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How to swallow water in big sips

Hello dear visitors of the forum!
I have the following problem: it is difficult to swallow any liquid in one sip (water, tea, soup, etc.). It is as if swallowing two times - I start to swallow normally, but in the middle of the process the muscles tighten and the liquid remains completely swallowed in the throat, then it is swallowed a second time and the liquid is swallowed completely. Because of this, I am forced to drink in small sips and the process takes a long time (I drink a cup of tea for about 20 minutes).
Examination by ENT did not reveal any throat abnormalities, now I am undergoing treatment by a physician (I think the reason for the violation is neurological), we have received injections of celebralesin, Petrova’s mixture (as general sedatives), and cytoflavin droppers. According to the prescription, I take anti-anxiety: phenozepam, haloperidol and cyclodol. But despite the abundance of drugs, there are no improvements in terms of swallowing, and this upsets. On the other hand, there is no alarm, there is no panic, there is no uncertainty, I swallow solid food normally, but there are still problems with the liquid.

The reason for this problem (it seems to me) was that 3 years ago I choked on wine, cleared my throat for a long time and was very afraid that I would suffocate. After this incident, problems began which I have been trying to get rid of last year.

Well, actually the question: has anyone encountered such a problem and what other drugs are most effective to use. Thank you all in advance for your answers.

Faced almost the same

Faced almost the same situation. Only the first time I can swallow, and when the muscles are tensed I can only spit it out. This has been going on for more than half a year. It all started with (it seems to me) that choked with mineral (carbonated) water (this was a year ago), began to choke, ate away. Then I choked on another 2 times (also began to choke, ate away). I swallow solid food without any problems. I noticed that iced liquid is swallowed much better. No matter how I tried, I did not solve the problem. This is very upsetting. When I come to visit someone, I can’t even drink tea, and it’s somehow not decent to refuse either. It's horrible.

Andrey, and in the morning you have a little better swallowing?

You general description of the drug

Have you read the description of the drug cyclodol? Do you have Parkinson's disease? Why do you need to be discharged? As far as I managed to study the issue of spasms in the throat (at one time they got me to the PA) in such cases antipsychotics help. You drink haloperidol, but maybe it doesn’t help you simply. In general, neuleptil helps with spasms in the throat. Only a dose MUST be prescribed by a doctor. With antipsychotics it is impossible differently. And then phenazepam is a tranquilizer, getting used to it. How much do you already drink? I think you need to find another doctor. This one has already planted so much chemistry for you, but no use. Your problem is actually not worth the eggs. I think she would have passed without any medication anyway. Or do you still have other problems (Pa, fear, anxiety.)?

And I also think you need

And I also think you need to start doing muscle relaxation exercises. Either this site has an NMR or Kurpatov in the book “Cure for Fear” also has an exercise (just with NMR you learn to gradually relax all the muscles of the body, but Kurpatov does it all at once). You will begin to exercise the muscles in the throat, too, will begin to relax.

Brief anatomy

In the process of normal swallowing, 26 muscles take part, all of them are innervated by 5 cranial nerves. Swallowing is divided into three phases:

  • The oral phase. This stage begins at the end of chewing food, when the food coma shifts to the level of the pharynx. It takes less than 1 second in time. It is the only component of swallowing that is consciously controlled by the cerebral cortex.
  • Pharyngeal phase. At this stage, soft palatine pharyngeal closure occurs, the larynx rises, protection of the respiratory tract and peristaltic movement of the breast down the throat, bypassing the level of the open cricoid pharyngeal muscle. The phase is controlled reflexively by the swallowing center located in the medulla oblongata. Its duration is less than 1 second.
  • Esophageal phase. It consists in the action of gravity together with a coordinated and progressive contraction of the muscles of the esophagus, the breast moves down to the gastroesophageal sphincter. It usually lasts 8-20 seconds.

Manifestations of dysphagia indicate a violation of the passage of food through the esophagus. In this case, swallowing does not cause a person any discomfort. But after it there is a “stop and stuck" lump in the throat, there is a feeling of fullness in the posterior sternum. In most cases, difficulty swallowing is not accompanied by pain, they are possible in the presence of a diffuse spasm of the esophagus.

The main signs of dysphagia are distinguished:

  • the movement of food into the esophagus in the area of ​​the pharynx is disrupted, a lump is thrown into the nose or mouth,
  • the feeling of suffocation is characteristic
  • there is a cough
  • saliva liberates abundantly,
  • the occurrence of aspiration pneumonia (inflammation of the lung tissue, resulting from the penetration of a foreign body into it),
  • it is impossible to swallow food completely or you have to put in a lot of effort.

As a rule, the symptoms of dysphagia are caused by the use of solid food, especially in the initial stages. Ingestion improves with water. It is usually much easier to take liquid food, although it happens that dysphagia is present even with simple swallowing of water.

Classification and Degrees

Regarding the localization of the pathological process, there are:

  1. Oropharyngeal (oropharyngeal) dysphagia - while there are difficulties in the transition of food from the pharynx to the esophagus. It develops due to pathologies of the pharyngeal muscles, peri-pharyngeal muscles or nervous diseases.
  2. Esophageal (esophageal) dysphagia - occurs due to the overlap of the lumen of the esophagus or impaired movement of its muscles. It is conditionally divided into lower, upper and middle.
  3. Cricofaringeal discoordination is an inconsistent contraction of the circular fibers of the upper esophageal sphincter.
  4. Dysphagia due to squeezing of the esophagus by large vessels passing nearby (aorta and its branches). It develops in the case of pathologies of these vessels.

There are also 4 degrees of the disease:

  1. It is difficult to swallow only solid food.
  2. It is impossible to consume solid food, with soft and semi-liquid at the same time there are no difficulties.
  3. A person is able to eat exclusively liquid food.
  4. Complete impossibility to perform the act of swallowing.

Dysphagia can occur due to a number of diseases:

  • Pharyngeal cancer or benign tumors. At the same time, in addition to difficulties with swallowing, discomfort in the throat appears, swallowing is accompanied by pain, which is given to the region of the ear.
  • Pharyngeal “pocket” - usually this pathology is congenital in nature, the mucous membrane protrudes and forms a pocket. It is accompanied by difficulties with swallowing, bad breath, a bulging bag is visible on the neck.
  • Stroke - in this case, dysphagia is accompanied by other signs: asymmetry of the muscles of the face, paralysis of the extremities, difficulty understanding or reproducing speech, confusion.
  • Encephalitis - dysphagia develops as a result of impaired consciousness (inadequacy, agitation or stopper), fever and other signs of brain damage: low blood pressure, impaired breathing.
  • Botulism - in this case, the patient has double vision, the person is not able to read the text, wide pupils are characteristic, which do not respond to light. It is usually accompanied by difficulty breathing. In the case of botulism, the pressure and temperature indicators do not change.
  • Myasthenia gravis - there is a weakness in the muscles of the face, it is difficult for a person to chew, weakness in the muscles of the hands and feet.
  • Parkinson's disease - here in the foreground are motor and mental disorders, characterized by the presence of tremor.
  • Multiple sclerosis - in addition to dysphagia, blurred vision, paresthesia, speech impairment, weakness of the upper and lower extremities, and cognitive impairment can occur.
  • Guillain-Barré syndrome - at the onset of the disease, the temperature rises, after - pain in the arms and legs appears. Then the range of motion in the limbs is reduced, and paralysis can develop, which rises from the legs up and captures the muscles of the chest and abdomen.

Lump in the Throat Syndrome

Complaints about the presence of a "coma" in the throat (or scientifically "Globus pharyngeus") are the most common when visiting an otolaryngologist. According to statistics, about 45% of all people experienced similar feelings. This syndrome was first studied as a manifestation of hysteria, but later it was found that psychiatric causes are found only in some of all patients with a “lump in the throat”.

This pathology develops due to several reasons:

  1. There is indeed a foreign body in the throat that interferes with swallowing. Sensations of a lump in the throat can provoke the appearance of edema of the tongue of the soft palate, formations or cysts, an increase in the palatine or reed tonsil. This case occurs infrequently and is very easily determined at a medical examination.
  2. There is a sensation of a foreign object, but in reality there is nothing in the throat. The most common case. Usually, reflux disease causes such sensations. Reflux is a back-cast of the contents of the stomach into the esophagus and throat. The “lump” is actually a spasm of the muscles of the pharynx provoked by the contents of the stomach (the latter burns the mucous membranes of the throat and esophagus due to increased acidity). In addition to “coma in the throat”, chronic pharyngitis may be present.
  3. Psychological reasons. Often difficulties with swallowing are observed after severe stressful situations, in a state of intense fear or excitement.

At the moment, the lump in the throat syndrome is not well understood, but, as a rule, it does not pose a threat to the patient's life. The causes that caused the development of the pathology are also usually easily eliminated. Of course, to identify the exact causes and prescribe the appropriate therapy should consult a doctor.

