What is a barium swallow test. How is it performed. What are the risks associated with this procedure. How to prepare for a barium swallow test. What conditions can it diagnose. Are there any alternatives to barium swallow tests. How long does the procedure take.

What is a Barium Swallow Test and How Does It Work?

A barium swallow test, also known as cine esophagram, swallowing study, esophagography, modified barium swallow study, or video fluoroscopy swallow study, is a specialized imaging procedure that uses barium and X-rays to visualize the upper gastrointestinal (GI) tract. This includes the pharynx (back of the mouth and throat) and the esophagus.

The test involves ingesting a barium-containing liquid, which coats the inner lining of the upper GI tract. Barium is a contrast agent that appears white on X-rays, allowing radiologists to clearly see the size, shape, and function of the pharynx and esophagus. This level of detail is often not visible on standard X-rays.

During the procedure, fluoroscopy is typically used. This technique creates a kind of X-ray “movie,” enabling real-time visualization of the swallowing process and the movement of barium through the upper GI tract.

How long does a barium swallow test take?

The duration of a barium swallow test can vary, but it typically takes between 30 minutes to an hour. However, the actual time may depend on the specific reason for the test and the individual patient’s condition.

Why Are Barium Swallow Tests Performed?

Barium swallow tests are crucial diagnostic tools used to identify and evaluate various conditions affecting the upper GI tract. Healthcare providers may recommend this test if they suspect:

• Cancer of the head, neck, pharynx, or esophagus
• Hiatal hernia (stomach moving up into or alongside the esophagus)
• Structural problems such as diverticula (pouches), strictures (narrowing), or polyps (growths)
• Enlarged veins (esophageal varices)
• Muscle disorders causing dysphagia (difficulty swallowing) or spasms
• Achalasia (a condition where the lower esophageal sphincter muscle doesn’t relax properly)
• Gastroesophageal reflux disease (GERD) and ulcers

These conditions can significantly impact a patient’s quality of life and overall health. Early detection through barium swallow tests can lead to more effective treatment strategies and improved outcomes.

Risks and Precautions Associated with Barium Swallow Tests

While barium swallow tests are generally considered safe, there are some risks and precautions to be aware of:

Radiation Exposure

As with any X-ray procedure, there is a small risk associated with radiation exposure. However, the benefits of the test usually outweigh this risk for most patients. It’s important to inform your healthcare provider about any recent X-rays or scans you’ve had to help manage your overall radiation exposure.

Pregnancy Concerns

Pregnant women or those who suspect they might be pregnant should avoid barium swallow tests due to the potential risk of radiation exposure to the fetus. Always inform your healthcare provider about a possible pregnancy before scheduling the test.

Digestive System Effects

Some patients may experience constipation or impacted stool if all the barium doesn’t pass out of the body after the test. Drinking plenty of fluids can help mitigate this risk.

When to Avoid the Test

Certain conditions may contraindicate a barium swallow test:

• A tear or hole in the esophagus or intestines (perforation)
• Intestinal blockage or severe constipation
• Severe swallowing problems that increase the risk of aspiration (barium entering the lungs)

Always discuss your medical history and any concerns with your healthcare provider before undergoing the test.

Preparing for Your Barium Swallow Test

Proper preparation is key to ensuring the success and safety of your barium swallow test. Here are some important steps to follow:

1. Discuss the procedure thoroughly with your healthcare provider. Don’t hesitate to ask questions about the test, its purpose, and what to expect.
2. You may be asked to sign a consent form. Read it carefully and seek clarification on any points you don’t understand.
3. Fast for about 8 hours before the test, typically after midnight. This ensures your upper GI tract is empty for clear imaging.
4. Inform your provider about any allergies or sensitivities to medicines, latex, tape, or anesthetic agents.
5. Remove any metal objects, such as jewelry or dentures, before the test as these can interfere with the X-ray images.

Following these preparation steps can help ensure a smooth and effective barium swallow test experience.

