why does it hurt when i swallow sometimes
Devault KR. Symptoms of esophageal disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 13. Nussenbaum B, Bradford CR. Pharyngitis in adults. In: Flint PW, Haughey BH, Lund V, eds. Cummings Otolaryngology: Head and Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 9. Pandolfino JE, Kahrilas PJ. Esophageal neuromuscular function and motility disorders. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 43.
Wilcox CM. Gastrointestinal consequences of infection with human immunodeficiency virus. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 34.
For background, I m a 4th year resident in otolaryngology, so this is right up my alley. To first understand your question more clearly, let s define a few things. Aspiration occurs when you have some type of dysfunction of your larynx (structure composed of and supporting vocal cords that elevates during swallow) and epiglottis (cartilage flap that closes over your larynx to protect airway when swallowing).
Aspiration cause you to cough. Typically is not painful. This is what happens when people say it went down the wrong pipe. It can become an issue when it leads to aspiration pneumonia. Older folks and smokers (or other individuals whose lungs and windpipe cannot optimally clear mucus) can develop an infection of the lungs if bacteria continues to enter this area and is not cleared properly. Dysphasia can be divided up into a few different categories. Oral - involving the mouth, all voluntary muscle movement. Thing of someone with a paralyzed tongue trying to push a food bolus to the back of their mouth.
Very difficult. Oropharyngeal - a combination of voluntary and involuntary muscle movement. This phase of swallowing is basically your active swallow initiation motion followed by involuntary motion of pharyngeal muscles. Elderly with weak pharyngeal muscles, or someone who has suffered a stroke affecting this area. Additionally, at this stage, if the epiglottis fails to descend properly, aspiration can occur. Esophageal - completely involuntary muscle movement. Dysphasia in this phase can be functional or mechanical. Mechanical occurs if there is some type of obstruction in the esophagus, like a ring, web, or tumor.
This type of dysphasia occurs mainly with solid food and not liquid. Functional dysphagia occurs if there is some type of improper muscle motion, like lower esophageal sphincter spasm or diffuse esophageal spasm. It occurs with solid and liquid. Basically there is either a physiologic miscommunication among the nerves or a chronic problem. All these types of dysphagia can present with pain in different areas based on the location of the dysfunction. Typically in the morning, a short lived cramp/pain with swallowing is likely due to an esophageal spasm.
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