Language Disorders – More Serious Than We Think

Swallowing is a complex physiological process that combines voluntary and reflex activities. This process plays a crucial role during eating, as it allows the consumed food to enter the stomach, regardless of how much gravity aids this movement. When swallowing is disrupted, we refer to it as dysphagia, which means difficulty in swallowing. If swallowing is accompanied by pain, this is known as odynophagia. Both phenomena are warning signs that require immediate medical examination.

The Esophagus

The esophagus, or oesophagus, is a tubular organ that connects the pharynx to the stomach. The inner wall of the esophagus is lined with mucosa, while the outer layer consists of muscle. Along the esophagus, there are three physiological constrictions: the first is the upper esophageal sphincter, which prevents aspiration; the second is the indentation from the aorta located in the middle section; and the third is the lower esophageal sphincter, which prevents the backflow of stomach acid.

Disorders Causing Swallowing Difficulties

There are numerous abnormalities that can underlie swallowing disorders, causing various symptoms and consequences. One common cause is the appearance of diverticula, which are outpouchings of the esophageal wall. These can occur anywhere along the esophagus and can lead to severe eating problems, such as food regurgitation or even aspiration pneumonia.

Another significant condition is achalasia, which is characterized by spasms of the lower esophageal sphincter and a lack of peristalsis. This situation results in food not being able to pass properly into the stomach, leading to stagnation in the esophagus, which can cause frequent vomiting. Diffuse esophageal spasm is also a serious issue, as the incoordination of esophageal contractions can cause chest pain and difficulty swallowing.

Swallowing difficulties can be triggered not only by problems within the esophagus itself but also by diseases of other organs. For example, a hiatal hernia, which arises from weakness in the diaphragm that separates the thoracic and abdominal organs. In this case, part of the stomach moves into the chest, increasing the likelihood of developing gastroesophageal reflux disease. As a result of reflux, frequent food regurgitation and swallowing difficulties may occur.

Reflux Esophagitis and Other Inflammations

Reflux esophagitis is a very common disease that affects a significant portion of the population. The underlying causes of this disease include insufficient function of the lower esophageal sphincter, disturbances in gastric emptying, and weakened esophageal peristalsis. Inflammation can develop as a result of acidic or bile reflux, which may lead to scar formation and strictures in the long term. In severe cases, normal mucosa can transform into intestinal-type columnar epithelium, dramatically increasing the risk of esophageal cancer.

Esophagitis, also known as esophageal inflammation, is another common issue caused by various factors, such as fungal or viral infections, as well as accidental or intentional ingestion of corrosive substances. These cases are particularly dangerous, as they can lead to persistent esophageal strictures after healing, severely affecting the patient’s quality of life.

Additionally, medications can contribute to esophageal inflammation. Many drugs, such as nonsteroidal anti-inflammatory drugs, antibiotics, or osteoporosis treatments, can damage the esophagus, especially if taken with little water or in a lying position. Elderly, bedridden patients are particularly at risk for these complications.

Tumors and Foreign Bodies

Esophageal tumors, although less common, can cause serious swallowing problems. Besides benign smooth muscle-origin tumors, malignant esophageal cancer is more frequent, and swallowing difficulties often represent one of the first symptoms. Such cases require urgent medical intervention, as early diagnosis is crucial for treatment.

Moreover, the obstruction of foreign bodies is also a common occurrence, particularly among children and the elderly. This situation can lead to an inability to swallow, as well as drooling, and requires immediate medical attention. The removal of foreign bodies lodged in the esophagus is essential to prevent further complications.

Overall, swallowing disorders can arise from a variety of causes, and proper diagnosis and treatment are essential for maintaining the patient’s health.