What are the main causes of nasal regurgitation. How is nasal regurgitation diagnosed. What are the most effective treatments for nasal regurgitation. When should you be concerned about nasal regurgitation symptoms.

Understanding Nasal Regurgitation and Its Impact

Nasal regurgitation occurs when food or liquid comes up into the nasal cavity during eating or drinking. This swallowing disorder can affect people of all ages, though it’s most common in elderly individuals. Beyond the physical discomfort, nasal regurgitation can lead to social anxiety and embarrassment, making it crucial to address the issue promptly.

Is nasal regurgitation always a sign of a swallowing disorder? Not necessarily. The key is in the taste of the regurgitated substance. If it tastes like the food you’ve just tried to swallow, it’s likely due to a swallowing disorder. However, if the substance is bitter or sour, it may be stomach acid, indicating reflux rather than a swallowing issue.

Recognizing the Symptoms of Nasal Regurgitation

Nasal regurgitation is often accompanied by other symptoms that can indicate a swallowing disorder. These may include:

• Difficulty swallowing (dysphagia)
• Painful swallowing (odynophagia)
• Coughing or choking while eating
• Drooling
• Hoarseness
• Shortness of breath
• Chest discomfort
• Frequent throat clearing
• Changes in voice or speech

Are these symptoms always indicative of a serious condition? While not all cases are severe, it’s essential to take these symptoms seriously, especially if they persist or worsen over time. Ignoring them could lead to complications such as aspiration pneumonia, dehydration, or malnutrition.

Underlying Causes of Nasal Regurgitation

Understanding the root causes of nasal regurgitation is crucial for effective treatment. The condition can stem from various factors:

Oropharyngeal Dysphagia

This swallowing disorder affects the mouth and throat, making it difficult to initiate the swallowing process. How does oropharyngeal dysphagia lead to nasal regurgitation? When the muscles and nerves responsible for swallowing don’t function properly, food and liquid can be misdirected into the nasal cavity instead of traveling down the esophagus.

Velopharyngeal Dysfunction (VPD)

VPD occurs when the soft palate (velum) and the back and sides of the throat (pharynx) fail to close off the nasal cavity during swallowing. This malfunction can result in food and liquid entering the nasal passages. What causes VPD? It can be congenital or acquired due to neurological conditions, structural abnormalities, or trauma to the area.

Neurological Disorders

Various neurological conditions can affect the complex process of swallowing, leading to nasal regurgitation. These may include:

• Parkinson’s disease
• Multiple sclerosis
• Stroke
• Cerebral palsy
• Amyotrophic lateral sclerosis (ALS)

How do these conditions impact swallowing? They can affect the coordination of muscles involved in the swallowing process or impair the sensory feedback necessary for proper swallowing.

Diagnosing Nasal Regurgitation: A Comprehensive Approach

Accurate diagnosis is crucial for effective treatment of nasal regurgitation. Healthcare providers typically employ a combination of methods to identify the underlying cause:

Clinical Evaluation

A thorough medical history and physical examination are the first steps in diagnosing nasal regurgitation. What does this involve? The healthcare provider will ask about symptoms, medical history, and may perform a basic neurological exam to check muscle strength and coordination.

Swallowing Studies

These tests provide a detailed view of the swallowing process:

• Videofluoroscopic Swallow Study (VFSS): This X-ray test allows visualization of the entire swallowing process in real-time.
• Fiberoptic Endoscopic Evaluation of Swallowing (FEES): A small camera is inserted through the nose to observe the throat during swallowing.

How do these tests help in diagnosis? They can pinpoint exactly where and how the swallowing mechanism is malfunctioning, guiding treatment decisions.

Additional Diagnostic Tools

Depending on the suspected cause, other tests may be necessary:

• CT or MRI scans to identify structural abnormalities or neurological issues
• Manometry to measure pressure in the throat and esophagus during swallowing
• pH monitoring to rule out acid reflux as a cause

Treatment Options for Nasal Regurgitation

The treatment approach for nasal regurgitation varies depending on the underlying cause and severity of symptoms. Here are some common interventions:

Swallowing Therapy

Swallowing therapy, conducted by a speech-language pathologist, can significantly improve swallowing function. What does this therapy involve?

• Exercises to strengthen swallowing muscles
• Techniques to improve coordination during swallowing
• Postural changes to facilitate safer swallowing
• Dietary modifications to make food easier to swallow

How effective is swallowing therapy? Many patients see substantial improvement in their symptoms with consistent practice and application of learned techniques.

Surgical Interventions

In some cases, particularly those involving structural abnormalities, surgery may be necessary. Surgical options may include:

• Pharyngoplasty to correct velopharyngeal insufficiency
• Repair of cleft palate or other congenital defects
• Correction of acquired structural abnormalities

When is surgery considered? Surgery is typically reserved for cases where conservative treatments have not been effective or when there’s a clear structural issue that needs correction.

Medication

While medications don’t directly treat nasal regurgitation, they may be prescribed to manage related conditions or symptoms:

• Antacids or proton pump inhibitors for acid reflux
• Muscle relaxants for certain neurological conditions
• Antibiotics if aspiration pneumonia develops

Lifestyle and Dietary Modifications

Making changes to eating habits and food choices can significantly reduce the occurrence of nasal regurgitation:

Eating Techniques

• Eating slowly and taking smaller bites
• Chewing food thoroughly before swallowing
• Sitting upright while eating and for 30 minutes after meals
• Avoiding talking while eating

Food Consistency Modifications

Adjusting food textures can make swallowing easier and safer:

• Thickening liquids to slow their flow
• Pureeing solid foods
• Avoiding foods that are particularly challenging to swallow, such as dry or crumbly items

How do these modifications help? They can reduce the risk of food or liquid entering the nasal cavity and make the swallowing process more manageable for those with swallowing difficulties.

