Swallowing food is one of our most natural and routine daily actions. However, an increasing number of people are struggling with this basic function, which is known as dysphagia, or swallowing difficulties. If you frequently experience choking or feel like food is stuck in your throat, it may be a sign that you need to seek medical attention.
Swallowing is not simply an automatic process. It involves the coordination of six cranial nerves and over 50 muscle pairs, all working together in a precise and complex manner. The process of recognizing food and guiding it from the mouth to the stomach can be divided into three main phases: oral, pharyngeal, and esophageal.
Swallowing involves three key phases. In the first phase, food is moved to the back of the mouth, triggering the gulping reflex, closing the airway, and pushing the food toward the esophagus. In the next phase, the food moves through the pharynx and heads toward the entrance of the esophagus. Finally, the food enters the esophagus and travels toward the stomach through peristalsis, a wave-like motion that helps move food downward. Problems can arise at any stage of this process, leading to swallowing difficulties. Common symptoms include choking while eating, the sensation of food being stuck in the throat, and a hoarse or gurgling voice.
A swallowing disorder is typically diagnosed through an evaluation by a rehabilitation medicine specialist, who physically examines the mouth and throat. The most common causes of dysphagia are neurological disorders such as stroke or Parkinson’s disease. However, as we age, swallowing difficulties can arise from various other temporary or chronic causes. If left untreated, these issues can lead to serious complications, such as aspiration pneumonia or life-threatening airway obstruction.
Specialists often use video fluoroscopy to evaluate the severity of swallowing problems. During this test, the patient consumes different foods mixed with a contrast agent while seated.
The specialist observes the entire process via video fluoroscopy to assess whether food enters the airway, how much food remains in the mouth and throat, and other factors. This evaluation helps determine the severity of the condition and guides treatment recommendations.
Treatment for swallowing difficulties typically involves two main approaches: rehabilitation therapy and modifying food consistency. Rehabilitation therapy may include exercises such as chin tucks or effortful swallowing techniques to help patients practice safe swallowing. Occupational therapists can also stimulate areas like the cheeks, chin, lips, and soft palate to trigger the swallowing reflex. Electrical stimulation sometimes targets muscles around the chin and neck to aid treatment.
The type of food provided to patients depends on their ability to chew and move their tongue and lips correctly. For some, liquid foods with low viscosity (like water or juice) may be challenging to manage, resulting in choking. In these cases, training may be provided to help patients consume thicker, more manageable liquids. Many patients experience significant improvement in their swallowing difficulties through rehabilitation therapy, which allows them to resume eating orally.
In cases of severe nutritional deficiencies or an increased risk of pneumonia, healthcare providers may discuss the option of tube feeding with the patient and their caregivers. Dr. Kim Won Seok, a Seoul National University Bundang Hospital professor, advises, “Tube feeding can help improve nutritional status, and participating in rehabilitation therapy can enhance swallowing abilities. It’s important to thoroughly consult with healthcare providers before deciding about nasogastric tube insertion.”
It’s essential to recognize that dysphagia can have various causes and severity levels, so diagnosis and treatment should be personalized. Dr. Suk Jung Lee, a Catholic University of Korea Daejeon St. Mary’s Hospital specialist, emphasizes that eating is not just about nutrition—it also provides psychological comfort and enjoyment. She stresses the importance of seeking an accurate diagnosis, appropriate treatment, and dietary guidance from a rehabilitation medicine specialist when dealing with swallowing difficulties.
