The reasons are hard to swallow. Dysphagia. The most common causes of dysphagia and symptoms of difficulty swallowing that accompany these conditions

03.10.2023 Brain Research

Violations and their causes in alphabetical order:

swallowing disorder -

Swallowing is one of those processes that you hardly notice at all - until they are disrupted.

You start to notice this when you feel uncomfortable eating because you have difficulty swallowing food. You also notice these disorders when you experience unusual sensations or a “swelling” in your throat.

Swallowing- this is the same natural process as breathing. When you swallow, your throat muscles make hundreds of movements throughout the day as you eat, drink, and swallow the ever-present saliva. During these processes, the circular muscle of the upper esophagus - the sphincter - relaxes, due to which the contents of the oral cavity move through the throat into the digestive system.

These processes proceed smoothly during sphincter relaxation only in the absence of factors such as tension, stress or fear, which cause spasms in the pharynx. There is a reason why there is an expression: “It’s hard to swallow.”

What diseases cause swallowing problems?

Depending on the cause of the swallowing disorder, there are:

1. Mechanical or organic - occurs when a piece of food does not match the lumen of the esophagus.
2. Functional – occurs when peristalsis and relaxation are impaired.

Impaired swallowing can lead to serious consequences, such as exhaustion of the body, weight loss, constant choking, coughing and the development of pneumonia.

Organic swallowing disorder is associated with mechanical pressure on the esophagus from the outside or from the inside:

1. Blockage of the esophagus with a large piece of food or a foreign body.

2. Narrowing of the lumen of the esophagus can occur due to:
- edema that occurs against the background of an inflammatory process (tonsillitis, stomatitis, esophagitis);
- stenosis (pharyngeal and alimentary);
- damage and scars (reflux disease, burns due to taking pills, after inflammation and surgery);
- malignant (squamous cell carcinoma, adenocarcinoma) and benign formations (polyps, lipomas, angiomas).

3. External pressure due to:
- cervical spondylitis;
- vertebral osteophytes;
- diverticulum;
- enlargement of the thyroid gland;
- compression by blood vessels.

The most common organic causes of swallowing disorders are:
- esophageal carcinoma;
- strictures - narrowing of the esophagus due to scars;
- stenosis - narrowing of the walls of the esophagus, which is usually 4 cm in diameter.

Functional swallowing disorder is associated with dysfunction of the muscles:

1. In the phase of the swallowing reflex with paralysis of the tongue, sensory disturbances, damage to the brain stem, damage to the glossopharyngeal nerve.

2. Disease of the muscles of the pharynx and esophagus (stroke, neuromuscular diseases, injuries, tetanus, rabies, paralysis).

3. Damage to the smooth muscles of the esophagus, which leads to weakness of contractions or impaired relaxation (neuropathy and myopathy in alcoholism, diabetes; poisoning and side effects of drugs).

Swallowing food in large chunks can also lead to difficulty swallowing.
Approximately 50% of people with swallowing problems have had a stroke.

Swallowing disorders manifest not only in difficulties with swallowing, but also:
- cough during and after swallowing;
- feeling of lack of air during swallowing;
- feeling as if food is stuck in the throat;
- pain and shortness of breath.

How do swallowing disorders manifest?

The degree of swallowing impairment varies: from difficult, painful to the complete inability of a person to swallow solid food, and in rare cases, liquid food. It is possible for food to return from the esophagus to the oral cavity (regurgitation).

Causes of difficulty swallowing

The causes of the disorder may be diseases of the digestive tract, infections. Swallowing disorders are the result of diseases of the nerves, blood vessels, and muscles. Difficulty swallowing may be caused by esophageal cancer.

Infectious diseases

Difficulty in swallowing occurs due to an increase in the lymphoid ring of the pharynx, for example, with sore throat, scarlet fever, infectious mononucleosis and diphtheria. When swallowed, severe pain occurs and the patient is unable to take solid food. Such patients are given food in liquid form. Swallowing problems can also be caused by rabies.

Tumors

Overgrowth of tissue in the neck and chest area or tumors in these areas can also cause problems with swallowing.

Benign tumors of the esophagus are relatively rare; as a rule, esophageal cancer is diagnosed more often, to which men are more susceptible. A malignant tumor usually appears near one of the physiological narrowings of the esophagus. The tumor is accompanied by the following symptoms: difficulty swallowing, inability to swallow food, chest pain, regurgitation and bad breath.

Narrowing of the esophagus

The cause of narrowing of the esophagus, which causes problems with swallowing, can be not only tumors, but also injuries (especially severe burns from chemicals). In rare cases, the cause may be congenital narrowing of the esophagus or its blockage.

Esophagospasm

Esophageal spasm (convulsive contractions) most often occurs when a person swallows a large hard lump of food that gets stuck in the esophagus, which leads to convulsive contraction of the muscles around it; the spasm is accompanied by severe pain. When the food is softened, the spasm goes away. The cause of esophagospasm can be brain tumors, diseases of the nerves and muscles, for example, Parkinson's disease, multiple sclerosis, myasthenia gravis, myopathy, brain stem tumors.

Inflammation of the esophagus

Esophagitis often occurs when acidic contents from the stomach reflux into the esophagus, which is possible with insufficiency of the cardiac sphincter and hiatal hernia (a small part of the stomach exits through the opening of the diaphragm into the chest; in this case, part of the stomach is pinched).

The child must be gradually weaned from the breast, gradually accustoming him to regular food. After eating, vomiting is possible even in a healthy child. The reason that it is difficult to swallow may be congenital abnormalities of the aorta, for example, a narrowing of the lumen of the esophagus.

Mental illnesses can cause temporary impairment of swallowing function or permanent dysphagia, for example, in hysteria, depression.

Dysphagia is a condition of the esophagus that makes it difficult to swallow.

Dysphagia has two main types of manifestations:

Functional dysphagia can occur with disorders of the nervous system, while no physical irritants, such as foreign objects, are observed in the pharynx.
True dysphagia can occur due to physiological disturbances in the structure of the pharynx, which lead to difficulties in swallowing. It can also be various ulcers and neoplasms of the esophagus.

The main reasons that can lead to the disease:

Injuries to the spine or skull.
Stroke.
Spasms of the esophagus.
Achalasia (a muscular disease of the esophagus that impairs its functioning).
Parkinson's disease.
Sclerosis.
Various inflammatory and tumor diseases resulting from improper functioning of the immune system.
Scleroderma.