Complications and Long-term Outlook

While nasal regurgitation itself is not life-threatening, it can lead to serious complications if left untreated:

Potential Complications

• Aspiration pneumonia: This occurs when food or liquid enters the lungs, causing infection.
• Malnutrition and dehydration: Difficulty swallowing can lead to inadequate nutrition and fluid intake.
• Social isolation: Embarrassment about symptoms can cause individuals to avoid eating in public.

What is the long-term outlook for those with nasal regurgitation? With proper diagnosis and treatment, many individuals experience significant improvement in their symptoms and quality of life. However, some may require ongoing management, especially if the underlying cause is a progressive neurological condition.

When to Seek Medical Attention

Recognizing when to consult a healthcare provider is crucial for managing nasal regurgitation effectively. Consider seeking medical attention if you experience:

• Persistent or worsening symptoms of nasal regurgitation
• Frequent coughing or choking while eating
• Unexplained weight loss
• Recurrent respiratory infections
• Difficulty breathing during or after meals

Why is prompt medical attention important? Early intervention can prevent complications and lead to more effective treatment outcomes. Healthcare providers can conduct thorough evaluations to determine the underlying cause and develop an appropriate treatment plan.

Nasal regurgitation, while often distressing, is a manageable condition with proper diagnosis and treatment. By understanding its causes, recognizing symptoms, and exploring various treatment options, individuals can work towards improved swallowing function and overall quality of life. Remember, each case is unique, and a personalized approach under the guidance of healthcare professionals is key to successful management.

When to Worry About Nasal Regurgitation

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Evidence based

Evidence Based

This article is based on scientific evidence, written by experts and fact checked by experts.

Our team of licensed nutritionists and dietitians strive to be objective, unbiased, honest and to present both sides of the argument.

This article contains scientific references. The numbers in the parentheses (1, 2, 3) are clickable links to peer-reviewed scientific papers.

• Is Nasal Regurgitation a Swallowing Disorder?|
• Causes of Nasal Regurgitation|
• Diagnosing Nasal Regurgitation|
• Nasal Regurgitation Treatment|
• Bottom Line|

Nasal regurgitation is a swallowing disorder that occurs when food or fluid comes up into the nose while eating or drinking. It’s most common with elderly patients, but it can happen with patients of all ages (including infants). 

This type of swallowing disorder is not only a potentially dangerous health hazard — it can also affect the patient’s speech and ability to keep down food in public. These issues can be embarrassing and may lead to social anxiety, so it’s best to treat them as early as possible.   

Fortunately, there are treatments and therapies that can help address the issue and prevent it from damaging your body. But first, it’s important to understand the symptoms and cause of nasal regurgitation and how it relates to other health issues. Let’s take a look at each of these. 

Is Nasal Regurgitation a Swallowing Disorder?

Nasal regurgitation occurs when food or fluid comes up into the nose due to the nasopharynx not closing properly during swallowing [1]. There’s a difference between the type of regurgitation that signals a swallowing disorder and the type that signals acid reflux/heartburn or gastroesophageal reflux disease (GERD). The difference is the taste of the food bolus — the mixture of chewed food and saliva — that comes back up. 

If the bolus tastes like the food you’ve just tried to swallow, chances are your nasal regurgitation is a result of a swallowing disorder. If the substance is bitter or sour, that’s typically stomach acid, which means your food made it all the way down to your stomach and then came back up. In this case, you’re likely dealing with reflux.

Nasal Regurgitation Symptoms

Nasal regurgitation can be a symptom of a swallowing disorder. Other symptoms of a swallowing disorder may include [1, 2, 3]:

• Dysphagia: a sensation of food sticking to the throat and difficulty swallowing food or liquids
• Odynophagia: painful swallowing
• Coughing during or immediately after swallowing
• Choking
• Drooling
• Sore throat
• Hoarseness
• Shortness of breath
• Chest discomfort or pain
• Posture changes
• Weight loss
• Repeated chest infections or pneumonia 
• Bronchitis
• Changes in voice, articulation, speech, and language
• Frequent repetitive swallows
• Frequent throat clearing
• Dehydration
• Aspiration
• Malnutrition

It’s important to be aware that throat dysfunctions and abnormalities are serious problems that require intervention, especially if your airway is restricted or affected. Aspiration pneumonia (swelling or infection in the lungs due to food, saliva, liquids, or vomit being breathed into the lungs or airways), dehydration, and airway obstruction are all serious side effects of a swallowing disorder.

What Causes Nasal Regurgitation?

Nasal regurgitation can be a symptom of dysphagia, namely oropharyngeal dysphagia, which is a swallowing disorder that occurs in the mouth and throat [2].

It may also be a symptom of a dysfunction of the velopharyngeal sphincter, which is the threshold that separates the nasal and oral cavities during speech, swallowing, vomiting, blowing, and sucking [4].

The velopharyngeal sphincter consists of the soft palate (velum) and the back and sides of the pharynx (throat), all of which are critical to proper swallowing. In other words, if this sphincter misfires during dilation or closing, all of these functions can be affected — your speech or voice can change, or you may swallow air or aspirate on your food, for example [5].

There are a number of potential causes of nasal regurgitation, including the two swallowing disorders we’ve already mentioned: oropharyngeal dysphagia and velopharyngeal dysfunction (VPD). 

Since swallowing is a set of coordinated muscle movements that control the mouth, back of the throat (pharynx), and the esophagus, all manner of swallowing disorders could result in nasal regurgitation and aspiration (food entering the airway) [6].

During normal, healthy swallowing, the soft palate goes up and contacts the back and sides of the throat (pharynx), which closes off the nasopharynx and prevents regurgitation of food or liquids into the nasal cavity [6]. Any impairment of this coordinated set of muscles can lead to nasal regurgitation.

A combination of oropharyngeal dysphagia and esophageal dysphagia (this often causes GERD and possibly laryngopharyngeal reflux) can also lead to nasal regurgitation. Mixed dysphagia happens mostly in the elderly and can include impaired saliva production, loss of jaw strength and muscle, gum and dental problems, and loss of upper esophageal sphincter elasticity [7].

