Violation of the swallowing reflex: causes and treatment. Swallowing disorder, or dysphagia

Swallowing is considered a natural process of the body when eating. When swallowing, the throat muscles make many movements. But sometimes there is a violation of the swallowing reflex. This phenomenon is accompanied by discomfort. Dysphagia is a condition that should be treated. The causes of this condition and its therapy are described in the article.

The concept

Dysphagia is a difficulty or complete exclusion of the passage of food through the esophagus. Violation of swallowing leads to discomfort and pain in the throat. In this case, the coordination of the muscles of the food paths changes, and the food lump is not able to move freely through the throat.

Violation of the swallowing reflex appears when a very large piece of food is swallowed. This also occurs with a violation of peristalsis. This leads to complications of respiratory function, weight loss, depletion of the body, therefore, an urgent need to see a doctor.

Causes

If the violation of the swallowing reflex is one-time, then probably this came from a mechanical cause. The piece may be very large or may not correspond to the size of the lumen of the esophagus.

With a constant recurrence of problems, functional factors of their appearance should be suspected, which are associated with impaired peristalsis. Violation of the swallowing reflex is due to:

• lesions of the glossopharyngeal nerve ;
• paralysis of the tongue;
• damage to the muscles of the esophagus and pharynx after a stroke;
• damage to the smooth muscles of the esophagus with myopathy, neuropathy, alcoholism and other ailments.

Less commonly, this problem occurs with narrowing and upset esophagus:

• swelling with stomatitis or tonsillitis;
• pharyngeal or food stenosis;
• scarring after burns, operations, trauma to the esophagus;
• proliferation of tumors in cancer of the esophagus;
• damage to the walls of the esophagus.

In isolated cases with a violation, Parkinson's disease, cerebral palsy, systemic scleroderma, chronic pneumonia and other ailments appear. These are all the reasons for the violation of the swallowing reflex.

Localization

There are several types of dysfunction of swallowing, it all depends on the part of the digestive tract where the problem is located, as well as its severity.

By localization, the pathology happens:

1. Oropharyngeal or oropharyngeal, when the food lump is difficult to move from the pharynx to the esophagus.
2. Esophagic or esophageal. In this case, the lumen of the digestive tract is blocked or there are problems in the functioning of its muscles.
3. Cricofaringeal discoordination. In this case, there is a failure in the relaxation of the cricoid-pharyngeal muscle. An esophageal diverticulum and chronic lung pathology may still develop.

Degree of ailment

The severity of the swallowing disorder is divided into 4 degrees:

1. The patient has difficulty swallowing. This function is not available with some solid foods.
2. It is difficult to swallow any solid food, and semi-liquid and soft foods pass easily.
3. A person can only eat liquid food.
4. Swallowing is not possible completely; no food, even liquid, can pass through the throat.

Symptoms

Often there is a violation of the swallowing reflex after a stroke. Whatever the cause of this phenomenon, a person feels the following symptoms:

1. It is impossible to swallow solid food. In severe cases - fluid, saliva.
2. Reflux is performed, the contents of the stomach penetrate back into the esophagus and throat.
3. There is a sensation of a coma in the throat due to the fact that the acidic content penetrates the pharynx and burns the mucous membrane.
4. During swallowing, there is a feeling of lack of air.
5. After eating, there is a feeling as if she was stuck in her throat.
6. There is a sore throat, shortness of breath.

Diagnostics

There is a violation of the swallowing reflex in the elderly and young people. To make a diagnosis and identify the cause, the doctor writes complaints, and it is also proposed to undergo tests with swallowing solid food and water.

To fully assess the patient’s condition after the tests, the doctor prescribes additional hardware examinations, for example, an x-ray of the esophagus with contrast. Ultrasound examination of the thyroid gland, magnetic resonance imaging is still allowed. Sometimes blood tests for tumor markers and other laboratory tests are prescribed.

Who to contact?

With difficulty swallowing, a sensation of a lump in the throat and pain, you need to visit a therapist or gastroenterologist.

The doctor performs an initial examination, treatment is selected. If required, the doctor may order an additional examination with an ENT specialist, surgeon, neurologist or oncologist.

In children

There is a violation of the swallowing reflex in newborns. In this case, you need the help of a pediatrician. Dysphagia in children usually appears due to disorders in the nervous system. This fact is associated with the immaturity of this system or congenital and acquired ailments. Often this pathology appears in children with cerebral palsy.

An increased risk of pathology in children occurs with:

• athetosis;
• congenital malformations in the pharynx and esophagus;
• Rossolimo-Ankylosing spondylitis and Arnold-Chiari anomalies.

Parents can identify the course of the disease by the following symptoms:

1. The child eats in small portions.
2. The baby sucks a breast or a pacifier for a long time.
3. There is a cough and hyperemia of the face after washing or eating.
4. Coughing and difficulty breathing does not appear if there is feeding in small portions.
5. The child puts his head in an unusual position before feeding.
6. The flow of milk or milk mixture into the nose is performed.

Such symptoms appear with frequent bronchitis and pneumonia, as well as bronchial asthma.

