|
When food gets stuck
BY JOAQUIN ORAMAS
SOME
people claim that they cannot swallow food because
it gets stuck in their esophagus, thus interrupting
its passage to the stomach.
These are cases of dysphagia, which is not an
illness as such, but instead a symptom characterized
by the non-painful sensation of food having
difficulty passing down the esophagus. It is
differentiated from odynophagia in which there is
pain in swallowing.
Many
people experience this condition as difficulty in
swallowing food or food getting stuck and not
advancing to the throat or beyond the sternum.
Swallowing depends on the perfect coordination of
diverse voluntary and involuntary muscle structures
of the tongue, pharynx, and esophagus. Three phases
can be distinguished: oral, pharyngeal and
esophageal. The first is voluntary and begins when
the food bolus is pushed back by the tongue which
presses against the palate. Upon reaching the
posterior part of the tongue the pharyngeal phase
begins in which the food bolus is transferred toward
the esophagus by way of the superior esophagus
sphincter. In this phase the larynx closes to
prevent the passage of food to the respiratory
tract. Upon arriving at the esophagus, the third
phase, food is transported by way of involuntary
rhythmic contractions of the esophagus muscles. From
there it reaches the stomach passing the inferior
esophagus sphincter.
Any
factor that alters this mechanism could trigger
symptoms of dysphagia.
Diverse general illnesses can also have an affect on
the esophagus producing a dysphagia, such is the
case with myasthenia gravis where there is a
disorder involving the organism’s striated muscles
which principally affects the first two phases of
swallowing.
There are two types of dysphagia, functional or
motor and organic or mechanical.
Functional dysphagia abruptly appears as difficulty
ingesting foods, solids as well as liquids
(non-selective), it has no specific location, does
not affect the general state of the person and lasts
for a determinant period of time, ceding
spontaneously. It manifests as disruptions in the
muscle contractions of the esophagus, as in
achalasia and diffused esophageal spasms.
Organic dysphagia, in contrast, appears in an
insidious and progressive form. It is selective; the
difficulty is first with solid foods, later
semisolids and then finally liquids. It is very
common for people to refer to a particular spot
where the food gets “stuck.” This type of dysphagia
is observed for example in esophagus cancer.
A
NEW ILLNESS
Frequent vomiting, difficulty swallowing or eating
disorders: if you experience any of these symptoms
you are in danger of suffering from a new illness
called eosinophilic esophagitis (EE). The New
England Journal of Medicine published a study
about the incidence of this condition in the United
States. Cases have also been recorded in Spain.
First detected at the end of the last century, this
condition affects more people than was initially
thought. According to the U.S. study, the number of
cases could be higher than other gastrointestinal
inflammatory disorders such as Crohn’s disease or
ulcerous colitis.
EE
is an emergent illness. Individuals have been
diagnosed with this infirmity in Switzerland,
Australia, Italy, Spain and the United States.
However, due to the scarcity of information
regarding this disorder many doctors do not detect
it or are unaware of the magnitude of this problem.
According to Dr. Lourdes Ruiz-Rebollo, of the
department of Gastroenterology at the Cormarcal
Hospital of Medina del Campo (Valladolid), it is a
rare condition. However, it is probably
under-diagnosed. "One of its symptoms is dysfagia
(difficulty swallowing) which is a frequent disorder
that could originate from this pathology in more
cases than suspected," she explained.
"Recently an article was published about a case
found during a hospital visit. It was a woman of 45
who, for a while, had thoracic pain and difficulty
swallowing. Initially I didn’t think of this
illness, but later, after doing a biopsy and
searching information we gave the diagnosis,"
commented Dr. Ruiz-Rebollo who published this case
in the journal Diseases of the Esophagus.
The
staff of the Cincinnati Children’s Hospital in Ohio
(U.S.) has examined patients with EE symptoms to
determine the incidence of the condition between
1991 and 2003. The results, with 315 cases, revealed
a higher incidence than expected.
These people responded to the diagnostic criteria
thus marking the presence of the new illness that is
being treated in several countries by specialists
who are dedicated to extending quality life to 120
years. |