What Causes Velopharyngeal Dysfunction (VPD)?

So, VPD can cause nasal regurgitation. But what causes VPD? The four potential causes of VPD are [4]:

1. Structural abnormalities
2. Neuromuscular or musculoskeletal injuries
3. Developmental challenges
4. Pediatric syndromes

Structural Abnormalities

The most common cause of VPD is a cleft palate (or cleft lip), which is a fetal development problem in which the palate doesn’t properly fuse together.. Infants born with a cleft palate usually undergo surgical repair before the age of two [8].

Other structural abnormalities that could lead to VPD include congenital short soft palate, nasopharyngeal disproportion (poorly functioning soft palate), poor sphincter mobility from enlarged tonsils (when enlarged tonsils block the soft palate from closing off the oral cavity from the nasal cavity), or scarring from prior surgery [4].

Neuromuscular or Musculoskeletal Injuries

This type of challenge, also called neurogenic dysphagia, comes from the trauma of a disease or neurological disorder. A stroke could result in VPD. Nervous system issues could lead to VPD — examples include cerebral palsy, myopathy, muscular dystrophy, neuropathy, amyotrophic lateral sclerosis (ALS), Parkinson’s disease, Moebius syndrome, Trisomy 21 syndrome, or myasthenia gravis [4].

Developmental Disorders

Swallowing disorders and speech problems often correlate, although they are two different diagnoses. A speech-language pathologist with experience in cleft speech abnormalities can help diagnose issues in these areas. Articulation disorders can often mimic VPD, so it’s important to note that speech issues can also be a red flag for VPD [4].

Pediatric Syndromes

After cleft palate, the second-most common cause of VPD is velocardiofacial syndrome (VCFS, also called 22q11 Deletion Syndrome or DiGeorge syndrome). This syndrome often happens alongside a cleft palate and is a genetic disorder characterized by “cleft palate, or an opening in the roof of the mouth, and/or other differences in the palate; heart defects; problems fighting infection; low calcium levels; differences in the way the kidneys are formed or work; a characteristic facial appearance; learning problems; and speech and feeding problems,” ​according to the National Human Genome Research Institute.

Other pediatric syndromes that are associated with VPD are Trisomy 21, Klippel-Feil, epidermal nevus syndrome, Turner syndrome, and VATER syndrome. VATER stands for vertebral anomalies, anal atresia, tracheoesophageal fistula, esophageal atresia, and radial and renal anomalies) [4].

What Causes Dysphagia?

Dysphagia is one of the two main causes of nasal regurgitation. There are three types of dysphagia: oropharyngeal, esophageal, and a mix of the two. While dysfunction of the esophageal muscles that leads to swallowing issues is more associated with GERD, it’s worth mentioning here, as GERD and other swallowing disorders have overlapping symptoms. These include chest pain, throat clearing, hoarseness, feeling of a lump in the throat, bronchitis, pneumonia, dysphagia, and odynophagia [9, 10].

Oropharyngeal Dysphagia

There are overlapping causes of oropharyngeal dysphagia and VPD, including stroke, the neurodegenerative and neuromuscular diseases we’ve already listed (cerebral palsy, myopathy, muscular dystrophy, neuropathy, amyotrophic lateral sclerosis (ALS), Parkinson’s disease, Moebius syndrome, Trisomy 21 syndrome, or myasthenia gravis), in addition to Alzheimer’s, multiple sclerosis, and poliomyelitis and postpolio syndrome.

In addition to these causes, diseases and procedures local to the throat can also lead to oropharyngeal dysphagia. This includes head and neck tumors, surgery, radiation, goiter, zenker diverticulum, or cricopharyngeal achalasia [3].

Certain medications may also cause dysphagia, such as anti-inflammatory drugs, benzodiazepines, psychotropic drugs, vasoactive drugs, and illicit substances [2, 11].

Esophageal Dysphagia

Esophageal dysphagia is the result of either a mechanical obstruction or motility (the movement of the food bolus through the digestive tract) disorder (or both). Mechanical obstructions may include [7]:

• Schatzki ring: a ring of tissue that forms inside the esophagus close to base of the stomach that makes it hard to swallow
• Esophageal stricture: abnormal narrowing or tightening of the esophageal muscles that makes it hard for food and liquid to pass through
• Cancer
• Eosinophilic esophagitis: a chronic immune disease that causes a build-up of white blood cells in the esophagus and makes it hard to swallow
• Peptic stenosis: esophageal narrowing due to damage or inflammation
• Post-surgical complications

Motility disorders include [7]:

• Esophageal spasm: painful contractions of the esophagus that can feel like chest pain or angina
• Achalasia: when the lower part of the esophagus fails to relax and won’t allow food to pass through to the stomach
• Ineffective esophageal motility: when the smooth muscle of the esophagus doesn’t contract properly to move the food through to the stomach
• Scleroderma: an autoimmune disease that results in a chronic hardening or contraction of connective tissue

Since a mixture of the two types of dysphagia is a potential cause of nasal regurgitation in the elderly, it’s important to understand the causes of esophageal dysphagia as well.  

Furthermore, reflux disorders like GERD and nasal regurgitation may both be associated with other chronic pharyngeal and nasal conditions such as rhinosinusitis (inflammation of the sinuses and nasal cavity) and post-nasal drip, according to two small studies [12, 13].

How to Diagnose Nasal Regurgitation

Since we now know that nasal regurgitation is a symptom, rather than a disease itself, you’d want to talk with your GI doctor or functional medicine doctor about diagnosing VPD or dysphasia. In both cases, your doctor would start by taking a careful and thorough patient history. They may also want certain types of imaging, such as endoscopy, to be able to see how things move in your throat as you swallow. 

Diagnosing VPD

After a thorough accounting of a patient’s medical history and physical exam, your doctor will also ask about your sleep history to see if you’ve had sleep apnea, snoring, restlessness, or other problems. They’ll also determine if nasal regurgitation takes place as you eat [5].

