http___logoped.hr_poremecaji-i-teskoce_disfagija__1.xml
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Overview Difficulty swallowing (dysphagia) means it takes more time and effort to move food or liquid from your mouth to your stomach. Dysphagia may also be associated with pain. In some cases, swallowing may be impossible. Occasional difficulty swallowing, which may occur when you eat too fast or don't chew your food well enough, usually isn't cause for concern. But persistent dysphagia may indicate a serious medical condition requiring treatment. Dysphagia can occur at any age, but it's more common in older adults. The causes of swallowing problems vary, and treatment depends on the cause. Symptoms Signs and symptoms associated with dysphagia may include: - Having pain while swallowing (odynophagia) - Being unable to swallow - Having the sensation of food getting stuck in your throat or chest or behind your breastbone (sternum) - Drooling - Being hoarse - Bringing food back up (regurgitation) - Having frequent heartburn - Having food or stomach acid back up into your throat - Unexpectedly losing weight - Coughing or gagging when swallowing - Having to cut food into smaller pieces or avoiding certain foods because of trouble swallowing When to see a doctor See your doctor if you regularly have difficulty swallowing or if weight loss, regurgitation or vomiting accompanies your dysphagia. If an obstruction interferes with breathing, call for emergency help immediately. If you're unable to swallow because you feel that the food is stuck in your throat or chest, go to the nearest emergency department. Causes Swallowing is complex, and a number of conditions can interfere with this process. Sometimes the cause of dysphagia can't be identified. However, dysphagia generally falls into one of the following categories. Esophageal dysphagia Esophageal dysphagia refers to the sensation of food sticking or getting hung up in the base of your throat or in your chest after you've started to swallow. Some of the causes of esophageal dysphagia include: - Achalasia. When your lower esophageal muscle (sphincter) doesn't relax properly to let food enter your stomach, it may cause you to bring food back up into your throat. Muscles in the wall of your esophagus may be weak as well, a condition that tends to worsen over time. - Diffuse spasm. This condition produces multiple high-pressure, poorly coordinated contractions of your esophagus, usually after you swallow. Diffuse spasm affects the involuntary muscles in the walls of your lower esophagus. - Esophageal stricture. A narrowed esophagus (stricture) can trap large pieces of food. Tumors or scar tissue, often caused by gastroesophageal reflux disease (GERD), can cause narrowing. - Esophageal tumors. Difficulty swallowing tends to get progressively worse when esophageal tumors are present. - Foreign bodies. Sometimes food or another object can partially block your throat or esophagus. Older adults with dentures and people who have difficulty chewing their food may be more likely to have a piece of food become lodged in the throat or esophagus. - Esophageal ring. A thin area of narrowing in the lower esophagus can intermittently cause difficulty swallowing solid foods. - Gastroesophageal reflux disease (GERD). Damage to esophageal tissues from stomach acid backing up into your esophagus can lead to spasm or scarring and narrowing of your lower esophagus. - Eosinophilic esophagitis. This condition, which may be related to a food allergy, is caused by an overpopulation of cells called eosinophils in the esophagus. - Scleroderma. Development of scar-like tissue, causing stiffening and hardening of tissues, can weaken your lower esophageal sphincter, allowing acid to back up into your esophagus and cause frequent heartburn. - Radiation therapy. This cancer treatment can lead to inflammation and scarring of the esophagus. Oropharyngeal dysphagia Certain conditions can weaken your throat muscles, making it difficult to move food from your mouth into your throat and esophagus when you start to swallow. You may choke, gag or cough when you try to swallow or have the sensation of food or fluids going down your windpipe (trachea) or up your nose. This may lead to pneumonia. Causes of oropharyngeal dysphagia include: - Neurological disorders. Certain disorders — such as multiple sclerosis, muscular dystrophy and Parkinson's disease — can cause dysphagia. - Neurological damage. Sudden neurological damage, such as from a stroke or brain or spinal cord injury, can affect your ability to swallow. - Pharyngeal diverticula. A small pouch that forms and collects food particles in your throat, often just above your esophagus, leads to difficulty swallowing, gurgling sounds, bad breath, and repeated throat clearing or coughing. - Cancer. Certain cancers and some cancer treatments, such as radiation, can cause difficulty swallowing. Risk factors The following are risk factors for dysphagia: - Aging. Due to natural aging and normal wear and tear on the esophagus and a greater risk of certain conditions, such as stroke or Parkinson's disease, older adults are at higher risk of swallowing difficulties. - Certain health conditions. People with certain neurological or nervous system disorders are more likely to experience difficulty swallowing. Complications Difficulty swallowing can lead to: - Malnutrition, weight loss and dehydration. Dysphagia can make it difficult to take in adequate nourishment and fluids. - Respiratory problems. Food or liquid entering your airway when you try to swallow can cause respiratory problems, such as pneumonia or upper respiratory infections. Prevention Although swallowing difficulties can't be prevented, you can reduce your risk of occasional difficulty swallowing by eating slowly and chewing your food well. Early detection and effective treatment of GERD can lower your risk of developing dysphagia associated with an esophageal stricture.