Another cause of dysphagia is a blockage of the esophagus. This disease can occur due to the following reasons:

An esophageal ulcer develops.
Dissection of the esophageal tissue occurs.
Deformation (protrusion) of the esophagus occurs.
Various neoplasms appear in the esophagus.
Age-related changes in the esophagus.

The main symptoms of dysphagia

Dysphagia is manifested by disturbances in the process of swallowing food and its further movement through the esophagus. Swallowing itself is usually painless, but after this the patient complains of a feeling of a lump in the throat, as if food is stuck in the throat, causing bloating.

There are four stages of dysphagia:

The person may not be able to swallow certain types of solid food.
A person cannot swallow solid food in any form.
A person can only eat liquid food.
A person cannot swallow food at all.

The main symptoms that a person suffering from dysphagia may experience are:

Pneumonia due to foreign agents:

Heat.
Choking cough with green mucus.
Chest pain.
Difficulty breathing.
Feeling of distension of the esophagus.
Feeling of a lump in the throat.
Inability to swallow food.

Complications that threaten health with the development of dysphagia

Dysphagia is a disorder that can provoke the development of a number of dangerous complications.

The main types of complications that can be encountered if treatment is not started on time:

Weight loss, which can reach catastrophic proportions. The patient cannot eat, the body does not receive the necessary nutrition and is exhausted.
With neurological disorders, food often enters the nasopharynx, causing asphyxia. For such a patient, every meal is a risk of suffocation.
Disturbance and difficulty breathing.
Development of inflammatory processes of the esophagus.
Development of pneumonia.
Dehydration of the body.

Many diseases develop simultaneously with dysphagia, either as the cause of its occurrence or as a consequence of its damage.

Do not underestimate this disease, because the consequences of inaction can be very dire.

Treatment through traditional medicine

Treatment depends on the cause and type of dysphagia

In order to select competent therapy in the treatment of dysphagia, the primary issue is to identify the cause of its occurrence. To do this, the patient undergoes a diagnosis, which begins with a gastroscopy procedure.

If neoplasms are detected, the doctor will definitely take a biopsy and send the material for histological examination.

Depending on the result of the biopsy, there are several scenarios for treating the disease:

Surgical intervention.
Radiation therapy.
Endoscopic procedures.
The use of special stents that widen the esophagus.

If inflammation is detected, the doctor will take a smear for bacteriological culture. In this case, the treatment of the disease occurs as follows:

Prescribing antacids that will reduce stomach acidity.
Prescribing a special therapeutic diet. Avoid hard, smoked, spicy, fried and fatty foods. Tea, coffee and carbonated drinks are prohibited. Food should be taken fractionally and in small portions in a calm environment.

If a foreign body is detected in the esophagus or pharynx, surgical intervention will most likely be required.

More information about dysphagia can be found in the video:

When a neurological disease is detected, drugs are usually used that improve the condition of nerve cells and also fight inflammation and proliferation of connective tissues. If dysphagia is severe and food gets stuck in the nasopharynx, then, first of all, the airways are cleared. After this, the patient is admitted to hospital for treatment, and feeding occurs through a tube.

There are two types of feeding tubes that are designed for eating in dysphagia:

Nasogastric (passes from the nose to the stomach). Nasogastric tubes are placed for a short period of time. The maximum service life of such a probe is a month, after which it must be replaced.
Gastrostomy (passes through the skin into the stomach). Gastrostomy is performed in more severe cases. The service life of such a probe reaches several months.

Treatment with folk remedies

Dysphagia is a serious disease, the treatment of which should be under the supervision of a physician.

There are many folk recipes that help get rid of dysphagia:

Herbal mixture: 25 g hop cones, 20 g rosemary leaves, 25 g peppermint leaves, 20 g St. John's wort herb, 25 g lemon balm leaves, 30 g valerian roots, mix and chop. Brew 25 grams of the collection with 150 ml of boiling water and leave for two hours. Take a quarter glass half an hour before meals (3 times a day). This collection has a sedative effect.
Belladonna tincture. It is necessary to take the tincture 3 times a day, 5-15 drops, 10 minutes before meals. The tincture has an antispasmodic effect.
Herbal mixture: 15 grams of leaves and roots of ragwort, 20 grams of ephedra herb, 20 grams of motherwort herb, mix and chop. The collection is poured with cold, unboiled water and left for 4 hours. Then it must be boiled for three minutes and cooled. Take a decoction of 50 ml 15 minutes before meals. This collection has an antispasmodic effect and is recommended to be combined with a sedative decoction.

For a more pronounced effect of the therapy, it is necessary to adhere to a special diet.

Small meals, at least five times a day.
Before meals, you need to drink 10 grams of any vegetable oil.
Mainly dairy and plant foods.
Food should not be excessively salted, cooked in animal fat or fried in oil.
Food should be pureed.
You should eat slowly, chewing thoroughly, despite the liquid consistency.
Spicy foods, smoking and alcoholic drinks are excluded.
Before going to bed, it is recommended to do enemas using chamomile tea.
It is also recommended to take pine baths for 15 minutes every other day.

Water can be replaced with the following decoction: 25 grams of toasted flaxseed and anise seeds are mixed with a spoon of honey and 600 ml of water. Boil the mixture and cool.

In addition, it is useful for the patient to massage the sternum.

A couple of hours after eating, you should take a special syrup: 5 tbsp. plantain herbs are poured into a liter of water and boiled for half an hour. Then add three hundred grams of honey and 10 grams of celery seeds. After this, the mixture is boiled for another ten minutes. After the syrup has cooled, it is ready for use.

Dysphagia is a very unpleasant and at the same time dangerous disease that must be treated under the supervision of a doctor. It is timely prescribed therapy that will help avoid serious consequences of the development of the disease and maintain health for many years.

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Comments (1)

Irina Ivanova

04/30/2017 at 01:26 pm | #

Hello! You wrote the recipe

Herbal mixture: 25 g hop cones, 20 g rosemary leaves, 25 g peppermint leaves, 20 g St. John's wort herb, 25 g lemon balm leaves, 30 g valerian roots, mix and chop. Brew 25 grams of the collection with 150 ml of boiling water and leave for two hours. Take a quarter glass half an hour before meals (3 times a day). This mixture has a calming effect, but when you pour 25 grams of water into 150 ml of water, the grass swells and you get a strong concentrate and you can’t drink it, since there is practically no liquid, please write how to make it correctly

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The medical information published on this page is strictly not recommended for self-medication. If you feel negative changes in your health, immediately contact an ENT specialist. All articles published on our resource are for informational purposes only. If you use this material or a fragment of it on your website, an active link to the source is required.

