Swallowing is the process of the movement of the food from the lips till the stomach. The process of swallowing occurs through coordination of oral phase, pharyngeal phase and esophageal phase. The oral phase requires coordinated movement of the lips, tongue, and the palate . The pharyngeal phase requires coordination of the pharyngeal wall movement, epiglottis inversion, and the laryngeal vestibule closure. The esophageal phase involves the opening of the cricopharyngeal sphincter allowing the bolus to move into the esophageal wall, the peristaltic movement of the esophagus will allow the bolus to reach the lower esophageal sphincter which opens into the stomach.
Any anatomical or physiological deficit that affects any of these process involved in swallowing will result in swallowing impairment called ‘dysphagia’. This can occur in children and in adults. In children there can also be condition of refusal to eat the food, choking while having food, vomiting during food intake etc which can be considered as feeding issues in children. The reasons for swallowing issues in children are due to delay in achieving feeding milestones, presence of a repaired / unrepaired cleft lip and palate, occurrence of head and neck cancer. Among adults, the common issues are mainly post stroke individuals coughs on intake of food, occurrence of head and neck cancer, post radiation effect of head and neck cancer, and accidents or trauma that damages any of the anatomical structure required for swallowing.
When you encounter swallowing and feeding issues, then you can consult our Speech Language Pathologist (SLP) for understanding the reason for the condition and its further assessment and treatment. The SLP who is an expert in attending to feeding and swallowing disorders are known as ‘swallowing therapist’ or ‘deglutologist’. At our centre , we currently perform subjective assessment of swallowing , wherein our swallowing therapist will perform water swallow test and cervical auscultation as two subjective assessment to identify swallowing impairment. We also use various standardized scales of swallowing assessment to understand the pathology behind the swallowing disorder.
Based upon these findings if necessary, we will refer you to undergo an instrumental evaluation of swallowing at a nearby hospital. This will provide clear information on your swallowing physiology. This will guide our swallowing therapist to design your therapy sessions. The swallowing therapy sessions will include evidence based swallowing exercises which will have to be practiced for better airway protection and a safe swallow.