Deglutition Research Foundation (DRF)

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Introduction

Swallowing is a complex function that affects the physical and mental health of all human beings. in 17 people will develop some form of Dysphagia in their life time. Dysphagia is an important alarm symptom; however, the epidemiology remains poorly defined. The term Deglutition Disorder indicated difficulty in Swallowing. Occasional difficulty swallowing, which may occur when you eat too fast or don’t chew your food well enough, usually it is not cause of concern but, persistent dysphagia may indicate a serious medical condition which required treatment. Swallowing difficulty can happen with food, liquids or medicines. It is of two types Oropharyngeal Dysphagia and Esophageal Dysphagia.

Swallowing has four sequential phases:
  • Oral preparatory phase
  • 1Oral propulsive phase
  • Pharyngeal phase
  • OEsophageal phase
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    Sequential Phases

    Normal Swallowing has four
    Sequential Phases:

    The oral preparatory phase, the oral propulsive phase, the pharyngeal
    phase and esophageal phase. Each phase as described below:

    Oral preparatory phase:

    During this phase, food in the oral cavity is manipulated and masticated in preparation for swallowing. The back of the tongue controls the position of the food, preventing it from falling into pharynx.

    Oral Propulsive Phase:

    During the oral propulsive, the tongue transfers the bolus of food to the pharynx, triggering the pharyngeal swallow.

    Pharyngeal Phase:

    During the pharyngeal phase, complex and co-ordinated movements of the tongue and pharyngeal structures propel the bolus from the pharynx into the esophagus. The closing of the vocal cords and the backward movement of the epiglottis prevents food/ liquid from entering the trachea.

    OEsophageal Phase:

    During the esophageal phase of swallowing, coordinated contractions of the esophageal muscle move the bolus through the esophagus towards the stomach. -(Logemann, Ergun, &cheng et al., 1989).

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    Prevalence of Dysphagia

    Deglutition Disorder can significantly impact a person’s quality of life as well as their health status. Researches says that prevalence rate of Dysphagia in general population is about 11% and 40-70% in stroke patients, 60-80% patients with Neurodegenerative disease and up to 13% of adults aged 65 and older >51% of institutionalized elderly patients. 60-70% of patients who undergo radiotherapy for Head and Neck cancer and 70% in patients with COPD.

    Causes of Dysphagia

    • Stroke
    • Head Injury
    • Spinal cord injury
    • Muscular dystrophy
    • Cerebral palsy
    • Parkinson’s disease
    • Motor neuron disease
    • Multiple sclerosis
    • Myasthenia gravis
    • Alzheimer’s disease
    • Chemotherapy/Radiotherapy
    • Lung disease/COPD

    Symptoms

    • Odynophagia(Having pain while swallowing)
    • Drooling.
    • Sensation of food getting stuck in throat/chest/ behind your breast bone(sternum).
    • Regurgitation(bringing food back)
    • Having food/ stomach acid back up into your throat.
    • Sudden Weight loss.
    • Coughing/gagging while swallowing.
    • Having to cut food into smaller pieces or avoiding certain foods because of trouble in swallowing.
    • Difficulty chewing .
    • Choking .
    • Food left in the mouth .
    • Feeling of lump in the throat .
    • Changes in eating habits.
    • Notable delay initiating the swallow .
    • Wet gurgling voice .
    • Spiking a fever .
    • Changes in respiration while swallowing .
    • Coughing with medication after meal.

    Complications

    • Malnutrition
    • Weight loss
    • Dehydration
    • Aspiration
    • Pneumonia.