Svelgning

Svelgning, also known as deglutition, is the biological process by which food and liquid are transported from the mouth to the stomach. It requires coordinated activity of the tongue, soft palate, pharyngeal constrictors, larynx, and the upper and lower esophageal sphincters, and is commonly described as occurring in three phases: oral, pharyngeal, and esophageal.

In the oral phase, the tongue and jaw prepare and propel a bolus, aided by saliva. This phase is voluntary. The pharyngeal phase is reflexive and rapid; the soft palate closes the nasopharynx, the larynx elevates and the epiglottis protects the airway, and the constrictors push the bolus through the pharynx. The esophageal phase involves peristaltic waves moving the bolus through the esophagus into the stomach via the lower esophageal sphincter.

Disorders of svelgning are collectively called dysphagia. They can arise from neurological disease (stroke, Parkinson’s disease, multiple sclerosis, dementia), muscular disorders, or structural problems such as tumors, strictures, or diverticula. Aging can also affect swallowing. Symptoms include coughing or choking during meals, a sensation of food sticking, regurgitation, excessive saliva, or weight loss.

Diagnosis often starts with a bedside assessment and may be followed by instrumental tests such as videofluoroscopic swallow study (VFSS) or fiberoptic endoscopic evaluation of swallowing (FEES). Treatment depends on cause and may include dietary modifications (thickened liquids, texture changes), swallowing therapy with specific maneuvers, medical or surgical management of underlying conditions, and strategies to reduce aspiration risk.

See also: deglutition, dysphagia, aspiration.