Food Bolus

The swallowing apparatus
Photo © A.D.A.M.

Definition: A bolus is a small, round mass of food that is formed when a piece of food is chewed, lubricated with saliva, and formed into a cohesive mass. It is held in the mouth, or oral cavity, until the onset of swallowing.  After swallowing, the bolus moves to the stomach where it is further broken down during the gastric digestion process. Bolus formation and its disintegration are important steps in the digestion process because it controls the rate by which food and nutrients are absorbed and released into the body.

The condition of the person chewing the food affects the formation of the food bolus. As a bolus enters the stomach, it will be stacked into the curvature of the stomach forming layers according to the density of the bolus. During the gastric digestion process, the bolus is chemically broken down by the acid and enzyme conditions of the gastric systems secretions.

The creation of the bolus is dependent upon four steps of oral processing. These steps include:

  • Moving the food from the front of the mouth to the teeth
  • Transporting the food to the back of the mouth to form a bolus
  • Moving the bolus to the back of the tongue for swallowing
  • Swallowing the bolus

Patients who have had a stroke may experience difficulty swallowing. This condition is known as dysphagia or, paralysis of the throat muscles. Patients with dysphagia have difficulty eating, drinking, breathing and taking medicine. It is not the same as painful swallowing or the feeling of having a lump in the throat.

Symptoms of Dysphagia

Patients with dysphagia may experience the following symptoms when trying to swallow:

  • Choking
  • Coughing or gagging
  • Liquid coming out of their nose
  • Food getting caught in the lungs
  • Weakened voice
  • Drooling
  • Lack of tongue control
  • Loss of gag reflex

Treatment of Dysphagia

Treatment of dysphagia involves therapy with the help of speech language, occupational or physical therapists.

Exercises of the tongue, lips, throat, and mouth will relax and strengthen the muscles and increase flexibility of the area. Posture changes, both standing and seated, as well as eating slower and with softer textured food are other methods to stimulate the nerves involved with swallowing. Other forms of treatment may include neuromuscular electrical stimulation (NMES) for those patients with aspiration or difficulty managing their diet. Medications to help open the throat and make swallowing easier may be prescribed. Thinner liquids, like water, are more difficult to swallow. Changing the thickness of liquids can be helpful.

If not adequately diagnosed and managed, dysphagia can lead to poor nutrition, pneumonia and further disability.

Continue Reading