Dysphagia: when every sip is difficult?

Dysphagia, or difficulty swallowing, is a type of functional disorder of the esophagus in which a person is unable to swallow food.

Usually, while eating, we do not think about the swallowing process. We throw food into our mouths and simply swallow, sometimes without even having time to chew properly. Meanwhile, swallowing is a rather complex process. It includes the root of the tongue, the pharyngeal cavity, the soft palate, and the circular muscles of the esophagus.

But sometimes we notice that something went wrong during the swallowing process. There is a feeling as if there is a lump stuck in the throat. It is also possible that food may return from the pharynx to the oral cavity or pain in the center of the sternum. Why does this happen and what could be the cause of dysphagia? Let's try to figure out this problem.

Types of dysphagia

The following types of dysphagia are distinguished:

Oropharyngeal (oropharyngeal). Characterized by difficulty passing food from the pharynx to the esophagus;

Esophageal. It manifests itself as disturbances in the movement of food from the esophagus to the stomach.

Cricopharyngeal incoordination. Uncoordinated contraction of the circular fibers of the upper esophageal sphincter.

Functional dysphagia. Difficulty swallowing occurs due to disorders of the nervous system.

Symptoms of dysphagia

Symptoms of dysphagia for different types manifest themselves differently. With oropharyngeal dysphagia, severe coughing, a feeling of suffocation, excessive salivation, and reflux of a lump of food into the nasopharynx or mouth are observed. This type of pathology is also characterized by the inability to swallow food or the need to make efforts to push through a bolus of food.

With esophageal dysphagia, the act of swallowing itself is not impaired, but the passage of a bolus of food is accompanied by pain in the upper abdomen, heartburn, and sometimes belching. An unpleasant taste appears in the mouth, and regurgitation is observed - the reflux of stomach contents into the pharynx and oral cavity.

Functional dysphagia occurs with disorders of the nervous system - increased excitability, neuroses, etc. In this case, the symptoms of dysphagia appear episodically. As a rule, they are provoked by one or more types of food (solid, liquid, spicy, etc.). In this case, the food bolus usually does not enter the respiratory tract, but swallowing is difficult, and its movement through the esophagus is accompanied by unpleasant and painful sensations.

Dysphagia, regardless of its type, can occur for the following reasons:

Pathologies of the esophagus (spasm of the esophageal mouth, inflammation of the esophageal mucosa, reflux disease, acquired or congenital dissection of esophageal tissue, etc.);

Chemical burns of the esophagus;

Foreign bodies in the esophagus;

Esophagitis and stomach ulcers;

Congenital pathologies of the pharynx (pharyngeal pouch);

Benign or malignant tumors of the pharynx;

In some cases, difficulties with swallowing and passing food through the esophagus can be the result of stroke, myasthenia gravis, Parkinson's disease and other pathologies.

Functional (oropharyngeal) dysphagia occurs with neuromuscular diseases leading to paralysis of the striated muscles, simultaneous non-peristaltic muscle contractions, as well as dysfunction of the upper esophageal sphincter.

Since dysphagia itself is not a disease, but only a symptom of various pathologies, a thorough gastroenterological examination is necessary to identify its true causes.

If the cause of dysphagia has not been identified through a gastroenterological examination, a neurological examination is performed to identify the affected nerve structure.

Treatment of dysphagia

As mentioned above, dysphagia can be caused by a wide range of diseases, so the doctor prescribes a specific treatment method depending on its causes. For example, if dysphagia is caused by a tumor in the esophagus, then surgery is necessary, and a functional swallowing disorder requires exercises to train the muscles responsible for the swallowing process. For inflammatory diseases of the pharynx, treatment consists of anti-inflammatory and antibacterial therapy.

Treatment of difficulty swallowing with acute symptoms at the local level comes down to providing first aid to the patient. In case of an acute coughing attack caused by food being thrown into the respiratory tract, it is necessary to thoroughly clear the respiratory tract and ensure that the person does not suffocate.

If dysphagia is manifested by obstruction of a large piece of solid food down the esophagus, the patient should be given drinking water or another non-alcoholic drink that will facilitate the swallowing process.

Instructions for medications

Comments

Thank God that such a disease passed me by. With a sore throat, my throat was very sore, my tonsils were twice as large. She was treated by rinsing with a solution of furatsilin and dissolving lozenges with Isla-Moos.

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The information published on the site is for informational purposes only. Described methods of diagnosis, treatment, traditional medicine recipes, etc. It is not recommended to use it yourself. Be sure to consult a specialist so as not to harm your health!

Difficult to swallow

There are three phases in the act of swallowing:

The first is that oral, solid and liquid food is directed to the posterior part of the oropharynx using the tongue.
The second is pharyngeal, the swallowing reflex is caused by food touching the back wall of the pharynx. It is regulated by the swallowing center located in the medulla oblongata.
The third is esophageal, it is associated with the coordination of peristalsis of the esophagus and stomach. When swallowing, the lowered velum palatine rises up and closes the upper part of the pharynx, the epiglottis temporarily closes the entrance to the larynx. Food enters the esophagus, which connects the pharynx and stomach. The advancement of the food bolus occurs due to wave-like movements of the esophageal walls due to contraction of their muscles.

How do swallowing disorders manifest?

Causes of difficulty swallowing

Infectious diseases

Tumors

Overgrowth of tissue in the neck and chest area or tumors in these areas can also cause problems with swallowing.

Narrowing of the esophagus

Esophagospasm

Inflammation of the esophagus

Mental illnesses can cause temporary impairment of swallowing function or permanent dysphagia, for example, in hysteria, depression.

Additional articles on this topic:

Before starting treatment, consult your doctor.

Dysphagia

Dysphagia is difficulty swallowing solid and liquid foods. This condition can develop both as a result of diseases of the esophagus, larynx, pharynx and surrounding organs, and due to diseases of a neurological nature, because it is the nervous system that regulates the entire process of eating. Several related specialists are involved in the diagnosis and treatment of this syndrome: ENT, neurologist, gastroenterologist and oncologist. The prognosis depends on the cause that caused its development.

