Dysphagia and Swallowing 101

Tahlia Colebrook - Speech Pathologist, Vivir Healthcare

Tahlia Colebrook - Speech Pathologist, Vivir Healthcare

17 February 2023

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Thursday the 16th of March is Swallowing Awareness Day - but why do we need to be aware of swallowing?

Most people will swallow more than 700 times per day, and this is mostly a reflex and occurs without us thinking about it. When we’re awake, we swallow once a minute in response to how much saliva is in our mouth. When we’re asleep that number drops back to three times an hour. Of course, these numbers jump up even higher when we’re swallowing when eating and drinking!

But what happens when someone has difficulty swallowing?

Swallowing difficulties, or to use the medical term Dysphagia, is a condition that affects around 15 to 30% of people aged over 65 living in their own homes, and more than 50% of people living in residential aged care. It will affect 100% of people living with Dementia at some point, 84% of people with Parkinson’s disease and 65% of people who have had a stroke. The more diagnoses someone has, the more likely they are to develop Dysphagia. ​

Swallowing is a complex process that uses more than 26 muscles!

The act of swallowing begins from when you see the food, you look toward it and this encourages you to salivate. The saliva lubricates the food, helping us to break the food down and prepare it to be swallowed. Our tongue, teeth, lips and cheeks all work together to prepare the food and make it safe for swallowing. When it’s ready, the tongue transfers the food to the back of the mouth in a conveyer belt-like movement. This then triggers our swallowing reflex, which begins to move the food down the throat, while making sure it doesn’t enter the airway. The airway is pulled forward and up, and a little leaflike cartilage called the epiglottis drops into place, blocking off the airway, while the muscles in the back of throat squeeze the food down into the esophagus.

When something goes wrong with any part of the swallowing mechanism, this can result in dysphagia. Next time you take a bite of your sandwich, try to keep your tongue still; or try drinking water without closing your lips.

But why is Dysphagia an issue?

​If the swallowing mechanism is disrupted, then food, fluids or medication can enter the airway and end up in the lungs. This can sometimes lead to an infection, which can be so severe it leads to hospitalisation, and sometimes death. Larger pieces of food can cause a full obstruction of the airway, and if these aren’t dislodged, the person can choke to death. Dysphagia can also lead to issues with malnutrition and dehydration, constipation, and reduced quality of life.

How do you recognise Dysphagia?

A Speech Pathologist can assist in diagnosing and treating dysphagia. Signs to look out for include:

  • Coughing, choking or throat clearing during or following eating and/or drinking

  • Changes in how the voice sounds after eating and/or drinking

  • Shortness of breath during or following mouthfuls

  • Oral and/or nasal regurgitation

  • Unexplained weight loss

  • Difficulty coordinating breathing and swallowing

  • Holding food in the mouth for a long time and not clearing it adequately

  • Multiple swallows per mouthful

  • Reduced control of saliva

A Speech Pathologist can manage dysphagia by:

  • Rehabilitation

  • Provision of risk management strategies (e.g. positioning, safe feeding)

  • Modifying food and fluid consistencies

  • Encouraging improved oral care

You should refer to a Speech Pathologist whenever you are concerned about your own or another person’s eating, chewing, drinking or swallowing. You can enquire about our Speech Pathology services via our contact us page.