Swallowing Issues: When to Consult a Neurologist

Q: Swallowing Issues: When to Consult a Neurologist

Hello： The possible causes of the symptoms you mentioned are considered normal physiological phenomena. <br>The enhancement of sympathetic nervous system activity leads to decreased secretion from the salivary glands. <br>When food lacks moisture, it cannot effectively form a bol

About swallowing?

Hello, doctor.
Last time I noticed a small indentation on the sole of my foot, and I was too worried to visit a neurologist during this critical time.
The doctor told me it wasn't atrophy, and after listening to my medical history and performing a physical examination, he said my fascia was tight and that I have flat feet.
He advised me to switch to shoes that provide arch support and to stop wearing flip-flops.
I asked quite a few questions, and in the end, the doctor said, "Since the three doctors you've seen recently don't think there's any issue, try not to overthink it.
If something does come up later, we can address it then." However, I forgot to ask about my swallowing issue (I experienced a strange sensation while swallowing yesterday, which also occurred three months ago.
At that time, I was worried about myasthenia gravis, but the doctor said it was due to autonomic dysfunction, and it went away.
Now it has returned again last night).
I feel a bit regretful, and just now while eating the crust of a pizza, I found it difficult to chew.
It was easier to chew once saliva mixed in.
I'm not sure if there's a problem, and I'm uncertain whether I should go back to discuss this with the doctor.

xuesheng, 20~29 year old female. Ask Date: 2021/05/20

Dr. Jiang Junyi reply Neurology

Hello: The possible causes of the symptoms you mentioned are considered normal physiological phenomena.
The enhancement of sympathetic nervous system activity leads to decreased secretion from the salivary glands.
When food lacks moisture, it cannot effectively form a bolus, making it more difficult to chew and swallow.
Thank you for your inquiry! Wishing you good health and peace.
Dr.
Jiang Junyi, Taoyuan Medical Center, cares about you.

Reply Date: 2021/05/20

More Info

Swallowing issues can be concerning, especially when they occur intermittently and are accompanied by anxiety about underlying neurological conditions. Based on your description, it seems that you have experienced episodes of difficulty swallowing, which can be distressing. Given your previous concerns about conditions like myasthenia gravis and the recent advice from your neurologist, it is essential to approach this situation with a clear understanding of when to seek further medical evaluation.

Firstly, it’s important to recognize that swallowing difficulties, known as dysphagia, can arise from various causes, including neurological disorders, muscular issues, or even anxiety-related factors. Since you have already consulted a neurologist who has ruled out significant concerns, it may be beneficial to consider the context in which these swallowing difficulties occur. For instance, if they are linked to anxiety or stress, this could be a psychosomatic response rather than a direct neurological issue.

However, if you experience the following symptoms, it would be prudent to consult a neurologist or a specialist in swallowing disorders:
1. Persistent Difficulty: If the swallowing issues continue or worsen over time, it is crucial to seek further evaluation. Persistent dysphagia can lead to complications such as aspiration pneumonia or malnutrition.

2. Associated Symptoms: If you experience additional symptoms such as weight loss, coughing or choking while eating, or changes in voice quality (like hoarseness), these could indicate a more serious underlying condition that warrants further investigation.

3. Neurological Symptoms: If you notice other neurological symptoms such as weakness, numbness, or changes in coordination, it is essential to return to a neurologist for a comprehensive evaluation.

4. Anxiety and Stress: Given your mention of anxiety, it may be helpful to explore whether your swallowing difficulties are exacerbated by stress. Anxiety can manifest in physical symptoms, including muscle tension that may affect swallowing. Techniques such as cognitive-behavioral therapy (CBT) or mindfulness practices can be beneficial in managing anxiety.

5. Consultation with a Speech-Language Pathologist: A speech-language pathologist (SLP) specializes in swallowing disorders and can provide a thorough assessment of your swallowing function. They can also offer strategies and exercises to improve swallowing safety and efficiency.

6. Dietary Modifications: If you find certain textures or types of food challenging to swallow, consider modifying your diet. Soft foods or pureed options may be easier to manage while you seek further evaluation.

In summary, while your neurologist has indicated that there are no significant concerns at this time, it is essential to monitor your symptoms closely. If your swallowing difficulties persist or are accompanied by other concerning symptoms, do not hesitate to seek further medical advice. Additionally, addressing any underlying anxiety through appropriate therapeutic interventions can also be beneficial in managing your overall well-being. Remember, your health is paramount, and seeking clarity on any health concerns is always a wise decision.

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