What it is

The act of swallowing is a rather complex process:

First, a person chews food, bringing it to a crushed state, while each particle is moistened with saliva, creating better conditions for further swallowing. Then the tongue and cheeks push the food bolus so that it lands on the root of the tongue.
After it hits the root of the tongue, a reflex is activated, as a result of which the food enters the pharynx. The soft palate immediately rises, which seals the pharyngeal cavity from the nasal cavity (it will fall as soon as the food reaches a certain level), the muscles that lift the larynx contract (so that food does not fall into it and further into the trachea).
The esophagus opens only when a certain pressure is created in the throat. Food is pushed through the esophagus by its circular muscles towards the stomach. This act is facilitated by a “wave” of reduced tone of the esophagus, which, ahead of the food bolus, creates an area of low pressure.

Only by the process of chewing and moving to the root of the tongue can a person consciously; the remaining phases are produced by the joint work of the nervous system and pharyngoesophageal structures.

With dysphagia, it is these involuntary stages that are disrupted, which manifests itself:

returning food from the pharynx to the mouth;
pain in the esophagus (in the center of the sternum);
a feeling of “stuck”, “coma” of food in the throat or esophagus.

Classification

According to the localization of the pathological process, dysphagia can be:

Oropharyngeal (oropharyngeal), when it is difficult for food to pass from the pharynx to the esophagus. The causes of this form are pathologies of the muscles of the pharynx, peripharyngeal structures or nervous system.
Esophageal (esophageal), which develops as a result of either blocking the lumen of the esophagus, or disruption of the movements of its muscles. Conventionally, esophageal dysphagia will be divided into lower, middle and upper.
Cricopharyngeal incoordination is an uncoordinated contraction of the circular fibers of the upper esophageal sphincter.
Dysphagia that occurs as a result of compression of the esophagus by large vessels passing nearby (the aorta and its branches), which is possible with pathology of these vessels.

Degrees

There are 4 degrees of problems with swallowing food:

It is impossible to swallow only certain types of solid foods.
It is not possible to swallow solid food; soft and semi-liquid are swallowed without complications.
Only liquid food can be swallowed.
The act of swallowing becomes completely impossible.

Diseases of the esophagus accompanied by dysphagia

spasm of the esophageal mouth;
esophageal diverticula;
foreign body;
inflammation of the organ mucosa;
reflux esophagitis;
benign tumor of the esophagus;
hernia of the opening of the diaphragm through which the esophagus passes;
spasm of the lower esophageal sphincter;
benign stricture;
Plummer's syndrome;
chemical burn of the esophagus;
congenital narrowing of the muscle ring where the pharynx passes into the esophagus (Schatzky rings);
scleroderma;
acquired or congenital dissection of esophageal tissue.

What other diseases can cause dysphagia?

Benign tumor or cancer of the pharynx. In this case, in addition to problems with swallowing, there will be discomfort in the throat, a sensation of a “lump”, swallowing will be painful, and such pain will radiate to the ear.
The pharyngeal “pocket” is a pathology most often of a congenital nature, when the mucous membrane protrudes, forming a pocket. In this case, there will be dysphagia and bad breath, and a protruding pouch will be visible on the neck.
Stroke. In this case, other symptoms also occur: paralysis of the limbs, facial asymmetry, impaired understanding or reproduction of speech, confusion.
Encephalitis. Dysphagia occurs against the background of usually impaired consciousness (inadequacy and agitation or stupor), elevated body temperature, and other symptoms of brain damage: breathing problems, decreased blood pressure.
Botulism. In addition to difficulty swallowing, there is double vision, the inability to read text, and wide pupils that do not respond to light. Usually, with the onset of dysphagia, breathing problems also appear. Blood pressure and temperature do not change during botulism.
Myasthenia gravis will also manifest itself as weakness of the facial muscles, difficulty chewing, and weakness of the muscles of the limbs.
Parkinson's disease. In this case, movement disorders, tremors, and mental disorders come to the fore.
In addition to dysphagia, multiple sclerosis can manifest itself with various symptoms: paresthesia, blurred vision, speech impairment, limb weakness, and cognitive impairment.
Guillain-Barré syndrome usually begins with a fever, then pain in the extremities. Then the range of movements in the limbs decreases up to paralysis; such paralysis rises from the legs upward - to the muscles of the abdomen and chest.

Features in children

The main causes of dysphagia in children occur with diseases of the nervous system, for example, with cerebral palsy (the risk of developing this symptom is especially increased in a child with paralysis of all four limbs).

The risk is also high in children suffering from athetosis (constant involuntary movements), which is often congenital. Dysphagia also develops with muscle diseases, spina bifida, and Arnold-Chiari malformation. The symptom can also develop with congenital malformations of the pharynx and esophagus, Rossolimo-Bekhterev syndrome.

You should suspect a problem in a child with the following symptoms:

small amount of food eaten by the baby;
prolonged sucking of formula or breast;
cough or facial flushing after eating/drinking;
placing the head and neck in an unusual position when feeding;
cough and shortness of breath will not always be pronounced if a small volume enters the trachea during feeding;
milk or formula appears in the nose.

If a child often suffers from pneumonia or bronchitis, his face is red after eating, or he has developed asthma (but his relatives do not suffer from this disease) - this may also be a sign of problems with the innervation of the esophagus.

A lump in the throat can be caused by cervical osteochondrosis. Find out all the details about this disease.

Read about vegetative-vascular dystonia here.

Nervous dysphagia

It is also called functional. It is caused by various kinds of neuroses - inorganic diseases of the nervous system. The pathology develops in children, adolescents, and adults of both sexes up to 40 years of age; after this age, the disease is practically not registered in men.

In children, neurosis can “linger” from an early age. Initially, it manifests itself in the fact that the child has a decreased appetite, regurgitation, vomiting, and poor sleep.

At school age, such children are characterized by increased pain, thinness, intolerance to transport, and poor appetite. In adults, such dysphagia develops for the first time against the background of a traumatic situation and is characterized by choking followed by difficulty in breathing, which is accompanied by a panic attack.

