Difficoltà a deglutire: tutte le cause di disfagia

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Si parla di disfagia, quando alimenti e / o liquidi non si muovono normalmente dalla gola (faringe) allo stomaco e non va confusa con la sensazione di un “groppo in gola”: può essere molto pericolosa perché può indurre ad inalare il cibo o l’acqua e quindi non solo a provocare soffocamento, ma anche a sviluppare una polmonite acuta da aspirazione. Senza contare che se la disfagia è cronica, è probabile andare incontro a malnutrizione.

 

disfagia difficile deglutire cause


Cause della disfagia

Ma quali sono dunque le cause di questa condizione? Sebbene la maggior parte delle persone ritengano la deglutizione come un processo fisiologico, automatico, così non è: in essa interagisce il cervello con tanti muscoli della gola e dell’esofago. Se si altera uno di questi 3 componenti, la deglutizione può diventare complicata. Le cause dunque possono essere divise in tre grandi aree:

• Disturbi del cervello o del sistema nervoso

E’ il caso della malattia di Parkinson, dell’ictus, della SLA (Sclerosi Laterale Amiotrofica) o della Sclerosi Multipla.

• Disturbi dei muscoli in generale

Disturbi muscolari generali che causano difficoltà di deglutizione sono miastenia gravis, dermatomiosite e distrofia muscolare.

• Disturbi dell’esofago (un blocco fisico o un disordine della motilità )

Un blocco fisico può derivare da un tumore dell’esofago, strati di tessuto anomalo al suo interno, cicatrizzazione da reflusso acido cronico o consecutiva alla deglutizione di un liquido caustico. Talvolta l’esofago è compresso da un organo vicino come la ghiandola della tiroide ingrandita, un rigonfiamento nella grande arteria del torace (aneurisma aortico), o un tumore toracico.
Disturbi della motilità esofagea comprendono l’acalasia (in cui le contrazioni ritmiche dell’esofago sono notevolmente diminuite e il muscolo esofageo inferiore non si rilassa come dovrebbe per consentire al cibo di passare nello stomaco) e lo spasmo esofageo. La sclerosi sistemica (sclerodermia) può anche causare un disturbo della motilità.

Da sapere in caso di disfagia (difficoltà di deglutizione)

Non ogni episodio di disfagia richiede una valutazione immediata del medico. Le seguenti informazioni possono aiutare le persone a decidere quando è necessaria. Nelle persone con disfagia, alcuni sintomi devono essere motivo di preoccupazione. Essi comprendono
• I sintomi di un blocco fisico completo (come bava o incapacità a deglutire nulla)
• La disfagia con conseguente perdita di peso
• Deglutizione dolorosa (odinofagia)
• Tosse o senso di soffocamento ogni volta che si inghiottisce qualcosa
• Una disfagia correlata ad un nuovo disturbo del sistema nervoso, del midollo spinale o cerebrale

Cosa fare in caso di disfagia, esiste una cura?

Il modo migliore per trattare la disfagia è quello di individuare e cercare di curare per quanto possibile la causa specifica, oppure di controllare il sintomo. Per contribuire ad alleviare il problema, di base, i medici consigliano di assumere il cibo con piccoli morsi e masticare bene.

Le persone con disfagia provocata da un ictus possono trarre beneficio dal trattamento da uno specialista della riabilitazione. Provvedimenti possono comportare un cambio di posizione della testa mentre si mangia, (ad esempio abbassando il mento verso il petto al momento della deglutizione), di riqualificazione dei muscoli dell’esofago, facendo esercizi che migliorano la capacità di ospitare un pezzo di cibo in bocca, o fare esercizi per la forza e coordinazione della lingua.
I pazienti che non possono deglutire senza un elevato rischio di soffocamento potrebbero avere la necessità di smettere di mangiare e bere ed essere alimentate esclusivamente attraverso un sondino inserito nello stomaco o nell’intestino tenue.
Chi non riesce a deglutire i liquidi, può addensarli con determinati prodotti, o utilizzare gel appositi.

 

Foto: Thinkstock

 

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