Just like breathing or blinking, swallowing is an involuntary habit that we don’t often think about; however, swallowing is an important part of everything from speaking and socializing to consuming delicious food. Unfortunately, there are disorders that can affect a person’s ability to swallow. A swallowing disorder can be uncomfortable and troublesome, and a visit to an otolaryngologist can give you the answers you’re looking for as to what’s going on.
Some people having pain when they swallow while others may have trouble swallowing certain foods or feel as if there is something stuck in their throat. As a result, they may have trouble getting the proper nutrients and calories they need. Swallowing disorders are more common as a person ages. Swallowing disorders usually fit into one of two categories: esophageal and oropharnygeal dysphagia.
People who often feel like they have something in their throats are often dealing with esophageal dysphagia as a result of:
- Gastroesophageal reflux disorder (GERD)
- Esophageal spasms
- Achalasia (esophageal sphincter dysfunction)
- Scar tissue of the esophagus
- Certain medications that can cause dry mouth
There are certain conditions that can also affect how the muscles in the throat function, which makes it more difficult to swallow food properly. Common causes include neurological disorders, nerve damage (spinal cord or brain injuries) and cancers of the head, neck, and throat.
Along with trouble swallowing, those with swallowing disorders may also experience:
- Coughing after swallowing
- The sensation of food being stuck in the throat
- Sore throat
- Chest discomfort
If you experience persistent issues swallowing or if you also experience vomiting, regurgitation, or unexpected weight loss along with swallowing difficulties then it’s time to see an otolaryngologist.
Diagnosing Swallowing Disorders
To determine the cause of a patient’s swallowing problems their ENT doctor will go through their medical history, ask questions about the symptoms they are experiencing and then perform a physical examination. Based on the patient’s answers, your doctor will then determine which testing is needed to make a diagnosis. Common diagnostic tests include:
- Esophageal muscle test (manometry)
- CT scan
- Dynamic swallowing study
- Barium esophagram
- 24-hour pH impedance (to evaluate acid reflux and regurgitation)
Treating Swallowing Disorders
As you can see from the list above, there are many conditions and causes that could result in swallowing disorders. Therefore, the treatment you receive will depend on the cause and severity of your symptoms. Your ENT specialist will work with you to create an individualized treatment plan to reduce symptoms. With chronic conditions, your doctor will find ways to help you manage the underlying condition to make swallowing easier.
Contrary to what you might think, earwax is actually beneficial for protecting your ear from infection. It lubricates and keeps the ear canals clean of bacteria and dirt. Ears are typically self-cleaning, so you shouldn’t have to clean your ears regularly (and in some cases ever); however, sometimes your ears can use a little help. If you are dealing with an earwax blockage, or you are prone to blockages, you will most certainly want to turn to an otolaryngologist to find out the cause of these recurring blockages and ways to keep your ears clean.
Most people use cotton swabs when they clean their ears. The problem with this is that it often serves the opposite purpose, and just pushes the wax further into the ear canal. Using a cotton swab inside the ear can also lead to damage to the ear canal or eardrum. Again, if earwax buildup is a common problem for you this is something you should talk to your ENT doctor about. A simple rule to follow: Cotton swabs should be off limits for cleaning your ears.
Cleaning Your Ears at Home
If you are dealing with a blockage you may be able to remove the earwax yourself with these gentle measures. First, you will want to soften the wax. There are over-the-counter products with a special glycerin solution that can help to breakdown the wax. You can also choose to fill an eyedropper with baby oil or hydrogen peroxide and apply a couple of drops into the ear.
You will want to leave the oil in your ear for up to two days before squirting warm water into the ear canal using a rubber syringe. Again, this syringe can be found as part of an over-the-counter wax removal kit at your local drugstore. Once you have rinsed out the ear make sure to use a towel to dry the outer part of the ear only. If you are prone to ear infections you may want to use a blow dryer to gently dry the ear.
Since everyone’s ears are shaped a little differently this means that the cleaning method that works well for one person might not work as well for another. If you have excess buildup of earwax you may notice:
- Ear pain
- Fullness or ringing in the ears
- Muffled hearing
If you wear a hearing aid you may be prone to earwax buildup, so it’s important that you talk with your ENT doctor about ways to reduce your chances for developing impacted earwax. In some cases, doctors may recommend coming in every six months or once a year so they can remove excess earwax safely and effectively without causing damage to the ears.
Nosebleeds happen to most of us at some point during our lifetime. While it can be startling, nosebleeds are typically harmless and nothing to worry about. Of course, if you battle nosebleeds rather regularly you may be wondering what’s going on and whether you should turn to an otolaryngologist for an evaluation. Here’s what you should know about getting a nosebleed.
Common Causes of a Nosebleed
The blood vessels within our nose are very delicate, which means that they are prone to bursting and causing nosebleeds. Therefore, the two most common causes of nosebleeds are nose picking and dry air. Dry air can dry out the nasal passages, which leaves the area prone to infection and cracking.
Other causes include:
- Repeated nose blowing
- Broken nose
- Acute or chronic sinusitis (a sinus infection)
- Common cold
- Certain allergy medications (these medications can dry out the nose)
- Traumatic injury to the nose
- Deviated septum
- Bleeding disorders
- High altitude
- Excessive use of blood thinners or anti-inflammatory medications
There are two main types of nosebleeds: anterior and posterior. An anterior nosebleed is a bleed that originates in the septum of the nose (the wall that separates the two nasal passages). These nosebleeds are minor and can be treated with home care. If your child experiences nosebleeds an anterior nosebleed is usually the cause.