Diagnostics

Diagnosis can be made by swallowing liquids or solids. Next, based on research, the problem that led to the development of dysphagia is diagnosed:

Treatment

Therapy depends on the cause of the symptom. Thus, for reflux esophagitis, conservative treatment with Domperidone and Omeprazole is used, functional dysphagia is treated together with a psychotherapist. In the presence of tumors, strictures, chalasia, achalasia or diverticula of the esophagus, surgical intervention is performed. For inflammatory diseases of the pharynx, treatment consists of anti-inflammatory and antibacterial therapy.

Below is a video - the program “Live Healthy” about the causes and solution to the problem of a lump in the throat:

How we save on supplements and vitamins: probiotics, vitamins intended for neurological diseases, etc. and we order on iHerb (use the link for a $5 discount). Delivery to Moscow is only 1-2 weeks. Many things are several times cheaper than buying them in a Russian store, and some goods, in principle, cannot be found in Russia.

Difficulty swallowing: causes, treatment

This symptom can mean various conditions, so it is very important to find out what exactly the patient means: difficulties in initiating swallowing; feeling of stuck food; painful swallowing; This also includes a feeling of “something in the throat” even in the absence of attempts to swallow.

Causes of difficulty swallowing

globus hystericus (hysterical lump);
any painful conditions of the pharynx, such as pharyngitis;
GERD;
benign strictures;
esophageal carcinoma.

pharyngeal diverticulum;
throat cancer;
compression by a mediastinal tumor (eg, lymphoma, lung cancer);
achalasia of the esophagus;
stomach cancer;
xerostomia (age-related, postparathyroidectomy and Sjogren's syndrome);
foreign body;
medications: NSAID-associated esophagitis, improper use of bisphosphonates.

Plummer-Vinson syndrome;
Chagas disease (South American trypanosome infection);
scleroderma (CREST syndrome (CREST - calcification/Raynaud's phenomenon/esophagitis/sclerodactyly/telangiectasia.)), polymyositis and dermatomyositis;
neurological disorders, such as myasthenia gravis, palsy; □ motor neuron disease.

Diagnosis of difficulty swallowing

Examination methods

Basic: (except in cases with obvious signs of globus hystericus or local pharyngeal involvement) OAK, ESR/CRP, barium contrast, or endoscopy.

Additional: chest x-ray, liver function assessment.

Ancillary: Pharyngeal smear, chest CT, OAK and ESR/CRP may show signs of neoplasia or iron deficiency anemia.

Liver tests if a malignant process is suspected: changes indicate the presence of metastases in the liver.
Barium contrast is used in debilitated patients and can safely demonstrate the presence of narrowing or dysmotility in the absence of absolute fluid dysphagia (risk of aspiration).
Flexible upper gastrointestinal endoscopy allows visualization and biopsy of suspicious areas.
A pharyngeal swab may be useful for diseases of the pharynx.
Chest X-ray: if any mediastinal tumor is suspected.
CT and other imaging methods may be prescribed by specialists to further clarify the location of mediastinal tumors.

A stressed young patient who can swallow food and liquids without problem but who has a feeling of a lump in the throat “like something is stuck” almost certainly suffers from globus hystericus. Removing stress usually solves the problem.

Be sure to ask about medications: A current episode of painful dysphagia may be caused by severe secondary esophagitis from medications such as alendronic acid, nonsteroidal anti-inflammatory drugs, and slow-release potassium supplements.

Take the time to collect a medical history: difficulty swallowing can be caused by a variety of reasons, and the diagnosis is more likely to be made through careful questioning of the patient than through various tests.

New-onset progressive dysphagia with weight loss in an elderly patient is caused by esophageal cancer until proven otherwise.

A palpable firm lymph node in the left supraclavicular fossa (Virchow's metastasis) is strongly associated with gastric cancer.

Be careful with patients who have a long history of esophagitis but complain of worsening or unusual dysphagia: they may have developed an esophageal stricture or cancer.

If the cause was not found during endoscopy, and complaints persist, think about such rare causes as compression of the esophagus from the outside or neurological disorders. Consider barium contrast or refer the patient to a neurologist if other neurologic symptoms are present.

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What diseases cause dysphagia (difficulty swallowing)?

Impairment or difficulty in swallowing (dysphagia) is a feeling of painful and unpleasant sensation behind the sternum, a “lump in the throat,” directly related to the process of swallowing and eating food, or provoked by stressful or traumatic situations.

Dysphagia occurs as an isolated symptom, or can be combined with pain along the esophagus, heartburn and burning, heaviness behind the sternum, regurgitation (return of contents into the esophagus). With dysphagia (when swallowing food), the patient can feel the entire path of the food bolus until it enters the stomach. Dysphagia significantly affects the quality of life, which forces the patient to look for a solution to the problem and seek medical help.

Many diseases and pathologies have been described in which one of the defining symptoms is difficulty swallowing or dysphagia. There is no doubt that the majority of cases of dysphagia are observed in organic and inflammatory diseases of the esophagus and stomach itself, that is, directly with changes in the digestive organs of the upper floor.

However, in some cases, dysphagia may not have the nature of a primary lesion of the upper digestive tract, but be of a neurogenic and other functional nature, when, at least in the initial stages of the disease, it is not possible to identify structural changes in the esophagus and stomach. Sometimes dysphagia is not directly related to digestive diseases, which, for example, occurs with systemic scleroderma, myopathy, dystrophy, diabetes mellitus, and hysteria.

The most common causes of dysphagia and symptoms of difficulty swallowing that accompany these conditions:

1. Neoplasms of the esophagus or tumor formations of adjacent organs, intrathoracic lymph nodes, thyroid gland, which can cause compression of the esophagus. Esophageal cancer is one of the common causes of dysphagia. Dysphagia in tumor oncological diseases is a fairly early symptom, appearing before full-blown systemic manifestations. The symptom of dysphagia in late stages of esophageal cancer is combined with pain during and after eating, loss of appetite, weight loss, and anemia.

Dysphagia in cancer is combined with symptoms of increased salivation, distension in the epigastric zone, painful intractable nausea, repeated retching and self-vomiting. Subsequently, a characteristic symptom is progressive hoarseness and hoarseness of voice, unproductive, ineffective dry cough, difficulty and increased breathing, lymphadenopathy (enlarged lymph nodes), asthenic symptoms.

2. Stenotic transformation of the lumen of the esophagus (narrowing of the esophagus of an organic nature) often leads to symptoms of dysphagia. One of the causes of esophageal stenosis in adults may be post-inflammatory sclerotic changes as a result of scarring of the ulcer. In some cases, narrowing of the esophagus is formed as a consequence of fibrosis during systemic sclerotic processes (systemic sclerosis), in rheumatic diseases, which is manifested by multiple symptoms, including dysphagia.