The Barium Swallow Test Procedure: What to Expect

Understanding the procedure can help alleviate anxiety and ensure your cooperation during the test. Here’s what typically happens during a barium swallow test:

1. You’ll be asked to change into a hospital gown and remove any metal objects.
2. The radiologist or technician will position you on an X-ray table, usually standing or sitting.
3. You’ll be given a barium-containing liquid to drink. This may have different consistencies or flavors.
4. As you swallow, the radiologist will take a series of X-rays or fluoroscopic images.
5. You may be asked to move into different positions to allow for comprehensive imaging.
6. The entire process usually takes 30 minutes to an hour.

Remember, clear communication with your healthcare team throughout the procedure is crucial for obtaining the best possible images and diagnosis.

Interpreting Barium Swallow Test Results

After the barium swallow test, a radiologist will analyze the images and provide a report to your healthcare provider. The results can reveal various conditions:

• Abnormalities in the structure of the pharynx or esophagus
• Problems with the swallowing mechanism
• Presence of tumors, ulcers, or inflammation
• Evidence of GERD or hiatal hernia
• Signs of motility disorders like achalasia

Your healthcare provider will discuss the results with you and recommend any necessary follow-up tests or treatments based on the findings.

How long does it take to get barium swallow test results?

The time to receive results can vary, but typically, you can expect to hear from your healthcare provider within a few days to a week after the test. In some cases, preliminary results may be available immediately after the procedure.

Alternatives to Barium Swallow Tests

While barium swallow tests are valuable diagnostic tools, there are alternative procedures that might be considered in certain situations:

• Endoscopy: A flexible tube with a camera is inserted down the throat to directly visualize the upper GI tract.
• CT scan: This imaging technique can provide detailed cross-sectional images of the GI tract.
• MRI: Magnetic resonance imaging can offer detailed soft tissue images without radiation exposure.
• Esophageal manometry: This test measures the strength and coordination of esophageal muscles during swallowing.

The choice of diagnostic tool depends on the suspected condition, patient’s overall health, and the healthcare provider’s judgment. Each method has its own advantages and limitations.

Post-Procedure Care and Follow-Up

After your barium swallow test, it’s important to take proper care to ensure your comfort and health:

• Drink plenty of fluids to help flush the barium from your system and prevent constipation.
• Your stools may appear white or lighter than usual for a day or two due to the barium. This is normal.
• Resume your normal diet unless instructed otherwise by your healthcare provider.
• If you experience severe abdominal pain, fever, or difficulty passing stools, contact your healthcare provider immediately.

Your healthcare provider will schedule a follow-up appointment to discuss the test results and any necessary next steps in your treatment plan.

Can I eat normally after a barium swallow test?

In most cases, you can resume your normal diet immediately after the test. However, it’s important to drink extra fluids to help eliminate the barium from your system. Always follow any specific instructions provided by your healthcare team.

Barium swallow tests play a crucial role in diagnosing and managing various upper GI tract conditions. By understanding the procedure, its purposes, and how to prepare, patients can approach this diagnostic tool with confidence. Remember, open communication with your healthcare provider throughout the process is key to getting the most benefit from this important medical test.

Barium Swallow | Johns Hopkins Medicine

What is a barium swallow test?

A barium swallow test (cine esophagram, swallowing study, esophagography, modified barium swallow study, video fluoroscopy swallow study) is a special type of imaging test that uses barium and X-rays to create images of your upper gastrointestinal (GI) tract. Your upper GI tract includes the back of your mouth and throat (pharynx) and your esophagus.

Barium is used during a swallowing test to make certain areas of the body show up more clearly on an X-ray. The radiologist will be able to see size and shape of the pharynx and esophagus. He or she will also be able see how you swallow. These details might not be seen on a standard X-ray. Barium is used only for imaging tests for the GI tract.

A barium swallow test may be used by itself or as part of an upper GI series. This series looks at your esophagus, stomach, and the first part of the small intestine (duodenum).

Fluoroscopy is often used during a barium swallow test. Fluoroscopy is a kind of X-ray “movie.”

Why is a swallow test done?

A barium swallow test may be done to look for and diagnose problems in
the pharynx and esophagus. You may need a barium swallow test if your
healthcare provider thinks that you have:

• Cancer of the

  head and neck, pharynx, or

  esophagus

• Hiatal hernia. This means that your stomach has moved up into or alongside
  the esophagus.