Posterior nosebleeds occur further back in the nose where the artery branches are located. This type of nosebleed is much heavier, occurs more often in adults and may require medical care. While rare, it is possible for a posterior nosebleed to be a sign of high blood pressure or a blood disorder (e.g. hemophilia).
When to See a Doctor
While most people will be able to treat a simple nosebleed on their own without having to seek medical care, it’s important to see a doctor right away if:
- Your nosebleed is affecting your ability to breath
- Bleeding lasts more than 20 minutes
- Your nosebleed is the result of a traumatic injury or accident
- There is a significant amount of blood
While it’s not considered an emergency situation, it is a good idea to talk with your ENT doctor if you or your child experiences nosebleeds often. During an evaluation an ear, nose and throat doctor can ask you questions about your symptoms, perform a quick examination of the nose and determine the underlying cause of your persistent nosebleeds.
If you are concerned about you or your child’s nosebleeds then it’s best to play it safe and to schedule an appointment with an otolaryngologist. Call our office today.
Cancer can grow anywhere in the body, even the head and neck. These cancers are twice as common among men and they are usually diagnosed in adults over 50 years old. The common types of head and neck cancer include:
- Oral cavity
- Oropharnygeal (in the throat or back of the mouth)
- Nasal cavity
- Paranasal sinus
- Laryngeal (in the voice box)
- Hypopharyngeal (behind or beside the voice box)
Most of the time people don’t find out that they have head and neck cancer until symptoms start to surface that warrant visiting the doctor. Sometimes a dentist may be able to pinpoint early changes during your routine dental cleanings; however, your doctor may send you to an otolaryngologist for a more comprehensive evaluation and diagnosis.
During your evaluation, an ENT doctor will ask you questions regarding your current health and any symptoms you are experiencing. From there, your doctor will determine the best tests to perform to detect head and neck cancer. These tests may include a physical examination of the head and neck, a CT or MRI scan, or a biopsy.
If you are diagnosed with head and neck cancer the first thing your doctor will want to do is determine what stage the cancer is (which simply means determining how far the cancer has spread). The stages let us know the extent of the cancer’s growth but also which organs have been affected or could soon be affected. Stages of cancer range from 0-4, with the lower stages indicating that the cancer hasn’t spread to other organs or isn’t spreading quickly.
Treating Head and Neck Cancer
Today, there are many treatment options for head and neck cancer and your doctor will be able to go through the different options to determine the right plan for you. The type of treatment or treatments you will receive will depend on the stage and location of your cancer.
Localized treatments such as surgery or radiation are used to treat only the cancer and do not affect the body as a whole, while systemic treatments such as chemo and targeted therapy drugs will affect the whole body. Systemic treatments are often used on patients with more advanced stages of cancer that have spread to other areas of the body.
Surgery may be recommended if the cancer isn’t in a difficult location in which to operate. Surgery can be performed to remove lymph nodes from the neck or to remove part or all of a structure such as the voice box or jawbone.
If you are noticing changes in your voice, an oral sore or lesion that doesn’t heal, or a mass in the head or neck region it’s a good idea to see your ear, nose, and throat doctor right away for a thorough examination. The sooner head and neck cancer is detected the better.
Also known as canker sores and ulcers, mouth sores usually result from bite injuries or allergic reactions. They can also be a symptom of an underlying health condition. Unlike cold sores, which are caused by the herpes simplex virus (HS1 and HS2) and develop on the lips and the skin around the mouth, non-Herpes related mouth sores can form on the gums, tongue, lips, the lining of the cheeks and throat. Canker sores are not contagious, and usually clear up on their own. They tend to be painful and can be treated with topical over the counter analgesics, mouthwashes and rinses. If mouth sores do not resolve on their own and last longer than three weeks, it may be necessary to seek treatment from an ear, nose and throat (ENT) doctor.
Common Causes of Mouth Ulcers and Canker Sores
Accidental biting is the most common cause, along with friction from toothbrushing, orthodontics or dentures. Diet can also play a role, in the form of food allergies to anything from coffee, chocolate and highly acidic foods and citrus fruits. Deficiencies of essential vitamins and minerals like folic acid, B12, iron, folate and zinc can also cause mouth ulcers. Sodium lauryl sulfate in toothpaste and oral bacteria like Helicobacter pylori (which is also responsible for stomach ulcers) can cause lesions in the mouth as well.
Lifestyle factors like smoking and elevated stress levels are another cause. Ulcers that persist for more than a few weeks, do not respond to self-care and over the counter treatments and are accompanied by additional symptoms like fever, excessive pain, swelling and difficulty eating and drinking, can be a sign of an underlying medical condition.
Schedule an appointment with an ENT (ear, nose and throat doctor) if you are experiencing any of the following symptoms:
- swollen lymph nodes
- difficulty swallowing or speaking
Is an Underlying Medical Condition Causing My Mouth Sores?
Persistent and chronic mouth sores can sometimes be a symptom of immune deficiencies or inflammatory conditions like lupus, Celiac, Behcet's and Chron's Disease. Contact an ear, nose and throat specialist (ENT) for more information on treatment options and symptom relief.
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