.

    The voice box (larynx) rises and seals off the windpipe (airway) to prevent food or fluid from entering the airway.

  • Oesophageal phase - to the stomach

    A series of wave-like muscle contractions move the food or fluid down the food pipe into the stomach.


What is a Swallowing Disorder?

A swallowing disorder, also known as dysphagia, refers to any difficulty in the process of swallowing.

Any breakdown in one or more of the three swallowing phases can result in dysphagia. If you have dysphagia, you may find it difficult to chew food or to transport food or fluids from the mouth to the stomach.

Causes

Various medical conditions can cause dysphagia, including:

  • Stroke
  • Head injury
  • Dementia
  • Parkinson's disease
  • Motor neurone disease
  • Head and neck cancer
  • Respiratory diseases
Signs & Symptoms

Swallowing is a complex activity that requires precise control and coordination of the muscles in the mouth, throat and oesophagus.


Symptoms of swallowing disorder may include:

  • Difficulty chewing food
  • Frequent throat clearing, coughing or choking during or after swallowing
  • Wet or gurgly-sounding voice during or after meals
  • Taking a long time to finish a meal
  • Shortness of breath during or after meals
  • Multiple swallows per spoonful
  • Food (residue) left in the mouth after swallowing
  • Excessive drooling or food lost from the mouth
  • Food or fluid flowing up into the nose
  • Pneumonia or chest infection
  • Weight loss
  • Refusal to swallow

Detection & Treatment

Swallowing assessments are conducted by Speech Therapists.

Assessments will allow your Speech Therapist to identify the method of feeding (oral versus non-oral feeding), the consistency of diet and fluids that you can swallow safely, appropriate feeding strategies and possible therapy.

These procedures may be repeated at a later date to determine if your swallowing has improved after swallowing therapy.


Further types of swallowing assessments include:

  • Videofluoroscopy (VFS)

    VFS assesses your swallowing using an X-ray.

    It checks if food or fluids is entering your airway and/or lungs when you eat or drink.

    You will be seated for this procedure and will be given small amounts of food and fluid of different consistencies mixed with barium sulphate (a non-poisonous substance) to swallow.

    The entire procedure will last approximately 15-20 minutes.


  • Fibreoptic Endoscopic Examination of Swallowing (FEES)

    FEES assesses your ability to swallow by using a scope (a thin, flexible tube with a camera).

    It checks if food or fluids is entering your airway and/or lungs when you eat or drink.

    You will be given small amounts of food and fluids of different consistencies stained with food dye, while the scope is in place.

    The entire procedure will last approximately 20-30 minutes.

Additional Resources
TTSH_Swallowing_Caregivers_Guide_to_Swallowing_Disorders.pdf

Specialties & Services

TTSH Speech Therapy