We have all had a moment when something went down the “wrong tube” during a meal. Accidentally inhaling a piece of food or taking in too much liquid at one time can land you in a coughing fit, temporarily gasping for air. Few people realize that the phenomenon of food or liquid going down the “wrong tube” can lead to a much more serious illness. But first, here is a look at the process:

To round out our quick anatomy lesson, the voice box, also called the larynx, sits at the opening of your trachea/airway. The only thing you want passing through your trachea is air. Resting directly behind your trachea is the esophagus, which empties whatever you consume into your stomach. In the event that something does go down the wrong tube (trachea), it can most likely be expelled by coughing. However, if you have trouble getting your muscles to move, this may pose a larger problem.

WHAT IS DYSPHAGIA?

Difficulty swallowing, also called dysphagia, is a disorder that many experience as a symptom of Parkinson’s disease (PD). Dysphagia can be present in any stage of the swallowing process, starting from the time the food or liquid touches the lips to the moment it enters the esophagus. Dysphagia can develop during any stage of Parkinson’s. Changes in swallowing should be reported right away.

HOW DOES DYSPHAGIA IMPACT PD?

Parkinson’s disease is a movement disorder. It progressively impacts the brain’s ability to transmit messages telling the body to move. In the case of dysphagia, difficulty initiating and following through with a swallow can be dangerous, causing food or liquid to fall into the airway before the swallow takes place. There are many factors that can cause or lead to dysphagia and one blog post cannot cover them all but here are a few things to look out for:

1. Do you have the sensation of food getting stuck in your throat?
2. Do you have a significant cough or increased coughing during meal times?
3. Do you have trouble keeping food and liquids in your mouth when eating a meal?
4. Do you experience freezing (suddenly unable to move) once you have placed something in your mouth?
5. Are you losing weight even though you are eating the same amount as before?

The questions above are a few that you would be asked during a swallowing assessment to determine your plan of care and how to keep you safe when you are eating. If you answered “yes” to any of the questions, you should consider addressing your symptoms with your treating physician.

WHAT IS ASPIRATION PNEUMONIA?

Most people do not have to think about the process of swallowing, but in the case of PD, it is vital to keep track if you have symptoms of swallowing difficulty. When a foreign object (i.e. anything other than air) enters the lungs, it is at risk for breeding infection. Infection in the lungs caused by a foreign object that is inhaled while eating is called aspiration pneumonia. In Respiratory problems in neurologic movement disorders, Mehanna and Jankovic state that “Aspiration pneumonia has been reported as the most frequent cause of death in PD patients, and it has been estimated to account for 70 % of the mortality.”

WHAT ARE THE NEXT STEPS?

If you believe that you may have a swallowing disorder, talk with your treating physician as soon as possible. Your physician can refer you for a swallowing assessment with a speech-language pathologist (SLP). An SLP will outline an individualized plan addressing your needs along with recommendations for improving and managing your symptoms.