There are many possible factors which can contribute to swallowing problems. The swallowing mechanism is very complex, involving several phases and multiple muscle groups acting in very fine coordination to facilitate passage of food or liquid bolus safely into the upper esophagus. There is an inherent challenge to swallowing we all face at every age. At one point or another everyone has aspirated – an event where one tries to speak to quickly after swallowing liquid or food (“getting something caught in the wrong pipe or windpipe”). Our bodies have evolved extremely complex and well-coordinated throat mechanisms to protect our airway as we swallow, but sometimes we forget to swallow completely before speaking. Perhaps the most common cause of swallowing problems is eating too fast and taking bites which are too large. Small bites well-chewed and then carefully swallowed will help prevent most episodes of aspiration. The number one cause of admission to the hospital in the over 65 year-old age group is aspiration. As we age, our muscles get weaker, including our throat and swallowing muscles. Hence it is very important in this age group to pay extra attention to proper swallowing techniques (small bites, extensive chewing, and then holding one’s breath for an extra 1-2 seconds after feeling the bolus go down).
Other contributing causes of dysphagia (difficulty swallowing) include reflux laryngitis (GERD), infection, neck trauma, autoimmune disease, and rarely benign tumors and cancer. It is important if dysphagia persists for more than one week to have an evaluation by an otolaryngologist. It dysphagia is severe and prevents eating or drinking, one should seek immediate medical attention (go to the Emergency Room or call 911). An evaluation for swallowing problems starts with a thorough history and physical exam. The exam will likely include a flexible laryngeal endoscopy. The can be done in about 5 minutes in the office while awake. No anesthesia is required. It is very well-tolerated, and can give very useful information as it allows for direct inspection in the deeper throat, and voice box and esophagus. Find helpful information regarding ear neck and throat pain, ear neck and throat specialist, ear nose throat symptoms and more.