3. Dysphagia as a consequence of trauma and damage to the esophagus, for example, due to trauma by a sharp foreign body or bone, is a common symptom. Post-inflammatory or sclerotic changes in the esophagus after chemical (thermal) burns can cause dysphagia and difficulty swallowing. After chemical burns of the esophagus, organic stenoses are common, as a result of which it is possible to consume only liquid food or food products in puree form. Such dysphagia can often be eliminated only by surgery.

4. Cardiac achalasia. Achalasia is a motor-neurogenic disorder of the motor function of smooth muscles of the esophagus. Achalasia cardia is a condition the essence of which is the lack of friendly opening of the esophageal sphincter when food enters the lower part of the esophagus during swallowing, as well as an increase in its tone. As a result, patients feel a feeling of a “lump in the throat”, difficulty swallowing, that is, all manifestations of dysphagia.

Achalasia cardia, the main symptom of which is dysphagia, goes through a number of stages in its development. At the initial stage of the disease, dysphagia and difficulty swallowing are not constant, and expansion of the lumen of the esophageal tube is not yet observed. With progression, the lumen of the esophagus expands, while its distal part remains narrowed. At the last stage, the cardiac part is constantly narrowed due to sclerosis, the overlying parts of the esophageal tube are sharply dilated (widened), and the passage of food through the esophagus is extremely difficult.

Dysphagia and difficulty swallowing are not permanent at first. More often, the symptom of dysphagia appears when eating in a hurry, with insufficient chewing. Dysphagia in this disease may initially manifest itself paradoxically. Solid foods are easy to swallow, while liquids cause dysphagia. Stress and certain types of food, especially those high in fiber, can cause dysphagia.

Dysphagia with achalasia cardia is not the only symptom. Often, discomfort and heaviness behind the sternum, pain localized behind the sternum, and a feeling of fullness in the abdomen (in the epigastric region) are simultaneously observed. In the presence of prolonged stagnation of food in the esophagus, along with dysphagia, its return into the oral cavity (regurgitation) is observed. This can be facilitated by an increase in intra-abdominal pressure, bending forward, or lifting heavy objects. Nocturnal reflux of esophageal contents can result in food entering the respiratory tract (pneumonia, asthma and bronchitis are possible).

Prolonged presence of food in the esophagus leads to its inflammatory transformation, which is manifested by pain, rotten belching, esophageal vomiting, bad breath, weight loss, dysphagia at this stage is constant.

5. Esophagospasm (segmental or total). The cause of the spasm is a violation of the nervous regulation of esophageal myocytes. When there is spasm of the esophagus in a limited area of the organ, the patient is bothered by dysphagia and moderate pain with different localization. Dysphagia and pain do not start and stop abruptly. If the esophagus is spasmed along its entire length, the symptoms of the disease are more vivid, the pain is extremely pronounced, localized behind the sternum, radiating to the epigastrium, reminiscent of the pain of angina pectoris. The difference is the clear connection between symptoms and pain with food intake. An attack of pain and dysphagia can last several hours and decrease with swallowing water and regurgitation. Liquid foods and water are more likely to cause dysphagia (dysphagia paradox). Changing body position and taking antacids can reduce pain and dysphagia.

6. Esophageal diverticulosis (single or multiple) often leads to dysphagia and other painful symptoms (esophageal pain, heartburn, regurgitation and belching). A diverticulum can be compared to a sac-like formation localized in any area of the esophagus, the wall of which is all layers of the esophageal tube. During meals, food debris, epithelium, and protective mucus are deposited in the diverticulum. When food remains in the saccular formation for a long time, conditions are created for the proliferation of bacteria and subsequent inflammation. Inflammation is aggravated by mechanical compression of the esophagus by the diverticulum itself, which inevitably manifests itself as dysphagia and symptoms of difficulty swallowing.

7. Esophagitis can often lead to dysphagia. Esophagitis can develop as a result of long-term nutritional errors (rough, spicy, hot foods, strong alcohol). The peptic factor in the form of constant irritation of the esophageal mucosa with hydrochloric acid and pepsin is one of the main causative factors of chronic esophagitis. Long-term esophagitis, especially erosive and ulcerative, leads to hypertrophy and dysplasia of the esophageal epithelium, swelling of the mucous and submucosal layer. These pathological changes are reflected in the form of dysphagia. Dysphagia is felt as a “lump in the throat, behind the sternum,” fullness, discomfort along the esophagus. During periods of exacerbation, dysphagia intensifies and is combined with other symptoms (typical pain associated with eating, burning and heartburn).

8. Reflux (reverse reflux) of stomach contents, which are acidic in nature, into the lumen of the esophagus. The epithelium of the esophagus throughout its entire length has reduced resistance to aggressive gastric juice. Long-term aggression by hydrochloric acid and the substance pepsin of the esophageal epithelium inevitably leads to gastroesophageal disease, which is based on reflux (GERD), which is often manifested by symptoms of dysphagia.

9. Hernia of the opening of the diaphragm, through which the esophagus from the chest cavity enters the abdominal cavity (HH). Normally, only the esophageal tube passes through this physiological opening, which is small in size. A diaphragmatic hernia is formed if, for one reason or another, the hole in the diaphragm becomes larger and allows part of the stomach (sometimes quite significant) into the chest cavity. A hernia creates significant discomfort, and patients experience symptoms of heaviness in the chest, pain along the esophagus, difficulty swallowing, a feeling of a lump, hiccups, sour taste, difficulty breathing and dysphagia.

Esophageal hernias are formed with prolonged increased pressure in the abdominal cavity (obesity, heavy lifting, prolonged constipation and abdominal wall tension) in combination with weakness of the connective tissue formations of the said area.

10. Difficulty swallowing in childhood (from birth) manifests itself with congenital defects in the formation of internal organs and the formation of hollow structures (esophagus). The most common such anomalies include stenosis, narrowing, cysts, congenital esophageal diverticula, and esophageal-tracheal fistulas. Dysphagia in infants manifests itself from birth with uncontrollable vomiting, inability to eat, and weight loss.

11. Hysteria, neuroses and neurotic reactions are often accompanied by subjective sensations of difficulty swallowing in the absence of an organic cause. Dysphagia is most often manifested by the fact that the patient cannot swallow water; eating solid food is not accompanied by dysphagia.

