![]() ![]() Disorders of oral and pharyngeal swallowing are usually amenable to rehabilitative measures, which may include dietary modification and training in specific swallowing techniques. Manometry and endoscopy may also be necessary. The gag reflex is an essential tool but like any tool we need to know when to use it and when it can stay out of the way. A videofluorographic swallowing study is particularly useful for identifying the pathophysiology of a swallowing disorder and for empirically testing therapeutic and compensatory techniques. The Control the Gag Reflex session will focus on retraining your gag response to be more subtle and discerning. Supplemental studies are usually required. The physical examination should include the neck, mouth, oropharynx and larynx, and a neurologic examination should also be performed. A thorough history and a careful physical examination are important in the diagnosis and treatment of swallowing disorders. Impaired swallowing, or dysphagia, may occur because of a wide variety of structural or functional conditions, including stroke, cancer, neurologic disease and gastroesophageal reflux disease. By using a finger, the base of a kiddie toothbrush, spoon or small toy, pressure is pressed onto the front of the tongue, moving back slowly until a gag reflex occurs. These disorders may affect the oral preparatory, oral propulsive, pharyngeal and/or esophageal phases of swallowing. ![]() Swallowing disorders are common, especially in the elderly, and may cause dehydration, weight loss, aspiration pneumonia and airway obstruction. ![]()
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