Dysphagia

 

Normal swallowing

Normal swallowing is a complex neuro-physiological sequenced response to move food and fluid from the mouth. There are 4 stages to swallowing:

1. Oral preparatory stage - Involves self placement of food and drink into the mouth and mixing it with saliva in order to form a cohesive bolus

2. Oral transit stage - Moves the bolus from the mouth to the throat in order to swallow

3. Pharyngeal stage - The soft palate elevates to close off the nasal cavity. The airway is protected by closure of the true and false vocal cords together with the up and forward movement of the hyoid which brings the epiglottis flat over the airway. The bolus moves either side of the trachea and into the oesophagus.

4. Oesophageal stage - The bolus moves down the oesophagus to the stomach via peristalsis and the laryngeal mechanism returns to resting position