A speech language pathologist may also check your speech quality for hoarseness, nasal tones, or other issues. They may also look at your nasometry, which measures the ratio of sound coming from your nose and your mouth [4].

Your doctor may also want to take a video-nasal endoscopy, a multiview videofluoroscopy, cephalometrics, or an MRI to determine if there are any structural abnormalities or evidence of other causes of VPD. 

Diagnosing Dysphagia

Finally, after getting your medical history and conducting a physical examination, your doctor will assess your swallowing through a series of screening tools. This will help them diagnose oropharyngeal dysphagia. They may do a combination of the following tests [2]:

• Toronto Bedside Swallowing Screening Test
• Volume-viscosity swallow test
• Standard Swallowing Assessment
• Guggen Swallowing Screen

You might also hear your doctor talk about a few different types of imaging tools they want to use to help them assess swallowing function, including videofluoroscopy (modified barium swallow), fiberoptic endoscopic evaluation, high resolution manometry, functional imaging probe, and/or accelerometry [14]. It’s ok if you don’t know these terms. If your doctor wants to use one, they will explain the process to you.

To diagnose esophageal dysphagia, your doctor may use one or more imaging tools, including endoscopy with biopsy, videofluoroscopy (barium swallow), esophageal manometry, intraluminal impedance, and/or impedance planimetry.

How to Treat Nasal Regurgitation

To treat nasal regurgitation, you need to address the root cause, either VPD or dysphagia. For the former, the treatment options are speech therapy, oral prosthetics, and/or a number of different surgical options. 

Most physicians will start with speech therapy in children in order to minimize surgical procedures unless absolutely necessary [4]. Surgery can help by creating a functional seal between the nasopharynx and oropharynx during speech [4]. There are four main types of surgery to address VPD. We won’t go into detail about these, but you might hear your doctor mention them:

1. Pharyngeal flap
2. Sphincter pharyngoplasty
3. Palatoplasty
4. Posterior pharyngeal wall augmentation

All four seem to be effective at improving nasal resonance, speech intelligibility, swallowing, and obstructive sleep apnea [15]. The earlier the intervention, the better. Getting a diagnosis as soon as possible is especially important for children who may still be developing speech habits and patterns. 

To treat oropharyngeal dysphagia, certain head, throat, tongue, and swallowing exercises are prescribed in order to tone and strengthen the areas that are malfunctioning. A systematic review of the research shows these exercises have not only improved swallowing but also reduced the length of hospital stay and incidence of chest infection or pneumonia [16].

Acupuncture and electrical stimulation are also viable treatment options. Specific exercises to address oropharyngeal dysphagia will depend on how the patient presents and should be determined by a qualified speech pathologist [17].

Treatment of esophageal dysphagia depends on the cause. Some treatments for esophageal dysphagia may include surgery, radiation, or chemotherapy for cancer, balloon dilation for mechanical obstructions, and an elemental diet or elimination diet for eosinophilic esophagitis [18].

The Bottom Line

Nasal regurgitation is a sign of a potentially serious swallowing disorder like velopharyngeal dysfunction (VPD), oropharyngeal dysphagia or a mix of oropharyngeal dysphagia and esophageal dysphagia. If these issues are left unaddressed, quality of life can suffer. Whether it’s due to social anxiety due to abnormal speech, reduced enjoyment of food, or something more serious and deadly like chronic chest infections or aspiration pneumonia, the consequences of leaving these health issues unchecked are serious. 

If you’d like to talk to one of our functional medicine doctors to find out if you’re dealing with one of these issues, reach out to schedule an appointment.

➕ References

1. Swallowing Disorders | Johns Hopkins Medicine [Internet]. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/swallowing-disorders
2. Rommel N, Hamdy S. Oropharyngeal dysphagia: manifestations and diagnosis. Nat Rev Gastroenterol Hepatol. 2016 Jan;13(1):49–59. DOI: 10.1038/nrgastro.2015.199. PMID: 26627547.
3. Shaker R. Oropharyngeal Dysphagia. Gastroenterol Hepatol (N Y). 2006 Sep;2(9):633–4. PMID: 28316533. PMCID: PMC5350575.
4. Young A, Spinner A. Velopharyngeal Insufficiency. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2021. PMID: 33085296.
5. Glade RS, Deal R. Diagnosis and management of velopharyngeal dysfunction. Oral Maxillofac Surg Clin North Am. 2016 May;28(2):181–8. DOI: 10.1016/j.coms.2015.12.004. PMID: 27150305.
6. Bruss DM, Sajjad H. Anatomy, head and neck, laryngopharynx. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2021. PMID: 31751103.
7. Azer SA, Kshirsagar RK. Dysphagia. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022. PMID: 32644600.
8. Phalke N, Goldman JJ. Cleft Palate. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2021. PMID: 33085275.
9. Clarrett DM, Hachem C. Gastroesophageal reflux disease (GERD). Mo Med. 2018 Jun;115(3):214–8. PMID: 30228725. PMCID: PMC6140167.
10. Gaude GS. Pulmonary manifestations of gastroesophageal reflux disease. Ann Thorac Med. 2009 Jul;4(3):115–23. DOI: 10.4103/1817-1737.53347. PMID: 19641641. PMCID: PMC2714564.
11. You P, Chow L, Dworschak-Stokan A, Husein M. Velopharyngeal dysfunction from intranasal substance abuse: Case series and review of literature. Laryngoscope. 2018 Dec;128(12):2721–5. DOI: 10.1002/lary.27240. PMID: 29756302.
12. DelGaudio JM. Direct nasopharyngeal reflux of gastric acid is a contributing factor in refractory chronic rhinosinusitis. Laryngoscope. 2005 Jun;115(6):946–57. DOI: 10.1097/01.MLG.0000163751.00885.63. PMID: 15933499.
13. Wise SK, Wise JC, DelGaudio JM. Association of nasopharyngeal and laryngopharyngeal reflux with postnasal drip symptomatology in patients with and without rhinosinusitis. Am J Rhinol. 2006 Jun;20(3):283–9. DOI: 10.2500/ajr.2006.20.2849. PMID: 16871930.
14. Zerbib F, Omari T. Oesophageal dysphagia: manifestations and diagnosis. Nat Rev Gastroenterol Hepatol. 2015 Jun;12(6):322–31. DOI: 10.1038/nrgastro.2014.195. PMID: 25404278.
15. de Blacam C, Smith S, Orr D. Surgery for velopharyngeal dysfunction: A systematic review of interventions and outcomes. Cleft Palate Craniofac J. 2018 Mar;55(3):405–22. DOI: 10.1177/1055665617735102. PMID: 29437504.
16. Bath PM, Lee HS, Everton LF. Swallowing therapy for dysphagia in acute and subacute stroke. Cochrane Database Syst Rev. 2018 Oct 30;10:CD000323. DOI: 10.1002/14651858.CD000323.pub3. PMID: 30376602. PMCID: PMC6516809.
17. Krekeler BN, Rowe LM, Connor NP. Dose in Exercise-Based Dysphagia Therapies: A Scoping Review. Dysphagia. 2021 Feb;36(1):1–32. DOI: 10.1007/s00455-020-10104-3. PMID: 32140905. PMCID: PMC7483259.
18. Kaindlstorfer A, Pointner R. An appraisal of current dysphagia diagnosis and treatment strategies. Expert Rev Gastroenterol Hepatol. 2016 Aug;10(8):929–42. DOI: 10.1586/17474124.2016.1158098. PMID: 26906944.