• Structural problems, such as pouches (diverticula), narrowing
  (strictures), or growths (polyps)

• Enlarged veins (esophageal varices)

• Muscle disorders, such as difficulty swallowing (dysphagia) or spasms

• Achalasia

  . This is a condition in which the lower esophageal sphincter
  muscle doesn’t relax and allow food to pass into the stomach.

• Gastroesophageal reflux disease (GERD)

  and ulcers

Your healthcare provider may have other reasons to recommend a barium
swallow test.

What are the risks of a barium swallow test?

The risks of a barium swallow test may include problems from radiation
exposure, birth defects and intestinal issues. You should ask your
healthcare provider about the risks as they apply to you.

How can I manage my X-ray exposure?

You may want to ask your healthcare provider about the amount of radiation
used during the swallowing test. Consider writing down all X-rays you get,
including past scans and X-rays for other health reasons. Show this list to
your provider. The risks of radiation exposure may be tied to the number of
X-rays you have and the X-ray treatments you have over time.

How will a barium swallow test affect my stool?

You may have constipation or impacted stool after the swallowing test if
all of the barium does not pass out of your body.

Is it safe to have a barium swallow test while pregnant?

You should also not have a barium swallow test if you are pregnant.
Radiation exposure during pregnancy may lead to birth defects. Tell your
provider if you are pregnant or think you may be pregnant.

When should I avoid a barium swallow test?

You should avoid a barium swallow test if you have any of the following:

• A tear or hole in your esophagus or intestines (perforation)

• Blockage in your intestines or severe constipation

• Severe problems with swallowing. This makes it more likely that
  barium would accidentally go into your lungs (aspiration).

You may have other risks depending on your specific health condition. Tell
your provider if you are allergic to or sensitive to medicines, contrast
dyes, local anesthesia, iodine, or latex. Be sure to talk with your
provider about any concerns you have before the procedure.

How do I prepare for a barium swallow test?

You can prepare for a barium swallow test by considering the following:

• Your healthcare provider will explain the barium swallow test to
  you. Ask him or her any questions you have about the swallowing
  test.

• You may be asked to sign a consent form that gives permission to do
  the swallowing test. Read the form carefully and ask questions if
  anything is not clear.

• You will need to stop eating and drinking for about 8 hours before
  the swallowing test. Generally, this means after midnight.

• Tell your provider if you are pregnant or think you may be pregnant
  before scheduling a barium swallow test.

• Tell your provider if you are sensitive to or are allergic to any
  medicines, latex, tape, or anesthetic medicines (local and general)
  before scheduling a swallowing test.

• Tell your provider about all medicines you are taking. This
  includes prescriptions, over-the-counter medicines, and herbal
  supplements. You may need to stop taking these before the
  swallowing test.

• Tell your healthcare provider if you have had a recent barium
  swallow or upper GI test. This may make it harder to get good
  X-rays of the lower GI area during a barium swallow test.

• Follow any other instructions your provider gives you to get ready
  for the swallowing test.

What does a barium swallow test involve?

Generally, a barium swallow test involves the following process:

• You’ll be asked to remove any clothing, jewelry, or other objects
  that may get in the way of the swallowing test.

• You may be asked to remove clothing. If so, you will be given a
  gown to wear.

• You will lie on an X-ray table that can move you from a horizontal
  to an upright position. You may also be asked to change positions
  during the swallowing test. For example, you may need to lie on
  your side, back, or stomach.

• The radiologist may take X-rays of your chest and belly (abdomen)
  first.

• The radiologist will ask you to take a swallow of a thick, chalky
  barium drink. The barium is usually flavored, but it may not taste
  very good.

• As you swallow the barium, the radiologist will take single
  pictures, a series of X-rays, or fluoroscopy to watch the barium
  moving through your mouth and throat.

• You may be asked to hold your breath at certain times during the
  test.

• You will be given a thinner barium drink to swallow. The
  radiologist will use X-rays or fluoroscopy to watch the barium go
  down your esophagus. You may also be asked to swallow a barium
  tablet. This is a small pill that can help to show certain problems
  in the esophagus.

• Once the radiologist has taken all of the X-rays, you’ll be helped
  from the table.

A barium swallow test may be performed as an outpatient procedure or as
part of your stay in a hospital. The way the test is done may vary
depending on your condition and your healthcare provider’s practices.

What happens after a barium swallow test?

