Gag reflexes and Swallowing

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bilphi

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Sep 16, 2007
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17
Reason
PALS
Diagnosis
09/2004
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US
State
MN
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ER
I originally posted this inside a thread and got no response, so I'm starting a new thread.

I'm wondering if anyone else out there has lost their gag reflexes? I haven't had any for quite some time. I asked my neuro about it and he said he didn't know. On some web sites they mention gag reflexes but it's very vague.

Another question I have is those of you who have trouble swallowing, how did it start? My neuro says I'll have trouble drinking water but I don't. I do have to swallow everything two or three times before it goes down, and it seems to be getting worse. I'm just curious what the rest of you have experienced.

Bill
 
hi bill

in pls the gag reflex would tend to be hyperactive,i could not comment on loss of gag reflex.
like you about 2yrs ago i started having trouble swallowing,it is like there is a delayed reaction at the top of the throat and when you swallow not everything goes down at once.
this leaves food still left and the need to swallow a few times with each mouthfull,i am sure there must be a weakness issue here.
this has developed from odd times to more regular occurance.
i have only chocked odd times in the past but lately this is getting more regular.
last week some food went down the wrong way and got stuck in the middle of my throat,i could not breathe and was choking so badly my son had to help.
it was only by vomiting from the choking that the obstruction was cleared,this was the worst case i have had.
unfortunatly with bulbar progression these things are going to happen ,a speech therapist can help by giving advice on any eating or swallowing problems.
hope this helps a little:smile:
 
Hi, Bill ...

I seem to have lost my gag reflex, too. It was very intense for a long time after all this started ... if the doctor would put one of those little wood sticks in my mouth, I'd jump out of the chair. Dental work was impossible, as anything in my mouth would trigger it. Now, it's completely gone!

On chewing and swallowing, pull up a chair and relax ... this issue has more twists and turns than a Hitchcock movie.

6 months after the slurred speech started, I had big trouble chewing because of a constantly dry mouth.
6 months after that, my saliva returned (did it ever!), and I began having trouble swallowing liquids. (They would go down the wrong way.)

Along the way to now, I experienced a LOT of "spitting out" when I put anything in my mouth. It was like projectile vomiting, only it was just the liquid or solid I had just taken in. My conclusion is that this was part of the intense gag reflex I had at that time. Before I even had time to swallow or chew, it would spew out all over the computer screen, or the dinner table, etc. It was really hard to sneak food or liquids past the gag. This is when I gave up eating with others!

This has stopped now, and my gag reflex is kaput. BUT ...

What I have now (and have for quite a while), is delayed swallowing. It can take up to 5 mintues for me to initiate a swallow, and if I am trying to swallow a pill, the pill will usually be half-dissolved by then. Also, my mouth droops open to the right all the time, so it is hard to keep liquids in my mouth long enough for the swallow muscles to work. Making it worse, is that I have NO lip seal left ... that's the ability to close your lips tightly enough to keep liquids in. My tongue is no longer functioning, so if I want to move food around in my mouth, it takes fingers.

The last issue is chewing. Have you ever seen a dog chew peanut butter? They will chew and chew and chew ... that's me. I started timing myself, after I realized one day that it took me 50 minutes to eat two pieces of toast. I take a normal size bite, and chew, chew, chew ... and nothing happens. I have a soggy mass in my mouth, but my mouth has no intention of swallowing it. I spent 7 minutes on one bite the other night, then said "the hell with this" and spit the bite out and threw away the rest of the dish. (Except I can't spit any more ... have to just hang over the sink and let things fall out.)

But, oddly, I DO NOT have big problems swallowing water (or Diet Coke :)) any more, other than the lip seal problem and the delay.

Stay strong with your neuros ... even the best of them have habits of mind and will tell patients what symptoms they "should" have. Be very explicit about your symptoms, even if the neuros want to contradict you. YOU are the expert on your body. Everyone is SO different, the cookie-cutter approach doesn't work.

Good luck. Hope this didn't gross you out too badly!
 
Add me to the non existent gag reflex. I, too, had a hard time when the dentist took x-rays. It doesn't bother me anymore. I can touch the back of my throat without any gagging whatsoever.

I occasionally have a delayed swallow. I 'try' but nothing is happening. It's a little bit scary.

Ronda
 
Some of you are talking Hyper Gag Reflex and some are talking loss of Gag reflex .these are worlds apart
Hyper gag Reflex is Typical Upper Motor Neuron .Loss of Gag reflex is more Lower Motor Neuron ,This has to do with the Epiglottis and the Orapharygeal Muscles .Epiglottis is the little Flap that opens and closes when swallowing to keep Liquids out of the Lungs .The nerves around the Epiglottis sense something is at or about to get in the Lungs ,this is why you clear your throat when theres Phlem present there . Geo
 
Thank all of you for your replies. It has been quite some time I haven't had gag reflexes and like I said most web sites are vague about whether a lack of gag reflex is the norm or hyper gag reflexes. It seems like this disease is totally random as far as symptoms go.

I don't know how much even neuros know about the disease. They can't even agree that PLS exists. It's frustrating, but I'm sure you all feel the same.

Bill
 
That is a great explanation Geo.. and Olly.. That is so spot on... Thanks for clearing it up.
 
Well it didn't clear it up for me. :-?

Ronda
 
Get a Clue dear, Non Existent means None, Hyper Means Too Much of, As Hypo Means Little or None . Like Hypo Glycemia is too little of Sugar or sweets ,Hyper is too much Sweets or Sugars When the dentist Did your Exrays he or she problably hit the nerve that causes the gag reflex ,usually in the back of the mouth or on the Soft Palate . Get A Clue .Geo
 
Ronda, welcome to the forum. As you'll see, we have a variety of characters here, but we do our best to help each other out in our own ways.

Let us know any questions you have. Please feel free to share your concerns with us ...
 
Ronda,

I have to echo what BethU said, there are all kinds of different people contributing to this blog. This is what makes it interesting.

I never experienced hyper gag reflexes, mine just came up missing one day. I can diddle with that little hangy-down thing in the back of my throat and nothing happens. As I said my neuro said he didn't know what caused the lack of gag reflexes......he didn't seem concerned, but it certainly seems alarming to me. God must have put them there for a reason.....
 
I taught college Kids and I always taught them that if something was Hyper it was like a Hyperactive person...Super quick.. And hypo like a Hippo- slow... Also told them that ateries went away from the heart with the A.. Veins to the heart. I had all kinds of little silly things.. Again Hyper is a UMN symptom. Hypo Lower motor neuron symptom..
 
Very Well Put .Hoping .Geo
 
All I know is that brushing my teeth makes me gag. Has for years. Tried different paste, gels, powder. Stick a toothbrush in there, work up a foam, here comes the retching. Not fun at all, no matter what you want to call it.

AL.
 
al

that is so me,i think its more the frothy foam that makes you gag.
geo and hoping are both correct,it is the epiglottis or dangley thing at the back of the throat that effects the gag reflex.
in my origional post i said i could not comment,not that i did not know but i did not want to scare anyone of having possible lmn involvement.
if you find you loose your gag reflex you need a emg to verify any bulbar lmn involvement.
 
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