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Why Does Food Go up My Nose when I Swallow?

Source: weillcornell.org

When you swallow, food travels down your throat and into your stomach. But sometimes, food can get stuck in the back of your throat or even in the nose! Learn how to keep this from happening with these tips.

Nasal regurgitation is a condition in which food or fluids that you swallow end up coming out of your nose. It is usually caused by the sudden and forceful movement of swallowing, but it can also be due to a cold or allergies.

When you start swallowing, some disorders may weaken your throatmuscles, making it harder to transfer food from your mouth into your throat and esophagus. When you attempt to swallow or experience the feeling of food or fluids traveling down your windpipe (trachea) or up your nose, you may choke, gag, or cough.

People often wonder why when they eat, food comes out of their nose.

Because to food allergies, a person’s nose may run after eating, a condition known as allergic rhinitis. Gustatory rhinitis is a form of non-allergic rhinitis in which a person’s nose runs without their having a food allergy. The various reasons of a runny nose when eating are discussed in this article.

The issue then becomes, what causes excessive swallowing? Frequent swallowing as a result of worry is one of the most prevalent reasons of a dry throat. GERD (gastroesophageal reflux disease): GERD is a kind of acid reflux in which the contents of the stomach flow up the food pipe and occasionally into the throat.

As a result, how can sinus issues impact swallowing?

Center for Sinusitis This mucous is normally ingested unknowingly many times during the day. The feeling of post-nasal drip may occur when mucus becomes thick or overwhelming in volume. Cough, painful throat, frequent throat clearing, and the sensation of a lump in the throat are all common symptoms of post-nasal discharge.

Is it normal for food to get caught in my chest when I swallow it?

GERD Signs and Symptoms Heartburn and acid regurgitation are the most common symptoms. Some individuals have GERD but do not experience heartburn. Instead, they have chest discomfort, hoarseness in the morning, or difficulty swallowing. You may feel as if food is trapped in your throat, as if you are choking, or as if your throat is closing up.

Answers to Related Questions

What foods are associated with gustatory rhinitis?

Excessive, watery nasal discharge is a feature of both gustatory and senile rhinitis. Hot peppers are a spicy meal that may cause a runny nose. garlic.

What causes a drink to leak from your nose?

Air enters the nostrils and travels across the soft palate and uvula on its route to the lungs when we breathe with our lips closed. The uvula hangs down as a result of this. When you laugh while drinking, the liquid rises into your open nasal tube and exits through your nostrils.

Is it true that spicy food is healthy for you?

It turns out that a slew of studies back up the notion that adding spice to your meals may have significant health advantages. It’s the fundamental reason why spicy meals may help you lose weight and live a longer, healthier life. It’s found in jalapeos, habaneros, cayenne, and most other chili peppers.

What’s the best way to get stuff out of my nose?

1. If at all possible, remove the object

1. Allow the individual to breathe via his or her mouth.
2. Try to pull an item partly out of the nose with your fingers or tweezers if you’re an adult.
3. Pinch the transparent side of the nose closed to get a deeper item inside the nose.
4. Do not attempt to pull or grasp an item jammed up a child’s nose.

Is it possible for stomach acid to escape via your nose?

In certain cases, acid reflux may actually cause sinusitis! That is to say, the acid may go all the way up to your nose and sinuses (for example, when you are sleeping), inflaming the linings of your nose and sinuses. This issue is more prevalent in youngsters, although it may also affect adults.

Is it true that spicy food helps to clean your sinuses?

Spicy foods help to open nasal airways and get mucus flowing naturally. Capsaicin, the hot chemical found in chilies, may help relieve sinus discomfort, decrease inflammation, and clear clogged mucus. Pungenthorseradish may also be used as a natural nasal decongestant.

Gustatory rhinitis is caused by a variety of factors.

Many people suffer from wateryrhinorrhea (gustatory rhinitis) as a result of eating specific meals. Thus, spicy foods cause gustatory rhinitis by stimulating atropine-inhibitable muscarinic receptors (most likely in the submucosalglands), and the condition may be treated prophylactically with topical atropine.

Is it possible that food allergies induce post-nasal drip?

Allergens in food

Food allergies, whether to peanuts, strawberries, or anything else, may produce hives and swelling. Food allergies, on the other hand, may produce nasal symptoms such as congestion in certain individuals. Ask your doctor and be tested if you detect a link between constipation and specific meals.

Is it possible for a sinus infection to travel to your brain?

