Chances are, you've experienced food "going down the wrong tube" at some point. Your near-choking experience is caused by malfunction of the epiglottis — the structure that prevents food or liquids from getting into the lungs.
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Typically, this causes a coughing fit and the food or liquid eventually finds its way into your esophagus to travel to your stomach, rather than continuing down your trachea to your lungs. The technical term for this uncomfortable occurrence is aspiration. In some cases, aspiration can lead to pneumonia.
The epiglottis is a flap of tissue that covers your trachea, or windpipe, while you eat to prevent food from entering your lungs.
Swallowing and Your Epiglottis
Although swallowing occurs frequently — 500 to 700 times per day, according to Speech Pathology Australia — you likely don't pay it much attention until something goes wrong. Although it might seem simple, swallowing is actually a complex process.
Swallowing occurs in three phases, as described by the University of Wisconsin Hospitals and Clinics Authority — the oral phase (preparatory and transit), pharyngeal and esophageal phases. Your epiglottis is the star of the show during the pharyngeal phase of swallowing.
Swallowing begins with oral preparation of your food. You have chewed your food and it has mixed with saliva. Next is oral transit, or movement of your food to the back of the mouth. This is primarily the job of your tongue.
The tongue first moves up and forward, contacting the roof of your mouth. It then moves backward, pushing the food toward your throat. The pharyngeal phase then begins as the food enters your upper throat.
At this point, the epiglottis closes off your trachea, or windpipe, to prevent food from traveling down the wrong tube. The flexible part of the roof in the back of your mouth elevates and the tongue moves further backward. This propels food down toward your esophagus.
During the esophageal, or final, phase of swallowing, the food enters your esophagus and moves down to your stomach as your throat muscles contract.
When Swallowing Goes Wrong
Occasionally, instead of swallowing your food, you might start to choke. This can occur if you're laughing while eating or don't chew your food enough, Most people automatically begin to cough, contracting abdominal muscles to force air upward to dislodge the stuck food.
In severe cases, coughing isn't enough to clear the food and blood supply to the brain remains cut off. According to Mayo Clinic, signs of choking include a weak or ineffective cough, squeaking sounds with attempted breathing, inability to talk, blue-tinted lips or nails, and eventually loss of consciousness. This is a medical emergency that requires immediate intervention.
Mayo Clinic recommends using the "five-and-five" approach — a term coined by the American Red Cross. Call 911 before performing this maneuver.
- Bend the adult over at the waist — the upper body should be parallel to the ground.
- Perform five back blows with the palm of your hand, directed between the shoulder blades.
- Stand behind the person and perform five abdominal thrusts.
- Wrapping your arms around the person, make a fist and position your hand so your thumb is just above the person's belly button.
- Wrap your opposite hand around your fist.
- Press hard into the abdomen, then upward in a quick movement.
- Perform five times. Alternate between five back blows and five abdominal thrusts until the food is dislodged.
Read more: How to Stop Coughing Without Medicine
Perform Strengthening Exercises for Choking
Frequent choking or difficulty swallowing can be a sign of a condition called dysphagia. Most often, this condition develops as a side effect of a neurological disorder or other diseases, such as a stroke, cerebral palsy, brain injury, Parkinson's disease or cancer, according to the National Institute on Deafness and Other Communication Disorders (NIDCD). It can also occur after throat surgery, or develop from damage to the esophagus or severe dental problems.
Adjust the position of your neck while eating can improve swallowing and help prevent food from entering the airway. According to a January 2016 article published by International Archives of Otorhinolaryngogoly, the chin-tuck maneuver can be used during swallowing to help compensate for a delay in the epiglottis covering your trachea. This maneuver involves tucking your chin to your chest while you swallow.
In some cases, strengthening exercises can help treat dysphagia, according to Johns Hopkins Medicine. These exercises target muscles around the larynx, or voice box. For best results, work with a speech-language pathologist — a healthcare provider who treats swallowing disorders.
Move 1: Supraglottic Swallow
- Sit up straight. Take a deep breath and hold it.
- Continue to hold your breath, and swallow.
- Cough immediately after swallowing.
- Repeat several times.
The supraglottic swallow is sometimes performed while eating to help prevent food from entering the trachea. After placing a small amount of food or liquid your mouth, breathe in deeply through the nose. Hold your breath as you swallow. Cough after swallowing to clear any residual food from the respiratory system.
Move 2: Super-Supraglottic Swallow
- Take a deep breath and hold it.
- Tighten your abs and bear down as if you are attempting to move your bowels.
- Swallow (while continuing to bear down and hold your breath).
- Cough after swallowing.
If you have high blood pressure, it might not be safe for you to bear down. Check with your doctor before performing these exercises.
Move 3: Breathe and Bear Down
- Breathe deeply and hold your breath.
- Bear down and hold for three seconds.
- Relax, then repeat several times.
Move 4: Use a Chair
- Sit up straight in a chair.
- Grab the edges of your chair with both hands.
- Take a deep breath and hold it as you pull up on the chair with your hands.
- As you continue to pull up on the chair, breathe out and say "ah" as you exhale.
Move 5: Turn Your Head
- Take a deep breath and hold it.
- Turn your head to the right as far as you comfortably can.
- Exhale while saying "ah."
- Return your head to the front and repeat, rotating your head to the left side.
- Speech Pathology Australia: "Swallowing Awareness Day"
- National Institute on Deafness and Other Communication Disorders: "Dysphagia"
- Johns Hopskins Medicine: "Swallowing Exercises: Closure of the Larynx Exercises"
- International Archives of Otorhinolaryngogoly: "Effectiveness of Chin-tuck Maneuver to Facilitate Swallowing in Neurologic Dysphagia"
- University of Wisconsin Hospitals and Clinics Authority: "Stages of Swallowing"