Nervous Dysphagia

Its other name is functional. It arises as a result of neuroses of various etiologies - that is, inorganic diseases of the nervous system. It can develop in childhood and adolescence, as well as in adults under 40 years old, in older men, the disease practically does not occur.

In children, neurosis occurs even at a very young age. At first, they are manifested by decreased appetite, frequent spitting up, vomiting, and disturbed sleep. At school age, such children have increased pain, thinness, intolerance to transport, poor appetite.

In adults, nervous dysphagia occurs for the first time due to a strong psycho-traumatic situation, characterized by choking with subsequent difficulty in inspiration. In this case, a person begins a panic attack.

Difficulty swallowing in children

The main causes of dysphagia in children are various pathologies of the nervous system, for example, such as cerebral palsy (especially high risks of this condition in case of paralysis of both arms and legs at the same time).

Very high risks are also observed in children suffering from athetosis (constant involuntary movements), which often differ in congenital nature. Perhaps the development of difficulties with swallowing and muscle diseases, in the case of a cleft spine, Arnold-Chiari anomaly. Congenital malformations of the esophagus and pharynx, Rossolimo-ankylosing spondylitis can lead to dysphagia.

Clinically, dysphagia in children is manifested by the following symptoms:

  • the baby consumes a very small amount of food,
  • takes breasts for a long time or consumes mixtures,
  • after drinking and eating, a cough occurs and the face turns red,
  • while feeding the neck and head are in an unusual position,
  • shortness of breath is possible, although it may not be very pronounced with a small amount of food falling into the trachea,
  • a mixture or milk appears on the nose.

It is worthwhile to beware in case of frequent pneumonia and bronchitis, the appearance of asthma, if close relatives do not suffer from it. All this can also indicate problems with the innervation of the esophagus.

Diagnostics

The diagnosis is established on the basis of a test with swallowing solid or liquid food. Further, it is necessary to conduct a series of studies with which the root cause of the development of dysphagia is identified, namely:

  • X-ray examination of the esophagus using a contrast medium (barium),
  • ultrasound diagnostics of the thyroid gland,
  • fibrogastroduodenoscopy,
  • magnetic resonance imaging of the brain.

It is mandatory to undergo an examination with an otolaryngologist.

First of all, in the course of treatment it is important to establish the reasons that provoked the appearance of pathology. Based on them, one or another type of therapy will already be prescribed. To ease the manifestations of the disease, various medications are used.

Also carry out a number of activities:

  • The patient is cleaned of the respiratory tract from food debris.
  • A light diet is prescribed, fatty, heavy foods, sodas, tea and coffee are excluded from the diet. It is recommended to use dairy products, cereals and soups. You should eat only at certain times. You can eat light varieties of meat and fish in the form of mashed potatoes.
  • Prescribe drugs that lower the acidity of the gastrointestinal tract and medications belonging to the group of antacid drugs.

In cases where dysphagia has arisen due to weakened muscles or their dysfunction, special exercises to restore muscle tone are prescribed to the patient.

In severe forms of the disease, they resort to surgical intervention, radiation therapy is carried out, the patency of the esophagus is expanded, endoscopic methods of biological and chemical effects on the affected areas of the digestive tract are used.

Complications

The consequences of dysphagia can be divided into social and psychological. Eating is a social action, and as a result of physical changes that make it difficult, taste sensations from eating food can be greatly reduced. Also, psychological problems arise, among which: a craving for solitude, a feeling of depression and anxiety. All this directly affects the quality of life of the patient.

Swallowing disorders can provoke various serious complications, including malnutrition, weight loss, dehydration, as a person can not take liquid and food in the quantities necessary to maintain a normal level of hydration and nutritional status.

In addition, often food due to aspiration is in the trachea, which can lead to acute pneumonia. Repeated manifestations of pneumonia can lead to chronic lung pathologies and even death.

Prevention

First of all, you should eat right, do not eat fatty, spicy foods too often, do not allow foreign bodies to enter the esophagus, this is especially true for children, carefully monitor bones (in meat and fish) while eating. It is important to prevent them from entering the gastrointestinal tract, you should not eat too hot food so as not to get burned.

Women should not often wear tight belts or corsets. It is necessary to constantly engage in physical exercises to maintain muscle tone, systematically undergo examinations for the presence of pathologies of the gastrointestinal tract, various formations. If you have the first symptoms of this condition, it is important to immediately seek medical help.

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