Sinus infections in the back center of the head may also extend to the brain in rare instances. According to Dr. Sindwani, this may result in life-threatening diseases such as meningitis or a brain abscess. “People would die from sinusitis before antibiotics,” he adds. He does, however, stress that such problems are unlikely.

What methods do physicians use to empty sinuses?

Four pairs of sinuses connect to your nasal cavity via tiny holes. Mucus generated by your sinuses flows into your nose and down the back of your throat via holes. The nose is maintained moist and clear of dust, bacteria, and other germs as the mucus drains.

Is it possible for sinus issues to produce a foul taste in the mouth?

A sinus infection’s mucus may have a foul odor, resulting in stinky breath or a terrible taste in the mouth. Intense sinus pressure may induce gum discomfort, which can result in toothaches, gum pain, or overall mouth pain. Sinus infections may become persistent in certain cases.

Is it possible for clogged ears to create throat problems?

Throat discomfort and soreness are typical symptoms of postnasal drip. Inflammation may also create a blockage in the ears, preventing mucus from draining correctly and causing ear discomfort and pressure.

Dysphagia manifests itself in a variety of ways. What are the indications and symptoms of dysphagia?

Dysphagia may cause the following signs and symptoms:

• Having difficulty swallowing (odynophagia)
• The inability to swallow.
• Feeling as though something is trapped in your throat, chest, or below your breastbone (sternum)
• Drooling.
• Being unable to speak clearly.
• Bringing food back to the surface (regurgitation)
• Having a lot of heartburn.

Can dehydration make it difficult to swallow?

Why do people have difficulty swallowing?

Dehydration, not chewing long enough, or eating too large chunks of food are all examples. Other swallowing issues are caused by gastroesophageal reflux disease (GERD) (GERD). When bile or stomach acid backs up into your food pipe, this occurs (esophagus)..

What are your strategies for dealing with swallowing difficulties?

Dysphagia may be treated in a variety of ways, including:

1. Exercises to strengthen the muscles in your throat and esophagus. You may need to perform exercises to teach your muscles to work together to assist you swallow if you have a problem with your brain, nerves, or muscles.
2. Changing your eating habits.
3. Dilation.
4. Endoscopy.
5. Surgery.
6. Medicines.

Is it possible for worry to produce excessive saliva?

Too much saliva may cause speech and feeding difficulties, as well as chapped lips and skin diseases. Social anxiety and low self-esteem may also be caused by hypersalivation and drooling.

What are the early symptoms of throat cancer?

Among the signs and symptoms of throat cancer are: There was a cough. Changes in your voice, such as hoarseness or a lack of clarity in your speech. Swallowing problems.

Who is responsible for the treatment of swallowing disorders?

If you’re experiencing trouble swallowing, see your doctor. Your doctor may send you to an ear, nose, and throat specialist, a gastroenterologist, or a doctor who specializes in nervous system illnesses, depending on the probable reason (neurologist).

The how to fix nasal regurgitation is a common problem that can be hard to deal with. The article will give you an overview of the issue and how to fix it.

Frequently Asked Questions

What are the signs of dysphagia?

Signs of dysphagia include difficulty swallowing, drooling, and coughing up saliva or food.

What causes nasal regurgitation in adults?

The most common cause of nasal regurgitation in adults is a condition called gastroesophageal reflux disease, or GERD.

How do you fix dysphagia?

Dysphagia is a condition in which food or liquid cant be properly swallowed. It may be caused by an injury to the throat, mouth, or esophagus. Treatment for dysphagia includes pain medication, surgery, and speech therapy.

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Swallowing disorder

Violation of swallowing – the causes of occurrence, in which diseases it occurs, diagnosis and methods of treatment.

Violation of the act of swallowing, or dysphagia, is due to the impossibility of passing the food bolus formed in the oral cavity through the oropharyngeal or pharyngeal-esophageal part into the stomach.

It is necessary to distinguish between true dysphagia and pseudodysphagia, which is manifested by a sensation of a lump in the throat, but is not accompanied by a violation of the act of swallowing.

The process of swallowing is regulated by the nerve center, which is located in the medulla oblongata, so damage to the brain structures leads to a violation of the swallowing reflex. The act of swallowing involves the muscles of the oropharynx and esophagus, the pathology of which also leads to dysphagia.

Varieties of swallowing disorders

Swallowing disorders are usually a symptom of gastrointestinal, oncological or neurological diseases.

The act of swallowing consists of three phases: oral (carried out voluntarily), pharyngeal (carried out reflexively) and esophageal (also carried out reflexively). Depending on the stage at which the difficulty in swallowing occurs, we can talk about the cause of this phenomenon. In some cases, difficulty in swallowing is caused by a violation of the act of swallowing in combination with soreness (odynophagia) . Sometimes there is a feeling that when swallowed, a lump gets stuck in the throat, at other times there is no such complaint. In some diseases, fear of swallowing develops ( phagophobia ) , the person is afraid of choking, feels that he cannot swallow food. This condition can occur with anxiety disorders, hysteria, previous negative cases. Some people can feel the process of food passing through the esophagus. However, this sensitivity is not associated with food retention in the esophagus or with its blockage. Sometimes patients complain of difficulty swallowing, when in fact they have a full stomach after a meal, especially when the hasty meal is accompanied by swallowing air.

Depending on the reason that does not allow food to enter the stomach, there are functional and organic dysphagia. Functional violation of the act of swallowing is caused by a disorder of contraction and relaxation of the muscles of the upper esophageal sphincter or the oropharynx and esophagus due to a violation of the nervous regulation. It is also possible the organic cause of the disorder of the act of swallowing due to a mechanical obstruction or narrowing in the oropharynx or esophagus.

Possible causes of swallowing problems

One of the leading causes of swallowing disorders are the consequences of a stroke .

Clinical manifestations of swallowing disorders in this case include choking or coughing when eating; salivation; accumulation of food behind the cheek or its loss from the mouth, difficulty in taking tablet medicines.