12. A rare cause of dysphagia can be inflammation of the pharynx and larynx of various origins, in which dysphagia may be present along with cough and sore throat. As a rule, dysphagia is reversible after relief of inflammation and swelling in these organs.

13. Dysphagia when a foreign body is in the esophagus is the main symptom of this pathological condition, requiring urgent (urgent) measures.

14. Dysphagia with damage to the muscles and nervous system - conditions not associated with dysfunction of the digestive system. Difficulty swallowing often complicates strokes (cerebrovascular accident), myopathy, and neurodystrophy.

Treatment and diagnosis of dysphagia

Thus, each type of dysphagia requires an individual approach and treatment depending on the cause that causes it. Difficulty in swallowing, caused by an organic lesion (tumor, stenosis, narrowing, diverticulum), requires surgical (combined) treatment. In case of inflammation or ulcerative lesions, treatment aimed at stopping this process will bring relief to the patient and the disappearance of the painful symptoms of dysphagia. Functional pathologies of the neuromuscular regulation of esophageal tone require complex treatment, including the use of pharmacological and psychotherapeutic methods of treatment.

Diagnostic approaches to clarify the nature of dysphagia are dictated by the patient’s accompanying complaints. X-ray (using barium contrast) and endoscopic (EGD) imaging techniques are used to identify the cause of dysphagia. The diagnosis is clarified using R-graphy of the lungs, ultrasound of adjacent organs, blood vessels, and examination of the composition of peripheral blood.

Important. Dysphagia can be a symptom of a serious disease, the effectiveness of treatment of which depends on timely consultation with a doctor.

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Unpleasant sensations in the oral cavity accompany everyone from time to time.

A common case of pain when swallowing is a throat disease, which is accompanied by an inflammatory process.

What should you do if it’s hard to swallow, but your throat doesn’t hurt? This is a difficult question to which not every doctor is able to give a definite answer.

An analysis of the general condition of the body and a complete examination are necessary. Causes of discomfort when swallowing.

Unpleasant sensations and discomfort when swallowing can be observed in various diseases, and sometimes may not be related to the disease.

An irritating lump in the throat may form in the following cases:

Somatic diseases against the background of an inflammatory process;
Disease of the digestive tract;
Reaction of the endocrine system to the pathogen, enlargement of the thyroid gland;
Diseases of the cardiovascular system;
Obesity;
Oncology;
Allergic reaction;
Neurology;
Diaphragmatic hernia;
Traumatic result of damage to the mucosa;
Anatomical feature of the larynx.

Discomfort when swallowing can be felt to varying degrees and be irregular. In this case, observations are necessary: under what circumstances and for how long does a lump in the throat feel?

When a person is nervous, the mucous membranes dry out, resulting in difficulty swallowing saliva.

Nervousness and constant emotional negative stress often cause prolonged discomfort in the throat.

Based on their medical practice, almost half of the cases of a lump are associated with a depressive state.

If the unpleasant sensations continue for a long time, turning into a chronic condition, it can be assumed that the cause is more serious, for example, vegetative-vascular dystonia.

In rare cases, mental illness and endocrine system disruption may be the cause.

Among ENT diseases, this condition can be observed in people with chronic tonsillitis. In this case, discomfort is felt, but is not accompanied by pain.

The short-term nature of a lump in the throat can occur in people who travel frequently and are exposed to sudden changes in climatic conditions.

Based on the observations of specialists, it is noted, especially in men, that there is an anatomical feature of the oral cavity in adulthood.

The mucous tissue of the tonsils and uvula becomes ossified and, having an anatomical deformation, creates an uncomfortable swallowing process with age. Sometimes a similar phenomenon is noted by people who have had their tonsils removed.

Who performs the diagnosis?

How to find out the reason and what to do when your throat doesn’t hurt, but it’s hard to swallow? To find out the nature of the formation of a lump in the throat, sometimes you have to undergo examination by a number of specialists.

Without medical education, it is difficult to determine which doctor you should see.

In the absence of painful sensations, it is very rare for anyone to seek medical help, but when the discomfort is long-term and inconvenient, it is worth making an initial appointment with a therapist.

Based on the epicrisis of past diseases, external examination and analysis of possible additional symptoms, the doctor can give referrals for diagnostics from the following specialists.

The otolaryngologist will examine for the presence of pathology and identify the results of a hidden inflammatory process of the respiratory system, if any.

A neurologist will be able to determine whether problems in the throat are related to the state of the nervous system.

Even vegetative-vascular dystonia, detected against the background of a problematic throat condition, can only be severe symptoms, again, as a result of an unstable psyche.

Endocrinologist. By palpating the thyroid gland and identifying additional hidden symptoms that a person may not pay much attention to, the doctor will be able to give a preliminary assessment.

If there is a risk of dysfunction of the thyroid gland, the specialist will recommend undergoing additional examination, performing an ultrasound of the thyroid gland and taking tests to determine the level of hormones that it produces.

Oncologist. A cancer disease has the ability to proceed in a sluggish manner, without revealing any special symptoms until a critical point.

If you feel discomfort, you need to look for the cause. The body itself “tells” about the presence of dysfunction of internal organs.

It is easier to stop a disease at its inception than to fight a disease that has developed in full force.

Associated symptoms

To understand the nature of uncomfortable swallowing, it is a good idea to analyze the additional signals that the body gives.

It is very rare that the pain is limited only during swallowing. And the process itself may have its own characteristics:

Constant discomfort in the throat;
Pain when swallowing in a certain position;
Systematic disturbances of respiratory tract processes;
Location of the source of discomfort: throat, Adam's apple, trachea.

The optimal solution to the issue would be a comprehensive examination of the emerging pathology. What causes the defect, what else can it be accompanied by?

Many factors can trigger the problem, and stress is a common one. In this case, apart from a lump in the throat, no unpleasant sensations are observed.

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The general functioning of the internal organs is not impaired. In a state of constant anxiety and depression, the muscles of the cervical vertebra contract, which leads to complaints when swallowing.

Discomfort in the area of the Adam's apple can be caused by an injury that provoked displacement of the vertebrae.

With frequent, prolonged colds, severe irritation of the mucous membrane is created after the coughing process.

In this case, sensitivity even to liquid increases greatly. The optimal solution to the issue would be a comprehensive examination of the emerging pathology.

