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November 25, 2009
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Swallowing (cont.)

How Do I know if I Have a Swallowing Problem?

Normally, individuals rarely choke during a meal. Occasionally, food will stick in the esophagus for a few seconds (especially solid foods) but will pass spontaneously or can be washed down easily with liquids. However, there are a number of symptoms that require evaluation for a possible swallowing problem, including:

  • Frequent choking on food
  • Hesitancy in food passage for more than a few seconds
  • Pain when swallowing
  • Recurring pneumonia (an indication that food may be going into the lungs rather than the esophagus)

Urgent evaluation by a doctor is required when food becomes lodged in the esophagus for more than 15 minutes and will not pass spontaneously or with liquids.

Some people are unaware that they have swallowing problems because they compensate unconsciously by choosing foods that are easier to eat, or they eat more slowly. They are at risk for choking or having large pieces of solid food lodge in the esophagus if they let down their guard.

How Are Swallowing Problems Diagnosed?

Your doctor will decide which phase of swallowing needs to be tested and order appropriate tests after asking questions to determine the details of your swallowing symptoms and previous medical problems, as well as performing an appropriate physical examination. Three tests are most commonly used to evaluate a swallowing problem:

  • Cineradiography. An imaging test in which a movie camera is used to film the images of internal body structures. The patient swallows a barium preparation (liquid or other form that lights up under X-ray) and an X-ray machine with videotaping capability is used to view its movement through the esophagus. This is often performed under the guidance of a speech pathologist, an expert in swallowing as well as speech.
  • Upper endoscopy: A flexible, narrow tube (endoscope) is passed into the esophagus and projects images of the inside of the pharynx and esophagus on a screen for evaluation.
  • Manometry: This test measures the timing and strength of esophageal contractions and muscular valve relaxations.

Among other tests that may be necessary, according to the specific needs of the individual, are an impedance test and a pH probe test (for acid reflux).



Next: How are swallowing problems treated? »

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