For the healthy, swallowing seems as easy as drawing breath. But it is actually a complex process, and for those with a swallowing disorder it is a malady that needs medical intervention, said a Yuma specialist. Dysphagia is a swallowing disorder causing difficulty for the mouth or the pharynx - the space in the throat - to move food from the mouth to the stomach, said Shanna Cale, speech pathologist at Yuma Rehabilitation Hospital.

Dysphagia can happen whenever there are changes in the structure of the throat such as a weakened tongue, cheek or throat muscles and may cause coughing or choking while eating or drinking. Any damage to the part of the brain that controls swallowing, such as from a stroke, can trigger Dysphagia, but it can strike at any age, Cale explained.

"It is more common among older people because they have neuro-degenerative disease such as Parkinson's or Alzheimer's," Cale said. "It doesn't happen just because someone is older."

It may also occur in patients who are sedated for long periods during a critical illness. But what is most serious about it is it could develop into aspiration pneumonia, Cale said. This may happen when food or liquid that stays in the windpipe can enter the lungs allowing harmful bacteria to form, she said.

Dysphagia may also strike the young. It can be found in children with congenital disorders - the most common being cerebral palsy or a cleft pallet, she said. Any person experiencing dysphagia needs to be seen by a speech language pathologist, she stressed.

One way to cope with dysphagia is to avoid food and drink that may aggravate it, though that is not a therapy, Cale said. By modifying the diet with thicker liquids - ones that have a tendency to stick together - patients may avoid choking from thin liquids that can squeeze into the airways in the throat, she explained.

But the most up to date treatment for dysphagia is neuromuscular electrical stimulation (NMES), Cale noted. In this procedure, electrodes are placed on the outside of the neck in order to stimulate the muscles used in swallowing. This therapy strengthens the muscles and improves coordination, she explained.

The procedure is typically done on an outpatient basis three to five times a week. But depending on the severity of dysphagia, it may need to be repeated from several weeks to several months. Yet it is usually a very successful intervention, noted Cale.

She also advised taking common sense precautions to avoid choking or coughing while eating. This includes sitting up straight, cutting food in smaller portions, avoiding eating or drinking too fast and chewing food thoroughly. And to avoid choking on medications, people should not cock their head back while swallowing a pill.

More common is gastroesophageal reflux disease (GERD), which occurs when stomach acid backs up into the esophagus, the muscular tube connecting the mouth and stomach. Dr. Mitch Freeman, who has a family medicine practice in Yuma, said more than one in 10 people have symptoms of GERD but some are unaware of it.

The difference between simple heartburn and GERD is when it happens on a regular basis. Symptoms such as chest pain, nausea or stomach pain two or three times per week all may indicate GERD, said Freeman. He suggests sufferers try nonmedical treatment first, such as avoiding large fatty meals, citrus or carbonated drinks, or losing weight.

But if symptoms persist, the best over-the-counter medicine available is Prilosec, said Freeman. It is best to take 20 milligrams of Prilosec a half-hour before eating so it can block acid production.

If symptoms recur the following day, repeating the dosage once per day should counteract 90 percent of acid reflux, Freeman said. There are less expensive medications such as Pepsid, Axid, or Tadmet, but they do not have a record of working as effectively, he noted.

To avoid GERD over the holiday feasts, it is best to avoid alcohol, citrus, or carbonated drinks because they are like "pouring more fuel on a fire," cautioned Freeman. He also advised not eating for two to three hours before going to bed, so the stomach has a chance to empty and stomach acid is less likely to back up in the esophagus.

If any symptoms of GERD do not positively respond to over-the-counter medications people should consult their physician because, left untreated, it can develop into esophagal stricture, a narrowing of the esophagus and food, especially red meat may become lodged in the throat. The best precaution to take for the holiday is moderation, Freeman said.


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William Roller can be reached at
wroller@yumasun.com or 539-6858.