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Disfagija je termin za teškoću gutanja, točnije stanje u kojemu je potrebno više vremena i napora da hrana i tekućine prođu put od usta do želuca. U nekim slučajevima gutanje izaziva bol ili je pak onemogućeno. Naziv „disfagija“ dolazi od grčki korjen dys (teškoća, poremećaj) i phagia (jesti). Može se javiti u bilo kojoj dobi, ali najčešća je kod osoba starije dobi. Disfagija ukazuje na problem sa ždrijelom ili jednjakom, mišičnim cijevima koje provode hranu od usta do želuca. Mišići vrata i jednjaka se stišću i kontrahiraju, i tako prenose hranu i tekućine od usta do želuca, međutim katkad u tom prijenosu postoje problemi. Povremene teškoće gutanja, koje mogu nastati pri prebrzom gutanju ili gutanju nedovoljno prožvakane hrane, ne spadaju pod disfagiju. Disfagija je perzistentna teškoća koja zahtijeva medicinski tretman. SIMPTOMI - otežano gutanje krute hrane i/ili tekućina - nesposobnost gutanja - osjećaj „zapinjanja“ hrane u grlu ili prsima - osjećaj “stezanja” u grlu ili prsima - vraćanje hrane i/ili tekućine u grlo nakon gutanja (regurgitacija) - kašljanje/gušenje tijekom ili neposredno nakon gutanja - bol pri gutanju (odinofagija) - gubitak težine zbog nedovoljnog unosa hrane i/ili tekućine - osjećaj dehidratacije zbog nedovoljnog unosa tekućine - slinjenje - promuklost POZVATI DOKTORA AKO … - Ako Vam se teškoće gutanja javljaju često ili su praćene gubitkom težine, regurgitacijom ili povraćanjem. - Ako pri gutanju imate problema s disanjem, ili osjećate kao da Vam nešto blokira disanje, potrebno je potražiti hitnu liječniku pomoć! - Ako ne možete progutati jer osjećate da Vam je hrana „zapela“ u grlu ili prsima, potrebno je potražiti hitnu liječniku pomoć! Uzroci teškoća gutanja variraju, a vrsta tretmana ovisi o uzroku. Gutanje je složena neuromuskularna aktivnost i na njega utječu mnogi procesi. Gutanje započinje kao voljan proces i odvija se u nekoliko faza. Prva faza, oralna faza, je u najvećoj mjeri voljna, dok su ostale faze refleksne. Ovisno o tome koja faza gutanja je narušena, razlikujemo dvije vrste disfagije. OROFARINGEALNA DISFAGIJA dovodi do teškoće prijenosa hrane od usta do jednjaka. Oralna razina podrazumijeva žvakanje (usitnjavanje hrane u konzistentnu masu pogodnu za gutanje, zvanu bolus), pripremu i prijenos bolusa od usana do ždrijela (farinksa). Faringealna razina podrazumijeva prijenos bolusa do jednjaka. EZOFAGEALNA DISFAGIJA, koja nastaje pri oštećenoj funkciji jednjaka, dovodi do teškoće prijenosa hrane kroz jednjak u donji digestivni trakt. Funkcija jednjaka slabi sa starenjem. Normalne promjene kod starenja uključuju slabljenje sfinktera i muskulature jednjaka, a zbog raznih drugih bolesti, disfagije su često sekundarni problem. Katkada nije moguće odrediti točan uzrok disfagije. Faktori rizika za razvoj disfagije su starenje i određena zdravstvena stanja. Uzroci disfagičnih teškoća mogu biti: - Neurološki uzroci (moždani udar, ozljede glave, cerebralna paraliza, Parkinsonova bolest, Huntingtonova bolest, poremećaji perifernog živčanog sustava, myastenia gravis, amiotrofična lateralna skleroza, multipla skleroza, itd.) - Infekcije u orofacijanom području - Tumori i malignomi u predijelu vrata i glave - Specifični poremećaji - Anatomske nepravilnosti - Farmakološki uzroci - Psihogeni uzroci Prevedeno i prilagođeno s Internet stranica klinike Mayo1 i WebMD2 1. http://www.mayoclinic.org/diseases-conditions/dysphagia/basics/definition/con-20033444 2. http://www.webmd.com/digestive-disorders/tc/difficulty-swallowing-dysphagia-overview#1