Then the doctor can prescribe an adequate course of treatment for a specific disease.

What to do when you have difficulty swallowing?

In view of the cause of the formation of a lump in the throat, there are a number of ways to eliminate this unpleasant moment.

This may also be useful to you:

What to do if, but your throat does not hurt:

If the cause is the endocrine system, then a course of therapy consisting of iodine-containing drugs may be prescribed;
If a mucous infection is affected, it is necessary to be examined by an ENT specialist, who will prescribe additional examinations of a throat smear that will help determine the causative agent of the disease. Often this process is caused by bacteria, so an antimicrobial course of treatment is prescribed;
When a throat problem is associated with a muscle disorder, a course of treatment, physical therapy, and massage are prescribed;
Esophagus problem. There can be many reasons. With chronic gastritis, during an exacerbation, ulcers may appear on the esophagus, which creates pain when swallowing. The cause of compression of the esophagus may be a change in the structure of the aorta and glands. In this case, the gastroenterologist will prescribe a fibrogastroduodenoscopy procedure. Based on the results of stomach probing, the doctor will be able to prescribe a course of treatment;
A psychologist can eliminate emotional disorders. If the reasons are more serious and there is a fact of a psychiatric illness, consultation with a psychiatrist is necessary.

The swallowing reflex is very similar to the act of breathing in that a person performs them unconsciously. These unconditioned reactions of the body do not need to be specially learned. They are available to every living being from birth, because without them it would be impossible to ensure survival. However, sometimes swallowing may be impaired. Why this violation of the reflex act occurs and how to get rid of the problem, we will consider further.

What is the swallowing reflex?

Various muscles take part in the act of swallowing: the mouth, tongue, pharynx and esophagus. Their actions are clearly coordinated, so food or liquid that a person consumes can only enter the stomach.

In addition, the swallowing reflex is regulated by the central nervous system. Thanks to this, a person can swallow when he considers it necessary, that is, he can do this action voluntarily. Several so-called cranial nerves take part in the regulation. In addition, the brain has a special swallowing center.

Let's consider what happens during the act of swallowing in order to understand why the swallowing reflex may be impaired:

At the first stage, food enters the oral cavity, where it softens. This process takes no more than 10 seconds;
Next, the glossopharyngeal nerve is activated, which innervates the root of the tongue. Food is pushed towards the back of the throat. It is at this stage that a violation most often occurs, which leads to a violation of the swallowing reflex;
At the moment when the larynx is pulled up, the cricoid cartilage moves back, which closes the entrance to the trachea. After this, the muscles of the pharynx contract, and the lump passes into the esophagus without entering the trachea.

How and why can swallowing be impaired?

The causes of impaired swallowing reflex can come from different systems: nervous, digestive, etc. However, most often, swallowing disorders, or dysphagia, appear as a result of disorders in the central nervous system. These include:

Brain injuries;
Stroke;
Esophageal muscle spasm;
Myasthenia gravis and muscular dystrophies;
Multiple sclerosis;
Parkinson's disease;
Dermatomyositis;
Tumors of various localizations.

At the slightest sign of difficulty swallowing, you should immediately seek help. A violation of the swallowing reflex leads to rapid depletion of the body due to the fact that the latter does not receive enough nutrients. In addition, patients choke on food, which leads to it being thrown into the respiratory tract. This, in turn, can lead to the development of pneumonia.

What are the types and degrees of dysphagia?

All reasons that can cause a violation of the swallowing reflex are divided into two types:

Mechanical - blockage of the lumen of the esophagus with too large a piece of food or narrowing of the lumen of the esophagus or external pressure on it;
Functional - associated with impaired peristalsis and relaxation of the muscles of the pharynx and esophagus.

According to complexity, there are 4 degrees of manifestation of the swallowing reflex disorder:

Swallowing is slightly difficult, it is impossible to swallow only very large pieces of food or volumes of liquid;
It becomes impossible to swallow any solid food. At the same time, the patient can easily consume food in semi-liquid or liquid form;
A patient with a swallowing disorder can only consume nutrients in liquid form;
Swallowing becomes completely impossible.

How does swallowing disorder manifest?

The first manifestations of dysphagia make themselves known to the patient with pain that occurs at the moment of swallowing. You should pay attention if coughing attacks often occur during meals. Especially if the patient experiences throwing food into the nasal passages.

In addition, a characteristic symptom of a violation of the swallowing reflex is increased salivation and a feeling of suffocation. Often, the patient may express additional complaints of heartburn, discomfort in the solar plexus, or a lump in the esophagus.

How to restore the pharyngeal reflex

Most often, a violation of the swallowing reflex does not act as an independent disease, but as a symptom indicating a more serious problem. In this regard, treatment should be carried out in combination with the underlying disease.

If the problem is disorders of the gastrointestinal tract, then drug treatment is usually prescribed. It consists of taking substances that reduce the acidity of gastric juice, as well as antacids. In addition, patients need strict adherence to the diet.

Sometimes swallowing disorders can be caused not only by diseases, but also by psychological disorders. Treatment in this case is carried out not only with strict adherence to diet and posture when eating, but also with psychotherapy.

Dysphagia appears no less often in patients after a stroke. It takes at least 2-3 weeks for patients to restore lost swallowing function. Until the reflex recovers, the patient is transferred to nutrition using a nasogastric tube. However, the treatment does not end there, since the patient still has to regularly perform special exercises to stimulate the restoration of the lost swallowing function.

In this regard, let us consider in more detail what exercises are used to base the treatment of the swallowing reflex:

First of all, the patient begins by simulating a swallow. Such attempts should be repeated at least 10 times a day;
Next, an exercise is performed during which the patient yawns. It also needs to be repeated at least 10 times;
If the previous exercises are successfully completed, the tasks become a little more complicated and now the person is asked to try gargling;
Imitating snoring or coughing is also suitable for training;
In order to train the muscles of the soft palate, the patient is asked to touch it with the tip of the tongue. This procedure is performed first with the mouth open and then with it closed.

It is recommended that the patient perform such exercises only under the supervision of a qualified specialist. It is strictly forbidden to force a patient to do something that he cannot do the first time. Performing all exercises requires regularity. In addition, you cannot rush a person who has suffered a stroke, because the swallowing reflex takes time to recover. If the patient does not neglect exercise after a stroke, then all impaired functions are easily restored.