Schlucken

Schlucken, or swallowing, is the coordinated act of moving a bolus from the mouth into the esophagus. It combines voluntary actions and reflexes to protect the airway and initiate digestion.

Deglutition involves four phases: oral preparatory, oral transport, pharyngeal, and esophageal. In the oral stages the tongue shapes and propels the bolus while the soft palate closes the nasopharynx and saliva lubricates. The pharyngeal phase is rapid and predominantly reflexive: the epiglottis retroflexes, the laryngeal inlet closes, and pharyngeal constrictors propel the bolus toward the upper esophageal sphincter, which relaxes to admit it. The esophageal phase uses peristaltic waves to move content into the stomach. Neural control is distributed between brainstem swallow centers and cortical input, with cranial nerves V, VII, IX, X, and XII coordinating the muscles involved.

Disorders of swallowing, or dysphagia, impair safety and nutrition and are common after stroke, in neurodegenerative diseases, cancer, or with aging. Symptoms include coughing or choking during meals, prolonged meals, or recurrent chest infections from aspiration. Evaluation typically uses imaging or endoscopy, such as videofluoroscopic swallow studies (VFSS) or fiberoptic endoscopic evaluation of swallow (FEES). Management combines swallowing therapy, dietary modification, compensatory techniques (for example positional changes), and treatment of underlying conditions when possible.