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Swallowing

by Jonathan Aviv, M.D., F.A.C.S.

Swallowing is the process of passing foods and liquids from our mouths into the stomach. We rarely think about swallowing – until it becomes a problem. Dysphagia is the term for difficulty swallowing. Dysphagia can encompass difficulties in the mouth, throat (pharynx), vocal cords (larynx) and/or esophagus.

The esophagus is the tube that connects the throat to the stomach.

When swallowing problems occur – it can be the result of neurological problems such as stroke, or paralyzed or poorly moving vocal cords, or diseases such as Parkinson’s, Lou Gehrig’s Disease, Multiple Sclerosis and others. Inflammatory and infectious problems (eg. acid reflux disease, fungus infections, allergies ), anatomical problems (eg. scarring or stenosis, hernias or diverticulae), poor lubrication (eg. lack of saliva seen in a disease called Sjogren’s Syndrome) or even tumors or cancers in the mouth, throat, larynx or esophagus.

When experiencing dysphagia, it is imperative to have a comprehensive examination of the ears, nose, throat, head and neck by your otolaryngologist. Diagnostic studies in the office may be performed – including use of ultra thin flexible cameras as soft and thin as a cooked piece of spaghetti to examine the areas in question. For example, flexible laryngoscopy to examine the vocal cords and throat, transnasal esophagoscopy (TNE) to examine the esophagus, techniques called FEES (Fiberoptic Endoscopic Evaluation of Swallowing) or FEESST (Flexible Endoscopic Evaluation of Swallowing with Sensory Testing) to assess swallowing function. In addition the impact of acid reflux on swallowing can be determined with testing of acid content in the throat called pH testing,

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