Unusual Swallowing and Autonomic Symptoms

Dysphagia and Autonomic Dysfunction: What Links Them?

Unusual swallowing and autonomic symptoms are associated with various conditions affecting the nervous system and digestive function. Autonomic dysfunction, structural issues, and nerve damage can contribute to these issues.

What is Unusual Swallowing?

Dysphagia, or difficulty in swallowing, occurs due to issues with the neural control or structures associated with the swallowing process. This may include weakness in the cheek or tongue muscles, making it hard to move food down the throat. Stroke or cardiac arrest can affect the swallowing reflex. Additionally, oesophageal disorders or psychogenic factors can contribute to dysphagia.

Symptoms of Dysphagia

Here are a few symptoms of dysphagia, which can cause difficulties while having any meal.

• Odynophagia (painful swallowing)
• Coughing
• Choking
• Regurgitation
• Nasal regurgitation

If you do not take immediate care, dysphagia can lead to serious complications, such as:

• Increased risk of aspiration pneumonia
• Dehydration and malnutrition
• Choking
• Chronic lung disease

How is Dysphagia Linked to Autonomic Symptoms?

Autonomic dysfunction is often linked to dysphagia, as it can be a symptom of various autonomic disorders such as multiple system atrophy (MSA), Parkinson’s disease, and certain autoimmune conditions.

• Parkinson’s Disease : Parkinson’s disease exhibits non-motor symptoms, such as urinary issues and constipation. It can also manifest dysphagia, as there is an involvement of the autonomic nervous system.
• Multiple System Atrophy (MSA) : MSA exhibits a combination of symptoms, such as autonomic failure, Parkinsonism, or cerebellar syndrome. Dysphagia is a common and disabling symptom in MSA, and its early presence can be a diagnostic indicator.  
• Autoimmune Conditions : Certain autoimmune conditions, such as dermatomyositis and myasthenia gravis, can exhibit dysphagia, as these conditions cause problems in the somatic motor pathway. Recurrent autonomic dysfunction may play a role in the development of these swallowing difficulties.

Treatment for Dysphagia

Doctors treat dysphagia depending on the underlying cause and severity. Common treatments range from dietary modifications and swallowing therapy to medical interventions and surgical procedures.

The most common treatment options are as follows:

• Dietary Modifications : Doctors recommend adapting the consistency and texture of liquids and foods (puréed foods or thickened liquids). Consuming these foods can make swallowing easier and safer for patients suffering from dysphagia.
• Swallowing Therapy : Speech-language pathologists (SLPs) can teach exercises or different swallowing workouts to strengthen swallowing muscles and improve coordination. These are helpful for patients who are allergic to certain foods and medications.
• Medications : Medicines, like Botox or proton pump inhibitors, can manage GERD or acid reflux. Additionally, doctors prescribe certain antibiotics to patients suffering from swallowing difficulties. Antibiotics can eliminate other underlying throat-related conditions, such as strep throat or sore throat.
• Feeding Tubes : It can be beneficial in severe cases, when the patient cannot swallow anything. Sometimes, doctors provide feeding tubes to patients after a critical surgery to provide the essential nutrients and adequate hydration.
• Oesophageal Dilation : It is a surgical procedure that helps in widening the oesophagus if it becomes narrowed. This is done mainly to change the structural deformities inside the inner linings of the oesophagus. Additionally, a stent is sometimes used in surgeries to open a narrowed or partially blocked oesophagus.  
• Neurostimulation : Neurostimulation is done to improve swallowing function, as it modulates the brain’s activity or directly stimulates the swallowing muscles. Surgeons insert a sensory input into your brain, promoting neuroplasticity, strengthening neural pathways and contributing to swallowing.  

The oesophageal movement is under the somatic and autonomic nervous systems. Therefore, dysfunction in the autonomic nervous system can disrupt coordinated contractions of muscles involved in swallowing, causing dysphagia.