Chapter 10 Etiology and Risks of Swallowing Disorders

TABLE 10.1 Causes of Dysphagia Cause

Notes

Physical Obstructions Tumors

Physical abnormalities

Tumors of the pharynx and esophagus; commonly malignant Tumors of tissues surrounding pharynx and esophagus (unusual)

Structures of the esophagus; usually tied to Gastroesophageal Reflux Disease (GERD) Schatzki’s rings; benign, short narrowing at lower end of the esophagus Diseases of the esophagus Diverticula of pharynx or esophagus Congenital abnormalities of the esophagus

Physical Conditions Aging

Alzheimer’s disease Cleft lip and palate

Xerostomia (dry mouth) Diseases

Amyotrophic lateral sclerosis (ALS) or Lou Gehrig’s disease

Bell’s palsy

Degenerative diseases of the motor nerves

Gastroesophageal reflux disease (GERD)

Muscular dystrophies

Muscles in swallowing become weaker with aging and may cause problems in the elderly.

Abnormal development due to incomplete fusing of bones in the head resulting in gaps (clefts) in the palate and lip to nose area

Lack of adequate saliva

An incurable form of progressive neurodegeneration, the nerves in the spine and brain lose functionality progressively.

Weakness/paralysis of the muscles of the face due to malfunction of the facial nerve

Motor nerves in the brain impair swallowing by interfering with the control of skeletal muscle in the pharynx (eg, poliomyelitis [polio]).

Inflammation of the esophagus occurs when gastric acid from the stomach travels into the esophagus.

A group of inherited (genetic) diseases caused by abnormal proteins in skeletal muscle cells resulting in degeneration of the muscle cells and replacement with scar tissue or fat (eg, myotonic dystrophy, Duchenne muscular dystrophy, and Becker’s muscular dystrophy)

Multiple sclerosis (MS)

Myasthenia gravis (Goldflam disease)

Parkinson’s disease Scleroderma Stroke

Central nervous system is attacked by the immune system, destroying myelin, which protects the nerves.

Abnormal transmission of signals between motor nerves and the skeletal muscles; the pharynx may be affected.

A gradually progressive, degenerative neurological disorder that impairs motor skills, speech, writing, etc.

Chronic autoimmune disease causing the skin and connective tissues to tighten and harden progressively

Specifically, those affecting the swallowing center

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