12·12 World Swallowing Day | Understand swallowing disorders and let you swallow freely

December 12th of every year is World Swallowing Day. Food is the primary need of the people, and food safety is the first priority. The establishment of World Swallowing Day is to draw global attention to swallowing disorders, promote early intervention and treatment, and reduce the occurrence of complications.

In the swallowing rehabilitation clinic of the hospital, patients or their families often ask questions like this: " Doctor, my father often chokes when drinking water, and occasionally chokes when eating . What is going on?"

Under normal circumstances, when we talk or breathe, the epiglottis moves upward to open the airway; when we swallow, the epiglottis moves downward to cover the airway, so that food or water does not enter the trachea. If the epiglottis does not close in time when we talk or swallow, food will enter the trachea and cause choking.

Normal swallowing

Abnormal swallowing

1. What harm can swallowing disorders bring to our body?

Dysphagia refers to the process in which food cannot be safely and effectively transported to the stomach due to damage to the structure or function of organs such as the mandible, lips, tongue, throat or esophagus. Dysphagia is one of the common geriatric syndromes. If you often choke when drinking water, you need to pay enough attention. In particular, the incidence of dysphagia in the elderly population over 65 years old is 30% to 40%. Dysphagia can cause complications such as aspiration, suffocation, aspiration pneumonia, malnutrition, psychological illness, and increased risk of infection. In severe cases, it can lead to multiple organ failure and even endanger life.

2. What situations require prompt medical attention?

Food is retained in the mouth, swallowing is difficult, and food must be chewed repeatedly before swallowing; frequent oral and nasal regurgitation

drooling or sputum with food residues in the sputum;

A foreign body sensation in the throat and a burning sensation when swallowing;

When eating, you may choke on food or liquid and cough easily;

Hoarseness and turbidity of voice after eating; sudden difficulty breathing and wheezing

Unexplained weight loss, recurring fever, or aspiration pneumonia.

If you have any of the above problems, it indicates that you may have swallowing disorder and you need to go to a regular hospital for a swallowing function test.

3. Understanding the swallowing stages is the key to safe and effective recovery

Swallowing is a complex physiological activity, which consists of a series of highly coordinated reflex activities. The process of food entering the stomach from the mouth can be divided into four stages: pre-oral stage, oral stage, pharyngeal stage, and esophageal stage.

Pre-oral

From ingestion to chewing

Saliva lubricates the food to form a bolus, making it easier to swallow

Chewing process: stirring, grinding, crushing

Oral stage

The stage of chewing to form a bolus and transport it to the pharynx

Good lip muscle strength to ensure a proper seal and prevent food from escaping the mouth

The tongue moves to push the food bolus back into the pharynx

The cheek muscles on both sides move to control the food residue in the cheek grooves on both sides

Pharyngeal stage

The swallowing process begins when the food bolus enters the pharynx and ends when the cricopharyngeus relaxes and the food bolus enters the esophagus.

The soft palate rises and the nasopharynx closes to prevent food reflux

The epiglottis seals off the trachea before food reaches it, preventing food particles from entering the airway

The esophageal sphincter relaxes and the pharynx contracts, pushing the food bolus into the esophagus

Esophageal stage

The passage of food through the esophagus into the stomach

Esophageal smooth muscle motility

4. How to conduct home rehabilitation training for patients with swallowing disorders during the oral stage?

Please follow the demonstration video to perform rehabilitation training to improve the movement control, stability and coordination of lips, tongue, upper and lower jaws, etc., and enhance the strength of related muscle groups.

During home care, if family members find that their relatives have unexplained coughing after meals, changes in voice after eating or drinking, or patients have difficulty opening their mouths after radiotherapy for head and neck tumors, swallowing with difficulty and pain, causing them to be afraid of eating, etc., please go to the hospital in time. The doctor will provide evaluation and screening, and develop an individualized swallowing disorder rehabilitation treatment plan for the patient based on the swallowing stage.

author:

Zhang Lingyun: Standing Committee Member of the Swallowing Disorder Rehabilitation Committee of the Chinese Rehabilitation Medicine Association, Jiangwan Hospital, Hongkou District, Shanghai

Liu Jiaxin: Department of Rehabilitation Medicine, Jiangwan Hospital, Hongkou District, Shanghai

Audit:

Luo Zhendong: Honorary Director of the Rehabilitation Medicine Department of Jiangwan Hospital, Hongkou District, Shanghai, and Standing Committee Member of the Medical and Health Integration Working Committee of the Chinese Rehabilitation Medicine Association

Wan Guifang: Leader of the Science Popularization Working Group of Dysphagia Rehabilitation of the Chinese Rehabilitation Medicine Association