Dysphagia is also a symptom Parkinson’s disease and is detected in almost half of the patients.

Degenerative processes in the central nervous system eventually lead to damage to the muscles of the oropharynx, which is accompanied by a violation of swallowing and speech. The symptom often manifests itself in the later stages of the disease.

Dyskinesia of the esophagus leads to a violation of the act of swallowing, which may be accompanied by atony and paralysis or spasm of the esophagus (esophagus spasm).

By atony of the esophagus can lead to brain damage in head injuries, hemorrhages or brain tumors and disruption of the autonomic nervous system in systemic diseases (systemic scleroderma, myasthenia gravis, etc. ).

As a rule, the leading clinical signs are the symptoms of the underlying disease. With systemic scleroderma , connective tissues are affected with involvement of the skin, musculoskeletal system and internal organs in the pathological process. The esophagus in this pathology is affected more often than other organs, which is manifested by difficulty in swallowing. Dysphagia at myasthenia gravis (muscle weakness) is often the only symptom of the disease and is manifested by difficulty swallowing dry and poorly chewed food, especially when lying down.

Another cause of esophageal dyskinesia is spastic dysphagia (esophagospasm) , which occurs as a result of psycho-emotional stress in patients with esophagitis, gastric ulcer, etc. In addition, esophagospasm develops in diseases that are accompanied by a general convulsive syndrome (epilepsy).

Clinically, spasm of the esophagus is manifested by retrosternal pain and impaired swallowing.

Among the rather rare causes of swallowing disorders is achalasia of the cardia . With this disease, the intermuscular nerve plexuses are affected, which leads to the impossibility of relaxing the lower esophageal sphincter and esophageal peristalsis. Violation of the tone of the esophagus is accompanied by dysphagia, vomiting and pain at the time of swallowing food.

The contractile function of the esophagus is impaired at dysfunction of the upper esophageal sphincter, oculopharyngeal muscular dystrophy (a hereditary disease that affects the muscles of the face and head). In these cases, dysphagia is caused by damage to the neuromuscular tissue of the esophagus, which is accompanied by muscle weakness.

Organic causes of swallowing disorders include primarily neoplasms of the head, neck, esophagus and mediastinum . Since the anatomical space of the mediastinum is limited, growing tumors can compress the venous trunks, which is accompanied by the development of the syndrome of the superior vena cava (impaired outflow of venous blood from the upper body). Compression of the trachea and esophagus by a crowded venous trunk may be accompanied by symptoms of suffocation and dysphagia.

One of the frequent causes of violation of the act of swallowing is the appearance of diverticula of the esophagus – sac-like protrusions of the walls of the esophagus towards the mediastinum. This causes perspiration, increased salivation and a sensation of a lump in the throat.

Esophageal obstruction that causes dysphagia can develop in infectious processes in the esophagus or oropharynx (for example, with tonsillitis, abscesses and phlegmon), as well as in tuberculosis due to cicatricial narrowing of the esophagus.

Thyromegaly (enlargement of the thyroid gland) can also lead to a violation of the act of swallowing due to compression of the esophagus, but this process is observed only at a late stage of the development of the disease.

Against the background of psychosomatic disorders, hysteria, psychogenic dysphagia may occur, which is accompanied by other neurological symptoms (pseudo-stuttering, “lump in the throat”, etc. ).

Which doctors should I contact?

It is important to remember that the initial symptoms of spasm and dysmotility of the esophagus can occur in children of the first year of life.

The appearance of the first symptoms of indigestion – regurgitation, sudden vomiting of unchanged food immediately after eating, pain when swallowing – requires immediate treatment
pediatrician.

If such symptoms are detected in an adult for a long time (more than a month), it is imperative to visit
therapist. Based on the results of the examination, the therapist can give a referral to
gastroenterologist or oncologist to examine the gastrointestinal tract. For neurological disorders associated with dysphagia, it is necessary to refer to
neurologist or psychotherapist.

Diagnostics and examinations

A preliminary diagnosis can be made after a thorough examination of the patient. At the same time, attention is paid to the duration of dysphagia and the nature of its course. For example, esophagitis is usually accompanied by short-term dysphagia. Rapid and steadily progressive symptoms of difficulty swallowing are characteristic of esophageal cancer. With benign narrowing of the esophagus (strictures, tumors), dysphagia is characterized by periodicity and occurs more often when swallowing solid food. With functional dysphagia due to diseases such as achalasia of the cardia or esophagus spasm, it is difficult to swallow both solid and liquid food.

In patients with systemic scleroderma, the characteristic feature is a skin lesion. The neurological nature of dysphagia is evidenced by such symptoms as speech impairment, hoarseness, tongue atrophy, as well as signs of neuromuscular lesions. To identify diseases that can disrupt the flow of food into the esophagus, examine the oral cavity and pharynx.

To detect dysfunction of the muscles of the mouth and pharynx, as well as organic changes, fluoroscopy with barium sulfate and esophageal manometry are performed; computed tomography of the larynx.

Treatment

Given the different causes of dysphagia, the doctor prescribes treatment only after the diagnosis is made. With a progressive form of dysphagia, which may indicate an oncological disease, a visit to the doctor cannot be postponed.

What should be done in case of violation of the act of swallowing?

With post-stroke dysphagia, while maintaining the swallowing reflex, soft, semi-liquid dishes are consumed.

The patient should take all medications in the presence of medical staff, drinking medicines with small sips of water in a half-sitting position.

If the swallowing function is not restored within three days, nutrition is carried out through a nasogastric tube.

If the cause of the violation of the act of swallowing is esophagitis or gastroesophageal disease, it is necessary to shorten the intervals between meals and reduce the portion size. It is not recommended to eat hot and cold dishes, food should be chewed thoroughly. It is advisable to limit the consumption of foods that cause irritation of the esophageal mucosa (fats, alcohol, coffee, chocolate, citrus fruits, etc.).