You may go back to your normal diet and activities after a barium swallow
test, unless your healthcare provider tells you otherwise.

How do I manage constipation after a swallowing test?

Barium may cause constipation or impacted stool after the swallowing test
if it isn’t completely cleared from your body. You can manage constipation
by drinking plenty of fluids and eating foods high in fiber to help the
rest of the barium leave your body. You may also be given a laxative to
help with this.

Your bowel movements may be white or lighter in color until all the barium
has left your body.

What are some serious side effects after a barium swallow test?

Call your healthcare provider right away if any of these happen after your
barium swallow test:

• Trouble with bowel movements or you are unable to have a bowel
  movement or pass gas

• Pain or swelling of the abdomen

• Stools that are smaller in size than normal

• Fever

Your healthcare provider may give you other instructions, depending on your
situation.

Swallowing Center

The Johns Hopkins Swallowing Center offers specialized swallowing evaluation, diagnosis and treatment for patients with swallowing disorders. Our multi-specialty team includes laryngologists, speech-language pathologists and other specialists, who work together to provide you with personalized and compassionate care. 

Learn more about the Swallowing Center

What to expect and side effects

A barium swallow is a type of test used to look inside the esophagus, or food pipe. A doctor might recommend this test if they need to look at the outline of any part of a person’s digestive system.

Barium is a white liquid that is visible on X-rays. Barium passes through the digestive system and does not cause a person any harm.

As it passes through the body, barium coats the inside of the food pipe, stomach, or bowel, causing the outlines of the organs to appear on X-ray.

Share on PinterestA barium swallow can help a doctor identify problems in the food pipe, stomach, or bowel.

A barium swallow test may be used if someone has any of the following conditions:

• frequent, painful heartburn
• gastric reflux, where food or acid keeps coming back up the food pipe
• difficulty eating, drinking, or swallowing

This test can give a doctor information about how the person is swallowing.

It can also reveal if someone has any of the following in their food pipe, stomach, or the first part of the bowel:

• ulcers
• abnormal growths
• blockages
• narrowing

If someone has a tumor, this will show up on the X-ray as an irregular outline that extends from the wall of the affected organ.

People who are undergoing a barium swallow should not eat or drink for a few hours before the test. In some cases, the doctor may ask the person to stop taking medication before the test.

Some hospitals recommend not chewing gum, eating mints, or smoking cigarettes after midnight the night before a barium swallow test.

The test takes around 60 minutes and will take place in the X-ray department of the hospital. A person will need to change into a hospital gown.

People can bring a friend or relative for support. However, the companion will not be able to join them in the X-ray room.

In the X-ray room, the person drinks the barium liquid. It often has a chalky taste but can sometimes be flavored.

Share on PinterestA person will lie on a tilting table for part of the examination.

In some cases, a person will be given an injection to relax their stomach.

A person will be standing for some parts of the examination, and lying down on a tilting table for other parts. This allows the liquid to travel through the body, and for the radiologist and radiographer to take a selection of images.

People do not have to stay in hospital after the test and are free to go home as soon as it is complete. The results usually arrive within 1-2 weeks.

Risks and side effects

Patients may feel nauseous after a barium swallow test or become constipated. Drinking lots of fluids can help to relieve constipation. Symptoms of nausea should improve as the barium passes through the system.

It is normal for people to have white-colored stools the first few times they use the toilet after having a barium swallow test.

Some people might worry about being exposed to radiation as part of the X-ray process. However, the amount of radiation a person is exposed to is minimal.

Sometimes, the injection given to relax the stomach can cause temporary blurred vision.

Special considerations

People should not have a barium swallow test if they are pregnant.

If someone has glaucoma or heart problems and needs to have a barium swallow, the doctor may not give the stomach-relaxing injection.

If someone has diabetes then the doctor will schedule a morning appointment for the barium swallow.

If the person takes tablets to control their diabetes, the doctor will tell them not to take the medicine before the test. Instead, they should bring their tablets and some food to the exam to have after it is complete.

People who use insulin will be asked to miss their morning dose and maybe the previous evening’s dose. They should bring their insulin and some food to have after the test. However, those who take long-acting insulin should continue taking this.

Share on PinterestA barium enema allows doctors to examine the colon and rectum.