Therapy

Treatment of swallowing disorders should be comprehensive. Treatment is prescribed to relieve local symptoms and eliminate the underlying ailment. To improve the condition with inflammation of the esophagus, the patient is prescribed a course of treatment with “Zantac”, “Phosphalugel” and other antacids. When throwing food particles into the nasopharynx, the doctor provides immediate assistance and cleansing the airways.

Further treatment depends on the underlying ailment that provokes dysphagia. For example, with angina, antibiotic drugs are prescribed. If the walls of the esophagus are affected by benign and malignant neoplasms, their surgical removal and chemotherapy are required.

Another doctor corrects eating behavior. It is advisable to eat often in small portions. Hard and dry foods, products that can damage the esophagus are removed from the diet.

Surgical treatment

If the medications are not effective, surgical treatment is used. Plastic fundoplication is performed - acid reflux is eliminated. Tumors, cysts, polyps that interfere with the passage of food are removed. Used expansion of the lumen of the esophagus with air cylinders, by means of bougieurage.

Myotomy of the esophagus is performed through punctures of the abdominal wall - by laparoscopy or by penetration into the chest by topacotomy. The sclerosed area is excised by the surgeon, adhesions or adhesions are eliminated, lengthened, the lumen of the esophagus tube expands.

In difficult cases, a gastrostomy is established. A thin tube is inserted through the anterior abdominal wall. At the tip of the tube there is a cap that is opened to enter food with a special probe. Often, a gastrostomy is the only method of salvation from starvation.

Home therapy

It should be carried out only under the supervision of a doctor. The action of medicines is aimed at eliminating inflammation, muscle cramps, and calming the nervous system:

1. "Atropine" - helps to relax the muscles of the esophagus, eliminates spasm and pain.
2. Buscopan is a rectal suppository used to relieve spasms of smooth muscles and reduce the secretion of digestive enzymes.
3. "Gastrocepin." The tool temporarily blocks the vagus nerve, eliminates the excessive secretion of hydrochloric acid.
4. Motilium. The drug stimulates the motility of the stomach, with it the passage of the food coma through the digestive tract is accelerated.
5. "Platifillin." With it, the nervous system calms down, vascular hypertension is eliminated.
6. Nikoshpan. It has a relaxing effect on the cerebral vessels, improves blood circulation in the brain.

The drugs have contraindications and side effects. Therefore, they need to be treated only after consulting a doctor.

Folk remedies

Treatment with folk remedies is allowed only with a mild degree of pathology, which is caused by nervous tension, inflammation of the throat or esophagus, hyperacid gastritis.

To relax the muscles, calm the nerves, a collection of clover, oregano, nettle, kelp, hop, mint is used. Dry herbs take 1 tsp. and mix. The mixture (1 tbsp. L.) Is brewed with boiling water (300 ml) in a thermos. After 30 minutes, filtering is performed, the product is taken in 100 ml of warm broth 3 times a day.

An all-strengthening and anti-inflammatory effect has a collection based on rosehip berries, calendula and chamomile flowers, mint, licorice, sage, and ruta. Plant components must be mixed in the same amount. Collect (2 tbsp. L.) Brew boiling water (1 liter) in a thermos and insist hour. It is necessary to take 40 minutes after eating ½ cup broth.

To reduce pressure and normalize the stomach, a collection of motherwort grass, hawthorn flowers, mint leaves, and calamus root is used. 1 tsp. each dry raw material is mixed in a glass jar. It will take 1 tbsp. l mixture, which is brewed with boiling water (500 ml). In the morning, 20 minutes before breakfast, drink 150 ml of broth, and then repeat before lunch and dinner.

The treatment of peptic ulcer is carried out using in complex therapy a medicinal collection of identical parts of fennel fruits, chamomile flowers, licorice and marshmallow roots, wheatgrass rhizomes, and yarrow grass. The mixture (1 tbsp) is poured with boiling water (200 ml). Infusion is carried out for half an hour, and then you need to take ½ cup 3 times a day.

Herbal treatment should be performed for 10 days, and then a break of 2 weeks is required. If desired, herbal medicine is resumed, changing the composition of the treatment fee. If during treatment there is nausea, headache, skin rashes, stool disorders and other symptoms, then therapy is canceled.

Effects

When swallowing food is difficult for a long time, you need to see a doctor. In the absence of timely treatment of the cause, complications arise. They appear in the form of:

1. Esophagitis is inflammation in the esophagus, due to which pain constantly appears.
2. Esophageal cancer with constant irritation and damage to the mucous membranes.
3. Aspiration pneumonia associated with the penetration into the lungs of food particles, mucus, vomit.
4. Abscesses of the lungs that are caused by food ingress and appear as a complication of pneumonia.
5. Pneumosclerosis - a pathological proliferation of connective tissue in the lung. This is due to prolonged inflammation.

Prevention

To reduce the risk of dysphagia, it is necessary to follow simple recommendations:

1. Stop smoking.
2. A balanced diet is required, if possible, rough food should be avoided.
3. It is necessary to timely treat ailments of the esophagus, throat, ENT organs.
4. It is important to regularly undergo scheduled examinations by doctors.

To exclude violations in the child, it is important to monitor what toys he plays with. They should not contain small parts that can easily be swallowed.

Thus, dysphagia must be treated in a timely manner. Only effective therapy will relieve unpleasant symptoms. And preventive measures will prevent this pathology.