After eating, you should avoid bending forward and not lying down for 1.5 hours. In addition, it is worth refusing to wear tight clothing, tight belts.

Sources:

1. Clinical guidelines “Acute respiratory viral infections (ARVI) in adults”. Developed by: National Scientific Society of Infectionists, Russian Scientific Medical Society of Therapists. – 2021.
2. Clinical guidelines “Paratonsillar abscess”. Developed by: National Medical Association of Otorhinolaryngologists. – 2021.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.

Dysphagia: causes, symptoms and treatment recommendations. Dr. Peter

• Directory of Diseases

July 29, 2022

Dysphagia is a pathological condition in which difficulty swallowing develops. Trouble swallowing food or liquids can occur in people throughout life, but is more common among the elderly, infants, or people with neurological problems.

Source:

iStockphoto

The muscles of the head and neck move in a certain rhythm, clearly and harmoniously, simultaneously performing many functions. In addition to pronouncing words with the tongue and lips, the muscles of the mouth and throat must work in sync in the basic process of swallowing. These muscles are responsible for coordinating chewing, mixing food with saliva, moving food or liquid (called a bolus) from the lips to the back of the mouth, and then moving it down the throat into the esophagus to the stomach, bypassing the airways. Any difficulty in this process is called dysphagia.

Causes

Dysphagia is primarily caused by weakness or malfunction of one or more nerves or muscles that control sensation and movement during chewing and swallowing. Certain medications can also cause dysphagia.

Pathology may result from a stroke and occurs to varying degrees in approximately 65% ​​of stroke patients. It can also be caused by aging, diseases of the central nervous system (such as dementia, Parkinson’s disease, ALS, multiple sclerosis, or myasthenia gravis), gastroesophageal reflux disorder (GERD), radiation therapy, cleft lip and palate, dry mouth, cerebral insufficiency, or paralysis. , inflammation of the esophagus, trauma or surgery on the head and neck, various types of cancer.

Dysphagia can occur at various stages of the swallowing process. First of all, this may be a violation of the ability to close lips around food, or an obstacle is formed to the movement of food into the stomach.

Dysphagia can usually affect these three phases of swallowing:

• Oral phase: sucking, chewing, tasting, or moving food or liquids in the mouth. The disorders are often caused by dry mouth, dental problems, muscle weakness, or difficulty coordinating the tongue, lips, or cheeks.

• Pharyngeal phase: activation of the body’s swallowing reflex to extrude food or liquid into the back of the throat and at the same time close the airway to prevent aspiration (food or liquid in the airway). This phase is often disrupted due to neurological damage.

• Esophageal phase: Relaxation and contraction of the esophagus to move food or liquid into the stomach. This phase can be affected by irritation or blockage of the esophagus.

Symptoms of dysphagia

Look for any of the following signs that may indicate dysphagia:

• Coughing, clearing throat or choking during or immediately after eating or drinking.

• Hoarse voice during or after eating or drinking.

• Extra effort, discomfort or pain when swallowing.

• Food or liquid leaks from the mouth, gets stuck or is retained in the mouth (often the weaker side).

• Recurrent pneumonia or chest congestion.

• Weight loss or dehydration due to inability to eat or drink normally.

• Difficulty swallowing medicines.

• Growing difficulty in self-feeding.

• Inability to keep saliva in the mouth (drooling).

Possible complications and risks

Dysphagia can be a serious condition. Persistent difficulty in swallowing can have a profound effect on a person both mentally and physically. Malnutrition, dehydration, and unintentional weight loss can occur when it is difficult or painful for a person to get proper nutrients and fluids through the mouth.

When food or liquid enters the respiratory tract, aspiration occurs, which can lead to upper respiratory tract infections or pneumonia. It is important to note that sensitivity in the throat may be reduced after a stroke; food or liquid may enter the lungs without the person’s knowledge, and silent aspiration may occur.

Psychologically, dysphagia can result in a lack of pleasure or interest in food, embarrassment while dining in a restaurant or among other people, or isolation in social situations involving food. Texture-modified foods and drinks (semi-liquid and liquid) can be difficult to obtain, expensive, or generally unappetizing.

Diagnosis

If you think you may have dysphagia, see your doctor. A gastroenterologist who specializes in swallowing disorders can determine if you have dysphagia by using the following methods:

• Thoroughly analyzes the history of the signs, symptoms, and health conditions you experience, and evaluates any medications you take.

• Performs an oropharyngeal and neck exam to evaluate the strength, sensation, and movement of your lips, tongue, cheeks, and larynx.

• Watches you while eating or swallowing liquids to note your behavior, posture and mouth movements.

• Performs a modified barium swallow study to observe the swallowing process under x-rays called video fluoroscopy or endoscopic evaluation (called FEES) using a lighted tube with a camera inserted through the nose to observe the swallowing process.

How to treat disease

Medically supervised treatment of dysphagia provides an opportunity to use methods to help compensate for lost function.

A nutritionist can recommend nutritional options to reverse or avoid malnutrition. The gastroenterologist may also advise on adaptive instruments or positioning to make eating easier.

Treatment for dysphagia may include:

• Swallowing techniques. Your doctor may prescribe exercises or maneuvers to strengthen muscles or stimulate nerves in your mouth and neck.

• Strategies to reduce the impact of dysphagia. The doctor may recommend methods such as changing the position of the head when swallowing or swallowing repeatedly.

• Changing the texture of foods and liquids. Diet modifications, such as thickening liquids to a nectar-like consistency or puréing foods in a blender, can help a person with dysphagia maintain proper nutrition by making eating easier or safer to swallow. Sometimes more complex textures like crackers, rice, or some soups need to be omitted. In extreme cases, an oral withdrawal period (ORP) or a feeding tube may be required.

• Environmental change. Eliminating distractions, such as turning off the TV, can help a person with dysphagia focus on the task at hand. The person should be encouraged to take small bites or sips during slow and relaxed meals. Proper support is almost always recommended to keep the person upright while eating. Self-catering may require special utensils, plates, straws, or cups.