Swallowing Disorders

Swallowing is one of the most basic functions of everyday life. You swallow food, drink and saliva almost without thinking. The inability to swallow normally may range from a mild to major disruption of your everyday activities and enjoyment of life.

Our swallowing experts at UC Health Voice and Swallowing Center treat everything from the mouth to the esophagus. They have fellowship training in laryngology (throat conditions) and work closely with speech/language pathologists to find the cause of your swallowing problem and recommend ways to improve your symptoms and life.

 

Why Choose UC Health for Swallowing Problems? 

  • Physician Expertise. We are Southwest Ohio’s only center dedicated to swallowing and voice issues. We have two laryngologists, whose fellowship training and research put them in an elite group of fewer than 150 laryngologists across the country who specialize in throat disorders. They interact frequently with laryngologists from around the country to share and learn about the latest advances in treatment strategies.
  • Comprehensive, Holistic Care. Problems with voice, swallowing and breathing all can occur in your throat. We look at how these issues affect each other and work with you to optimize all three.
  • Team Approach. Our physicians and speech/language pathologists work alongside each other, giving you the benefit of multiple perspectives on your condition. They create a customized treatment plan for you and coordinate your care with each other and other specialists, such as gastroenterologists, pulmonologists or cardiothoracic surgeons, as needed – and your own primary care doctor.
  • We conduct research to improve our patients’ quality of life and track their progress. For example, we are studying cancer survivors with speech and swallowing issues. This is one form of clinical or outcomes-based research. True bench to bedside research is used in collaboration with the Laryngeal Biomechanics Laboratory.

 

How Swallowing Works

Once you’ve softened and moistened food in your mouth through chewing, your tongue pushes food or liquid to the back of the mouth. You have an automatic swallowing response that pushes food through the throat. Your voice box closes tightly to prevent food and liquid from entering your lungs. Next, food passes into the esophagus, the tube that carries food and liquid to the stomach.

 

Diagnosis

Identifying the source of your problem is an important first step in improving your ability to swallow.

Following a thorough evaluation with a physician and/or speech/language pathologist, our physicians may recommend one or more tests to give them further information:

  • Laryngoscopy is an exam inserting a small, flexible tube with a miniature camera on the tip through your nose and into the back of your throat. It allows your physician to see inside the throat to the level of the voice box to observe your throat while you are awake, breathing and talking.
  • Transnasal esophagoscopy (TNE) can be performed in the doctor’s office with some local numbing medicine in the nose. This sophisticated, high-definition scope allows your physician to view your esophagus and the top part of the stomach. It passes through your nose and throat while you are awake in the office. Your doctor can provide you with results while you are there, and you can return to work or other activities immediately afterwards.
  • Fiberoptic endoscopic evaluation of swallow (FEES) is a laryngoscopy procedure while eating. This allows your physician or speech/language pathologist to observe your throat while you are swallowing.
  • Esophagram or modified barium swallow requires you to swallow food or drink mixed with a thick, chalky liquid (barium) that coats your throat. A radiologist then takes X-rays (sometimes with a speech/language pathologist) to detect any abnormalities in the lining of the throat or during the swallowing process.
  • Esophageal manometry is a test that helps your physician evaluate your swallowing by measuring the strength and coordination of muscle contraction in your esophagus muscles and the pressure of those muscles while at rest and during a swallow. A small tube is inserted into your nostril, down your throat and into your esophagus. Then, a computer measures the pressures while you are swallowing.
  • pH Impedance test involves placing a thin, flexible tube, with an acid-sensitive tip through your nose into your esophagus. The catheter remains in place for 24 hours to record movement of liquid and gas in your esophagus and measure your pH level (level of acidity). A gastroenterologist usually performs this test, which is useful in diagnosing gastroesophageal reflux disease (GERD).

 

Conditions and Treatments

Problems can occur with the structures in the throat – such as the upper esophageal sphincter and vocal cords, or in the nerves that signal the swallowing process. At the UC Health Voice and Swallowing Center, we address both the structure of the throat and the way it works.

Our speech/language pathologists can help in many instances to provide exercises to improve swallowing function.

Conditions we treat include:

 

Zenker’s Diverticulum

A small pouch forms in the throat tissue just above the upper esophageal sphincter or cricopharyngeus muscle. The pouch, or diverticulum, causes problems with swallowing, frequent regurgitation, and coughing or throat clearing.

At UC Health Voice and Swallowing Center, our surgeons are specially trained for endoscopic (or minimally invasive) techniques to remove the pouch by inserting an endoscope into the throat and using a stapler or a laser to eliminate the diverticulum. This approach, which has a shorter procedure time, shorter recovery time and reduced complications compared to traditional surgery, can be used about 70 percent of the time at UC Health. In some cases, open surgery through the neck will be the best option to relieve your symptoms.

 

Esophageal Stricture, Web and Ring

Each of these conditions creates a narrowing or tightening in the throat, making swallowing difficult. These can affect both older and younger populations.

Anti-reflux medicine and endoscopy to dilate and widen the esophagus are treatment options, depending on your particular case.

 

Cricopharyngeal Dysfunction

Spasms in the upper sphincter muscle at the base of the throat prevent the muscle from relaxing and letting food pass to the esophagus. Food can become lodged in the area, and gradually a person is able to swallow only soft foods or liquids.

At UC Health’s Voice and Swallowing Center, our physicians first try anti-spasm medicines or Botox to relax the muscle or dilation to widen the throat opening.

If necessary, another procedure call a myotomy can be performed to cut the sphincter muscle and loosen it. The procedure can be performed through an endoscope or with an incision through the neck. It can make a great improvement with swallowing, but a potential side effect is additional reflux due to the loosened valve muscle.

 

Pharyngeal Reflux (Silent Reflux)

Backup of stomach acid into the throat occurs when upper or lower sphincter muscles in the esophagus are weak and do not prevent the stomach acid from returning to the throat.

Symptoms include hoarseness, chronic cough, excessive throat clearing or problems with breathing. Pharyngeal reflux, also called silent reflux, can scar the throat and voice box. It can also increase risk for throat cancer and worsen conditions such as asthma, emphysema and bronchitis.

This silent reflux often can be controlled with dietary changes and medication. In severe cases, surgery to tighten the lower sphincter muscle may be needed.

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    call (513) 475-8400 or
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