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kilamangiro

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Learn about ALS
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Hi,

I have been having a feeling in my throat for the last couple of days, like there is a build up of phlegm or something, and i have become very aware of my swallowing, which definitely seems more difficult when i'm thinking about it. A few questions:

1. When i swallow a piece of food i sometimes feel it at the back of my throat and then i dry swallow again to get it down. My girlfriend says this is normal (i have been constantly at her with questions) but i'm worried she's just trying to calm me. Is this normal for everyone else.

2. When i eat sticky or crumbly food like chocolate bits of it stick to my palate. I have never noticed it before but i have read it was a sign of swallowing difficulties? Does anyone else get this?

3. When i have a very large amount of food in my mouth, i'll make one swallow and most of it will go down but then i'll have to swallow again to get rid of the rest. My girlfriend also says it's the same for her. Again i've read this is bad to find residue on your tongue or in your mouth after swallowing.

4. i have heard that with neurological causes, swallowing is more difficult with liquids than solids. Is this the case? I seem to be ok with water i can drink lots of it quite fast (though it does make a noise in my throat when it goes down that may or may not have been there)

5. How much can anxiety affect swallowing?


Thanks, and sorry if the questions seem trivial.
 
Hi, kilamangiro, I do have problems swallowing, and what you're describing is not what I've experienced.

You do voice the concern that it could be anxiety, and although I do not know what role anxiety actually plays in swallowing, it certainly would have some effect.

One easy way to put your mind at rest would be to schedule yourself to see an laryngologist. (an ENT doctor that focuses on the throat and voice) This doctor would be able to learn quite a bit about how your swallowing mechanism is functioning just by the exam, but can also order a modified barium swallow test.

This test is done with a speech therapist and radiologist. It is not a test that you can have done just anywhere, it would most likely involve going to a major teaching hospital.

You would start out swallowing small sips of barium that is as thin as water, and work your way up to yogurt/applesauce consistency. Also a cookie sandwich made up of graham crackers with the barium yogurt between them. The people that do this sort of testing are highly specialized, and will be able for certain to see if there is any delay that should not be there, or any weakness.

If you decide to go to a laryngologist, during the interim while you wait for your appointment, just know that its not just large mouthfuls of food, but any amount of food or liquid will partly be left behind in your mouth when you swallow if there is a problem. When you say the food sticks to your palate, you would see it not only there, but on your tongue, gums, insides of cheeks, teeth (I know, yuck!) And this is not just while you're eating, but later you might still have particles until you rinse your mouth out. Also, other conditions such as dry mouth will cause food to adhere to the inside of the mouth cavity.

take care, :smile:
 
Hi ... I have bulbar symptoms only so far, and swallowing is my biggest problem (bigger even than speech, which is just very annoying, not dangerous). My symptoms seem different than yours ... but every situation is different, I understand.

Don't have problems with food sticking to my palate, except peanut butter! :) ... possibly because I can only take in such tiny amounts at a time. But, small pills do stick to my tongue or cheek when I try to swallow them. The liquid goes down, but the pills stick.

My chewing problems started when I developed a constant dry mouth because my mouth drooped open (permanently, it appears), and I started doing mouth breathing all the time ... and a dry mouth makes chewing and swallowing harder. If you are breathing or eating with an open mouth, that could make it necessary to swallow several times to get a large mouthful down. (I understand that anxiety can cause people to start breathing differently ... more shallow breathing, mouth breathing, etc. ... so that's something to consider.)

A dry mouth is no longer much of a problem for me, because I can only sip tiny bits of liquid ... maybe a tablespoon max per swallow ... and eat tiny bites of soggy food. Can't swallow mixed mouthfuls at all (liquid and solid ... like breakfast cereal in milk) or large mouthfuls of ANYthing. If you are able to chew large mouthfuls and get them down in a couple of swallows, that should be encouraging, I think.

However, I agree that if you are concerned, you should have your swallowing checked by a specialist.

The big danger with swallowing is aspirating food/liquids into your airpipe. Choking and coughing spasms are the warning signs.

I am no expert on any of this ... just diagnosed 3 weeks ago, with symptoms going on 2 1/2 years now ... but don't remember symptoms quite like yours. But best to always check with a doctor if you suspect there is something wrong!

Good luck,
Beth
 
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