Understanding Dysphagia (a part of having Myositis)

One of the many extra complications involved with Myositis and many other neuro muscular disorders is Dysphagia. (swallowing difficulty)

Swallowing involves three stages. These three stages are controlled by nerves that connect the digestive tract to the brain.

• Oral preparation stage
  Food is chewed and moved around the mouth by the tongue while being moistened by saliva. The tongue pushes food and liquids to the back of the mouth towards the throat. Where the swallowing action starts.

• Pharyngeal stage
  Food enters the pharynx (throat). A flap called the epiglottis closes off the passage to the windpipe so food cannot get into the lungs. The muscles in the throat relax. Food and liquid are quickly passed down the pharynx (throat) into the esophagus. The epiglottis opens again so we can breathe. (This phase starts under voluntary control, but then becomes an involuntary phase that we cannot consciously control.) It is at this stage that aspiration (breathing in of food particles) often takes place.  Aspiration can lead to, choking, dehydration, malnutrition, and pneumonia. In fact, aspiration pneumonia is the fifth leading cause of death in people over 60 years of age and the third leading cause of death in people over 80.

• Esophageal stage
  Liquids pass through the esophagus into the stomach by gravity normally in two to three seconds. Muscles in the esophagus push food toward the stomach in wave-like movements known as peristalsis. A muscular band between the end of the esophagus and the upper portion of the esophagus, known as the lower esophageal sphincter, relaxes involuntarily in response to swallowing, allowing food and liquids to enter the stomach.

Depending on the severity of the dysphagia, there are several different treatment options that may be beneficial for patients. This disorder may be treated by either a doctor or a speech-language pathologist, depending on exactly what is causing the swallowing problem. After the cause of dysphagia has been determined, it is possible that it can then be treated through a course of therapy, medication, or surgery.

Swallowing can be assisted by twisting the head to the side or tilting backwards or forwards. You need to experiment and find the most comfortable position. I avoid white bread, heavy or dry cake, baked potato, fatty or gristly meat, potato skins and chicken skin. I have also perfected a regurgitation process where I bring insufficiently chewed food back into my mouth for further chewing and saliva coverage before separating the mouthful into smaller swallowing portions. I also keep a glass of water handy to assist with the whole process.

Reflux and heartburn can result from insufficiently chewed food. Avoid foods that are highly acidic.

Chocolate

Coffee and other caffeinated drinks
Tomato-based products

Fatty/fried foods
Peppermint
Spicy foods
Oranges and other citrus foods

Most healthcare professionals suggest that you wait at least three hours after meals before lying down. Furthermore, you should wait 30 minutes after eating to drink a glass or two of lukewarm water to dilute the acid. When lying down, be sure that your head is raised 6-8 inches.

If the problem persists SEE YOUR DOCTOR