Swallowing: A Rube Goldberg Invention

I had a barium swallow test done last week. This is the second one I have had done and going forward the plan is to do them every two months to monitor the progress of the dilation procedures. One thing that this test along with my other research into swallowing has shown is that swallowing is way more complex than I ever realized. Aside from the whole chewing, swallowing, tongue movement and esophagus stuff there is also coordination between the throat muscles and one other minor thing, the epiglottis.

That last thing is one of the sources of my debris problems. BTW that now has a more formal name, nasal regurgitation. Personally I think they could have come up with a much better technical term for it, maybe something in Latin. Nasal regurgitation sounds like the punch line from a stand up comedian. Anyway I guess the way its supposed to work is that when you swallow the epiglottis moves down to cover the trachea and stays horizontal or even pointing a bit downward so whatever you are consuming doesn’t go down the windpipe and moves along on its merry way. What the test revealed is that the epiglottis (try saying that 10 times fast) just isn’t moving, instead it creates a pocket to gather some of the food stuff in there. When I cough it dislodges the particles but sends some up to my nose. My guess is that depending upon what I eat and how, i.e. with or without water or other lubricants (mayo for example) , determines how long things get stuck there and how much of a debris factor there is. This could explain why some things seem to be OK and others require a significant amount of coughing to dislodge.

At this point they really haven’t provided much info on how to change the way the epiglottis is behaving. From what I have been able to research there aren’t any muscle groups involved, it is just supposed to flop over when you swallow. Most likely strictures have formed from the radiation treatment so the question will be what, if any, means there are to deal with the strictures. Later this month I meet with the radiation doc and will see if he has any ideas. After that I will most likely get in touch with the ENT doctor to see what they suggest.