Swallowing is one of the most basic functions that mediates energy supply in the body. The act of swallowing, which enables the passage of food and fluids into the body, is vital. Emphasizing that swallowing is as essential for life as breathing, experts stated that the act of swallowing is performed 300 times in a 1-hour meal and drew attention to the dangers that may occur in swallowing disorders.
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Üsküdar University NPISTANBUL Hospital Neurology Specialist Prof. Dr. Sultan Tarlacı gave important information about swallowing disorders. "There are some functions in our body and we are not aware of most of them. Swallowing is an essential activity for life like breathing," said Prof. Dr. Sultan Tarlacı,
"Swallowing is one of the most basic functions that mediates energy by taking in nutrients from the outside, chewing them and transporting them to our stomach and from there to our intestine. Of course, this can be food or liquid. It somehow provides us with this and just as we are not aware of most of our actions, we are not aware of our swallowing in daily life; until it is disrupted."
We swallow 1,500 times a day
Pointing out that a person swallows 300 times during a 1-hour meal, Prof. Dr. Sultan Tarlacı,
"But people never think or count the 300 times they swallow. The saying 'life is in the throat' actually means that in order to maintain the integrity of the body, it is necessary to take in nutrients and this is done through swallowing. Somehow we get food into our bodies by chewing and swallowing. In daily life, we swallow almost 300 times during meals; but apart from that, we swallow up to 1500 times a day, and swallowing is such an essential thing that swallowing can occur in people even without consciousness."
An average of 35 muscles work in the act of swallowing
Üsküdar University NPISTANBUL Hospital Neurology Specialist Prof. Dr. Sultan Tarlacı stated that while swallowing; Nearly 35 muscles work in the larynx, under the jaw and including the muscles of the mouth, and continued his words as follows:
"Swallowing is a sweeping job. By wetting and softening the food we take into our mouths, we pump it backwards. There should be nothing left in the mouth after swallowing. But when the pumping is weak, food accumulates in the larynx, tongue root and cheeks. When the mouth is not cleaned sufficiently after swallowing, it leaks backwards and escapes into the trachea. Before, during and after swallowing, there may be escapes into the lungs. We call this 'aspiration'.
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Swallowing disorders cause severe infections
Normally, food should not go into the lungs. Food and saliva are chemical substances. When these substances get into the lungs, they can cause severe infections that we call pneumonia or pneumonia. This is the most important risk. These disorders can cause severe, non-healing pneumonia that can be life-threatening, especially in elderly patients."
Heimlich maneuver saves lives!
Prof. Dr. Tarlacı emphasized that in some cases, the escape of food into the trachea can be severe enough to cause suffocation and said, "For this reason, there is something called the 'Heimlich maneuver' in first aid. In this way, you try to remove the piece escaping from the person's lung."
"50 percent of dementia or Alzheimer's patients have malnutrition"
"Swallowing disorders are very common in neurology. Of course, this depends on the stage of the disease. Strokes can start with swallowing disorders. Almost half of the patients who have a stroke have swallowing disorders in the early period," said Üsküdar University NPISTANBUL Hospital Neurology Specialist Prof. Dr. Sultan Tarlacı,
"But luckily, the center of ingestion in the brain stem is bilateral and not easily affected. It is very resilient because it is essential for survival. But in the long term, this can change depending on the severity of the diseases. For example, in MS, swallowing disorder can develop as time passes and the disease progresses. Fifty percent of people with dementia or Alzheimer's disease have malnutrition. This can be in the form of weight loss, poor quality nutrition. But swallowing function can also deteriorate over the years. The patient's relatives usually need to control the nutrition plan and its content. But in very advanced stages, swallowing disorders do not only escape into the lungs and cause pneumonia. When there is malnutrition, the immune system is also weakened in these cases. A general state of weakness emerges. The tendency to infections increases. Swallowing disorders do not only kill or pose a danger by getting food into the lungs and causing pneumonia. It also causes serious harm indirectly. It even prolongs the duration of hospitalization," he warned.
"Swallowing is something that can be taught and learned"
"Under normal conditions, rehabilitation is very important for us. In other words, after a stroke, in severe diseases, when swallowing is impaired, when there are problems in other limbs, the first thing that comes to mind is physical therapy," Tarlacı said,
"But in general, when there is a swallowing disorder, there is a nihilistic approach in the society, also among physicians. 'We can't do anything for this anymore, it will stay like this, let's put a tube in, let it stay like this' etc... It is something that can be taught and learned in which position and in which foods the risk of escaping the breath is less. Therefore, it is necessary to take advantage of those opportunities. If the patient has a swallowing disorder, it is necessary to control the disease in a good way."
PEG increases the comfort of patient relatives
Prof. Dr. Sultan Tarlacı said that the patient with swallowing disorders should be checked by the departments of Otorhinolaryngology and Neurology:
"When Parkinson's, dementia and Alzheimer's diseases are very advanced, patients do not have the conditions that can be rehabilitated for swallowing disorders" and concluded her words as follows: "In general, we have a very difficult time convincing patients and their relatives on this issue. If a patient is unable to eat and take his/her medication, the quality of nutrition is probably low. In these cases, if the patient's condition is appropriate, then it is necessary to insert a PEG. We call PEG; a hole is made in the abdomen, a tube is inserted into the stomach and the patient is fed from outside. PEG provides many benefits to reduce the escape to the lung, to provide quality nutrition and to increase the comfort of the patient's relatives."