Another type of barium test is a barium enema. The barium enema test is similar to the barium swallow test and is used by doctors to examine the colon and rectum.

This test usually takes about 40 minutes. A person will be given a laxative the day before having a barium enema test. A laxative is a medicine that helps to clear out the bowel.

During the test, the person lies on their side on a table in the X-ray room. An enema containing barium and water is fed into their rectum through a small plastic tube. Air is also piped through the tube to inflate the bowel.

The table tilts, which spreads the barium throughout the colon. This allows the radiologist and radiographer to clearly see any lumps or swellings within the colon.

The person has to try and hold the liquid in the rectum while the test takes place. Afterwards, most of the liquid drains back into the tube and does not stay in the body.

After having a barium enema test, people may experience some cramping or diarrhea. As with the barium swallow, someone undergoing a barium enema may also have white stools the first few times they go to the toilet after the test.

There is a very small risk of the bowel lining tearing when having this test. This complication only tends to happen if the bowel is very inflamed.

Alternatives to a barium swallow test

An alternative to a barium swallow is a gastroscopy. In this procedure, a narrow, flexible, telescopic camera is used to look inside the food pipe, stomach and the first part of the small intestine.

A computed tomography (CT) scan may also be used in combination with a gastroscopy to provide X-ray images of the gut.

X-ray examinations

X-ray examinations GAUZ SO City Clinical Hospital №40Health news

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GASTRIC RADIOSCOPY

What is stomach roentgenoscopy?

Fluoroscopy of the stomach – x-ray examination of the pharynx, esophagus, stomach and duodenum with a contrast agent (barium).

This is an X-ray examination method. The dose of ionizing radiation received by the patient is small. The advantage of fluoroscopy is the ability to evaluate not only the anatomy, but also the function of organs: when you swallow a portion of a contrast agent, the radiologist observes not only the structure, but also the function of the esophagus, stomach, duodenum. In some cases, in addition to the contrast agent (suspension of barium sulfate), you are given an effervescent solution to drink so that the organs fill with air.

Can everyone get x-rays?

Pregnant women should not be tested because X-ray radiation can adversely affect the fetus.

Tell your doctor if you are allergic to barium or iodine contrast media.

How to prepare for the examination?

In order for the study to be successful, of high quality, you must come with an empty stomach. Therefore, before the study:

1. Do not eat
2. Do not drink
3. Do not take medicines, especially antacids (acid reducers)!
4. Do not chew gum or gummies
5. Do not smoke after midnight

How is the study going?

You will be asked to partially undress, remove jewelry, dentures, glasses, and any metal objects that may be in the path of the X-ray beam. The laboratory assistant will help you to make yourself comfortable. You will be told how to swallow barium sulfate. Barium sulfate (colloquially – barium) – a contrast agent, absolutely tasteless, the density resembles a thick milkshake. The radiologist will monitor the passage of the barium in real time, in addition, he will take several x-rays, for this you will be asked to hold your breath. The radiologist can put pressure on your stomach to assess the passage of barium, its entry into different parts of the stomach.

In some cases, you will additionally be asked to drink an effervescent liquid so that the gas will stretch the stomach and straighten its walls.

Examination time 15-20 minutes.

When will I get my result?

It usually takes the doctor 1-2 hours to evaluate the test results, but in difficult cases it can take up to 24 hours. The legislation of the Russian Federation (Order of the Ministry of Health and Social Development No. 132) is given 24 hours to write a protocol and provide an opinion. This order provides for the doctor’s opportunity to consult with colleagues, to contact the attending physician and provides time to consult the literature. Therefore, if you do not want to wait, it would be better to come the next day, at any time convenient for you, and pick up the results.

Irrigoscopy is an x-ray examination of the intestine, in which a contrast agent is injected through the rectum. The study allows to identify polyps, obstruction, perforation and tumor formations.

Preparation for the study

Preparation for the study is a necessary and most important aspect of a successful implementation and includes: diet for 2 days + drug preparation for the 3rd day (on the eve of the study).

Day 1, 2: diet

Exclude: grains, nuts, legumes, fresh and dried fruits and vegetables, dairy products, fatty meats and fish, mushrooms, spices, alcoholic and carbonated drinks, smoked meats, canned food.

