EAR, NOSE & THROAT
Dysphagia has nothing to do with indigestion, but everything to do with swallowing. Swallowing is an involuntary action that comes naturally. When you eat, I’m sure you are not thinking about how the food is going to get into your stomach. It is a process that just happens. Some people are not able to enjoy such a wonderful dinner spread. Why is that? They have trouble swallowing. Dysphagia is not a disease but a symptom of another problem.
Swallowing is a complex process that happens in four phases:
- Oral Preparatory Phase
- Oral Transit Phase
- Pharyngeal Phase
- Esophageal Phase
The phases explain how the food goes from the table to your stomach. Let us take a journey with a slice of pizza to see how it ends up in your stomach.
- Stage one – Once the pizza enters your mouth, you begin to chew with the help of both your teeth and tongue. The food immediately mixes with saliva. The chewing along with the saliva turns it into one mass of food called a bolus. When ready, the bolus sits on the tongue ready for transport.
- Stage two – The oral transit phase is contingent on the tongue. The tongue pushes the bolus from the front of it to the back, where it can go down the pharynx. The receptors in the tongue and pharynx called the oropharynx become stimulated and trigger pharyngeal swallowing.
- Stage three – is all about the pharynx. The pizza that you ate is now ready for its rollercoaster ride. There are a bunch of different mechanisms that happen all at once. As soon as those receptors are stimulated, both the epiglottis and velopharyngeal port close. The epiglottis covers the larynx to prevent food from going into the lungs; the velopharyngeal port closes to prevent food from entering the nasal passage. If you ever had food or liquid come through your nasal passage you know, it is very uncomfortable and burns. Contractions of muscles in the pharynx follow and push the food down towards the esophagus.
- Stage four – The bolus is received by the upper part of the esophagus, and now a new set of contractions commence. These contractions are known as peristalsis. Gravity assists peristalsis. The contractions along with gravity push the food down the esophagus. The process seems long, but it only takes 8-20 seconds. Once the bolus passes through the esophagus, the swallowing process is over. It enters the stomach and begins a new process- digestion.
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