Degluttition or swallowing has four phases or stages, oral preparatory and oral phase, pharyngeal phase and oesophageal phase. All the phases are affected as age advances.
WHAT HAPPENS ACTUALLY?
ORAL PHASE
There will be loss of teeth, and connective tissue loss of the tongue, as a result there will be weakening of the action of chewing, also the reflexes that aid in chewing is also weakened. The normal upward movement of the tongue during swallowing along with the movement of soft palate and uvula is weakened.
Drying of the mouth( can be due to various medicines taken for comorbidites) , loosening of dentures, mouth sores can create problems during chewing and swallowing.
PHARYNGEAL PHASE
Pharynx is the part between tongue and esophagus ( food pipe) Normally when bolus of food passes through the pharynx, laryngeal inlet ( part of airway) is closed by upward movement of laryngeal structures . Rising up of larynx is affected in old age and the transit time of food through pharynx is increased. So chance of aspiration ( food spill over) and respiratory infections are more.
OESOPHAGEAL PHASE
When the upper esophageal sphincter ( valve) relaxes ,food passes through the esophagus ( food pipe), in elderly there is prolongation of upper esophageal sphincter relaxation time. Peristaltic waves that pushes the food contents through the food pipe also is weakened in old age. Patient will have the feeling that food is stuck.
WHAT CAN BE DONE?
Drink water frequently in sips
Take lemon, which will increase saliva
Avoid alcohol, smoking, and coffee
If drying of mouth is severe , artificial saliva is available
Avoid overuse of antihistamines
Swallowing therapy and swallowing rehabilitation also done
EXAMINATION NEEDED TO RULE OUT ANY PATHOLOGY FIRST.
Very helpful articles Sunita
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ReplyDeleteInformative article Sunita
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