Allowed: flour products without additives (raisins, poppy seeds, whole grains, etc.), cereals, eggs, low-fat meats and fish, mashed potatoes, kissels, clear juices, broths, scrambled eggs, honey, weak tea and coffee, still water.

Day 3: liquids + drug preparation

Avoid all solid foods.

It is allowed to take any clear liquids in unlimited quantities (broths, tea, coffee, juices without pulp, water).

In our clinic, we recommend preparing for the study with preparations based on polyethylene glycol (Moviprep, Fortrans). The regimen of the drug depends on the time of the study.

If there are contraindications to the use of polyethylene glycol preparations, check the preparation schedule with your doctor (individually).

Bring with you:

1. Referral from the attending physician
2. Results of sigmoidoscopy
3. Results of previous examinations
4. Bed sheets

?

Pregnant women should not be tested because X-ray radiation can adversely affect the fetus.

How is the procedure?

You will be asked to partially undress, remove jewelry, dentures, glasses, and any metal objects that may be in the path of the X-ray beam. The technician will help you lie down comfortably on the X-ray table. A catheter will be inserted into your rectum and through it the intestine will be filled with a suspension of barium sulfate – a contrast agent. They’ll take some x-rays. The bowel will then be inflated with air so that the bowel walls can be assessed, and several more x-rays will be taken. At this time, you will have discomfort from stretching the intestines with air. The entire procedure takes 30-45 minutes.

You will then have a bowel movement. You may have a few more x-rays.

After examination:

For 3 days we recommend drinking plenty of fluids to speed up the elimination of the contrast from the intestines. The contrast agent is not absorbed in the intestines and has no effect on the body.

When will I get my result?

It usually takes the doctor 1-2 hours to evaluate the test results, but in difficult cases it can take up to 24 hours. The legislation of the Russian Federation (Order of the Ministry of Health and Social Development No. 132) is given 24 hours to write a protocol and provide an opinion. This order provides for the doctor’s opportunity to consult with colleagues, to contact the attending physician and provides time to consult the literature. Therefore, if you do not want to wait, it would be better to come the next day, at any time convenient for you, and pick up the results.

Hysterosalpingography.

Hysterosalpingography is an x-ray examination of the uterus and fallopian tubes with the introduction of a contrast agent, which allows you to evaluate their patency.

For patients.

Phone for appointment (343) 2669772

Examination is carried out from 7th to 12th or from 15th to 22nd day of the cycle,

cycle

You must have with you :

1. Referral from the attending physician
2. The results of the smear examination for flora not more than 10 days old
3. Diaper, sheet.
4. Sanitary napkin
5. Change of footwear

How to prepare for the examination?

• The perineum needs to be shaved
• Bowel preparation – in the morning a separate chair, or a cleansing enema, or a rectal suppository with glycerin.
• Light breakfast.
• From the beginning of the menstrual cycle until the time of the study, barrier contraception to exclude pregnancy.

How is the study carried out?

You will be asked to undress from the waist down. The technician will help you lie comfortably on the X-ray table, on your back with your knees bent. A catheter will be inserted into the vagina and the cavity of the uterus and fallopian tubes will be filled with a contrast agent. You may experience slight discomfort, this is normal. The doctor will then take an x-ray. The catheter will then be removed. You may experience discomfort in the lower abdomen for 1-2 days, this is normal, but if the pain is intense, tell your doctor about it.

When will I get my result?

It usually takes the doctor 1-2 hours to evaluate the test results, but in difficult cases it can take up to 24 hours. The legislation of the Russian Federation (Order of the Ministry of Health and Social Development No. 132) is given 24 hours to write a protocol and provide an opinion. This order provides for the doctor’s opportunity to consult with colleagues, to contact the attending physician and provides time to consult the literature. Therefore, if you do not want to wait, it would be better to come the next day, at any time convenient for you, and pick up the results.

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February 26

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, combined with soreness (odynophagy) . 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 ) , a 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).

To 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 in dysfunction of the upper esophageal sphincter, oculopharyngeal muscular dystrophy (a hereditary disease in which the muscles of the face and head are affected). 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 with infectious processes in the esophagus or oropharynx (for example, with tonsillitis, abscesses and phlegmon), as well as with 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”.