Choking while eating is the entry of food particles into the respiratory tract, causing an attack of painful coughing. The symptom occurs when the bulbar nuclei of the cranial nerves are damaged, the pathology of neuromuscular transmission of impulses, diseases of the digestive and respiratory systems. Neurological examination, electroneuromyography, MRI are necessary to establish the cause. In order to eliminate the symptoms, glucocorticoids and anticholinesterase drugs, methods of physiotherapy are prescribed.
Sometimes choking occurs in healthy people when talking while eating, but more often the disorder is provoked by pathological causes. A person has difficulty swallowing, food gets stuck in the throat, causing a feeling of "lump". Then part of the food particles enter the lumen of the larynx, which leads to an attack of severe coughing. If a large amount of food or liquid gets into the lumen of the respiratory tract, suffocation occurs.
A pronounced symptom occurs with bilateral damage to the nuclei of the caudal group of cranial nerves, which are responsible for the act of swallowing. Patients choke while drinking, self-feeding is impossible. There is no swallowing reflex, so saliva flows from the corners of the mouth. Choking is also due to atrophy of the muscles of the tongue, due to which patients are unable to chew food normally. The main diseases accompanied by bulbar syndrome:
Choking in myasthenia gravis is associated with weakness of the muscles of the larynx, which contributes to the free flow of food masses into the trachea and bronchi. The disorder is pathognomonic in the bulbar form of the disease - patients choke while eating and drinking liquids. Characterized by the variability of manifestations during the day, aggravation of symptoms after physical or mental overwork. Similar signs are determined in half of those suffering from a generalized form of myasthenia gravis.
Swallowing disorders are noted in the later stages of the disease, after the development of muscle weakness in the limbs. At first, choking on solid food is observed, with the progression of amyotrophic lateral sclerosis, patients constantly cough and choke while eating. The symptom is combined with a speech disorder, saliva usually accumulates in the mouth, which patients cannot swallow.
In this case, choking has no organic cause. Symptoms are due to dysfunction of the cerebral cortex and inappropriate behavior in severe mental disorders. Patients choke on both drinks and solid food, sometimes liquid flows out through the nose. At the same time, a painful paroxysmal cough begins, there is perspiration and discomfort in the throat.
Normally, a person swallows food on exhalation, when the airways are closed by the epiglottis and soft palate. In COPD, there is an indiscriminate contraction of the muscles of the pharynx and larynx, as a result, during the swallowing of food, a reflex inhalation occurs. An attack of severe coughing begins, which is associated with irritation of the larynx with pieces of food.
A neurologist examines patients with complaints of choking on food. Many causes are established already on the basis of carefully collected clinical data, so the doctor conducts a detailed examination with a check of tendon reflexes and an assessment of muscle tone. Further, specific diagnostic methods are assigned, the most informative of which are:
If the disorder bothers occasionally, due to the habit of talking while eating, specific therapy is not required. The appearance of regular choking during meals, as a result of which a person cannot eat normally, indicates a severe damage to the brain or other systems that requires qualified medical care.
Medical tactics is to eliminate or slow down the progression of the underlying disease that provoked choking. With myasthenia gravis, physiotherapy methods and massage are indicated to improve the functioning of the muscles. In difficult situations, when independent food intake is impossible, parenteral nutrition is provided. For etiotropic and pathogenetic treatment, drugs such as: