Swallowing is something all of us takes for granted. I mean, who really thinks about it, except perhaps when you have a sore throat. And swallowing is not only important for delivering energy (read food) to the stomach, but also to prevent aspiration.

For some who have suffered a stroke, swallowing may be difficult if not impossible. This occurs if the stroke affects the nerves which are responsible for coordinating all of the muscle action required for swallowing. The muscles need not only to work together, but also in a certain order so that the food is propelled down the esophagus.  At the same time the food is pushed toward the stomach, the epiglottis, which is a kind of shield shaped structure deep within your throat, closes off the trachea or airway passage into the lungs.

What happens when the system doesn’t work well? Food ,whether liquid or solid ,can then be aspirated down the airway into the lungs. This often leads to pneumonia, which especially in stroke victims, can be life threatening. Also, if vomiting occurs, then instead of swallowing it into the stomach, some may end up in the lungs. Not only pneumonia, but also inflammation of the lungs occurs. This is because regurgitated material contains a high level of acid from the stomach. Acid and lung tissue don’t mix well.

Other diseases can affect swallowing. These include multiple sclerosis, cerebral palsy and Parkinsons. Alcohol and drugs reduce or eliminate effective and safe swallowing as well. General anesthetics and many other medications will do the same.

If there is concern about a chronic condition such as a stroke causing difficulties, a swallow test will be done. Sometimes, when there is only a minor tweak, patients can be taught to swallow correctly. If not, eventually a tube will need to be placed directly into the stomach to avoid repeated aspiration. Changing the diet to more easily swallowed foods and eating only when upright help as well.