Solutions pour la dysphagie
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It's what?
Dysphagia is difficulty swallowing or chewing, or the sensation of food being blocked, felt in the mouth, throat or pharynx. It is estimated that around 20% of people over the age of 55 suffer from a moderate or severe form of dysphagia.
The 4 phases of swallowing
Oral preparatory phase
In the first phase, the oral preparatory phase , the food is brought into the mouth, if necessary chewed, mixed with saliva and shaped into a food bolus (portion ready to be swallowed, colored blue in the presentation). The oral preparatory phase is conducted in a voluntary manner, that is to say we can keep the food bolus in the mouth or chew it for as long as desired.
Oral transport phase
During the second phase, called the oral transport phase , the tongue transports the food bolus by pressure against the palate from front to back towards the throat (pharynx). As soon as the food bolus reaches the back of the tongue (approximately at the height of the pillars of the soft palate/over the years between the oral cavity and the epiglottis) the next phase is triggered.
Pharyngeal phase
The pharyngeal phase is mainly reflex. Apart from a large quantity of motor activities, the course of swallowing is modulated by permanent sensory reactions. This means that swallowing programming adapts to external factors such as the size or texture of the food bolus (liquid or solid).
The soft palate rises to close the nasal passages so that no part of the food bolus enters the nose. The food bolus progresses through the pharynx downwards, towards the esophagus. It is also necessary to prevent part of the food bolus from entering the airways. This results in an elevation of the larynx, a lowering of the epiglottis over the entrance to the larynx and a closure of the ventricular bands and vocal cords. As a result, breathing is interrupted for about a second. At the same time, the entrance to the esophagus opens.
Esophageal phase
In the fourth phase of swallowing, the esophageal phase , the food bolus progresses through the esophagus to the stomach by peristaltic waves. As well as at the upper as well as lower end of the esophagus, the sphincter opens in time and thus allows the passage of the food bolus. The transport of the food bolus through the esophagus takes place reflexively and lasts, depending on the texture of the food bolus and depending on the age of the person, between 2 and 20 seconds.
Signs of dysphagia
Swallowing disorders are not always easy to spot. They can occur slowly or very suddenly, depending on the underlying disease. Since unrecognized dysphagia can lead to serious consequences, early detection is very important. Experts distinguish between direct and indirect symptoms which can be observed when swallowing or during a meal.
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Direct symptoms:
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frequent cough and throat clearing
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change of voice in the sense of a “wet” voice
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more difficult or “gurgling” breathing
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feeling of food stuck in the throat / feeling of swallowing something wrong, in the “wrong hole”
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decreased oxygen supply and consequently blue discoloration of the lips or face
Indirect symptoms include:
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increased congestion of the lower respiratory tract
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confusing increase in temperature or spikes in fever
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bronchitis or pneumonia
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unintentional weight loss
The causes of dysphagia
Many pathologies can result in dysphagia. A neurological disease is the most common cause. Dysphagia can appear as a result of apoplexy or craniocerebral trauma . Other neurological diseases like Parkinson's disease , multiple sclerosis , amyotrophic lateral sclerosis (ALS), or brain tumors result in the insidious onset of a swallowing disorder. Myasthenia gravis , meningitis or certain muscular diseases such as polymyositis or muscular dystrophies can also lead to dysphagia.
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Aside from neurological causes, surgery , especially in the neck and cervical vertebra or a tumor in the area of the mouth, neck or head can cause dysphagia. Changes in the spine or esophagus can also trigger a swallowing disorder.
The consequences of dysphagia
A swallowing disorder often leads those affected to frustration or social isolation. They suffer because they can no longer eat their favorite food or are embarrassed by their constant coughing to eat or drink in society.
Dysphagia can also have significant physical repercussions .
Possible consequences are:
Undernutrition or malnutrition , if nutrition is no longer sufficient or unbalanced. Malnutrition, in turn, can negatively influence the immune system as well as wound healing.
Dehydration , if the body does not absorb enough fluid, for example for fear of swallowing wrongly or because drinking takes too long.
Aspiration/Crossroads : When food, liquid, or saliva enters the lower respiratory tract. This can lead to lung infection (aspiration pneumonia) and thus serious health risks.
Simple gestures
TIPS TO MINIMIZE FALSE ROUTES
The ideal position for meals is: seated, feet flat on the floor, head slightly bent forward.
Take small bites, pausing between each mouthful.
Eat slowly and chew.
Avoid talking while you eat.
If any food remains in your mouth after swallowing, swallow empty several times.
Give your mouth a thorough cleaning after each meal.
After each meal, wait at least 20 minutes before going to bed (to avoid reflux).
(to avoid reflux).
DRINKS
Drink as much as possible. A dry mouth doesn't help swallowing. What's more, drinking helps to hydrate the mouth and prevent bacterial proliferation.
Choose beverages that stimulate swallowing: hot or cold, carbonated, tasty or naturally thick (e.g. fruit juice). Plain water (tasteless, neutral) is the most conducive to false swallowing.
Swallow one sip at a time (small, spaced-apart sips). Pause between sips.
Bend your head slightly forward (tuck in your chin) as you swallow.
It's best to have a full glass (to avoid having to put your head back).