Swallowing is a process that many of us take for granted. We have been swallowing from the time of birth and is a reflex action when eating or drinking. Swallowing also occurs when saliva or mucus accumulates in the mouth and this is normal. However, there are cases where swallowing can be repetitive. This constant swallowing may be related to medical conditions and in these instances the repetitive swallowing is a sign of some underlying problem.
Why Do We Swallow?
The swallow reflex is a mechanism by which the body pushes the contents of the mouth down into the gut. The medical term for swallowing is deglutition and there are three stages to this mechanism. The first stage, known as the oral stage, occurs in the mouth and is under voluntary control. In other words this is where we consciously choose to swallow and can control the actions of this stage.
The next two stages are the pharyngeal and esophageal stages respectively. These stages are involuntary which means it cannot be consciously controlled by a person. Instead reflex actions coordinate these stages. In the pharyngeal stage, food or fluid is pushed down the throat. In the esophageal stage, the transit is through the esophagus (food pipe) until the food or fluid reach the stomach.
Read more on swallowing.
Swallowing is a carefully coordinated process by nerves that stimulate muscles in a way which pushes food and fluid from the mouth to the stomach. It is only necessary when it is initiated by a person as a means to push food, fluid, saliva, mucus or other substances like pills down the throat. Any reason for saliva to accumulate in the mouth will also trigger swallowing even without eating or drinking.
There swallowing assist and expedites the movement of the mouth contents down the throat. It also flushes the mouth of its contents which could be potential causes of choking should the food or fluid enter the lower airways. However, there are cases where this is down repetitively either consciously or it can occur involuntarily due to certain conditions or diseases.
Causes of Constant Swallowing
Most of the conditions that can cause constant swallowing involve the mouth, throat and/or esophagus. It is important to differentiate when constant swallowing is a possible symptom of some underlying condition. Usually there are other signs and symptoms. Medical attention must be sought. While non-stop swallowing can occur in the absence of any disease, it can in rare instances be linked to serious and even life-threatening conditions.
Whether it is gum, tobacco or some other substance, there will be a constant need to swallow due to this repetitive chewing. Saliva production is stimulated by chewing. In fact salivation is stimulated by the presence of any foreign object in the mouth even without the chewing action.
As a result, swallowing occurs to remove this excess saliva in the mouth. While people who chew tobacco or other substances like areca (betel) nut may occasionally spit out the excess salive, some of the saliva that is secreted is still swallowed. The swallowing can also become habitual even when not chewing anything.
Post Nasal Drip
A common cause of constant swallowing is post nasal drip. This is where excess nasal mucus drains down the back of the throat. Nasal mucus is not unusual. The nose produces mucus throughout the day to moisten the nasal passages and trap dust or other substances that enter the nasal passages.
Normally this mucus drains down the back of the throat undetected. However, when it is excessive like in post nasal drip then it can irritate the throat, cause a cough and lead to constant swallowing. Post nasal drip occurs with colds, the flu, allergies, sinusitis, certain medication or food, change in weather and airborne irritants.
The amount of saliva that is secreted by the salivary glands in a day varies but it can be as much as 50 ounces (1.5 liters). Most saliva is swallowed unless it is consciously spat out. This swallowing occurs occasionally during the day particularly when drinking, eating or talking.
However, if there is excessive saliva secretion (hypersalivation) then swallowing will occur more frequently. Hypersalivation occurs for several reasons due to poorly fitting dentures, nausea, acid reflux, throat infections, mouth ulcers, mouth pain, dental problems, poisonous substances and certain infections like tuberculosis (TB).
Read more on excessive saliva.
Gastroesophageal Reflux Disease
Gastroesophageal reflux disease (GERD) is another common cause of repetitive swallowing. This occurs for two reasons. When the stomach acid rises up into the esophagus, swallowing is triggered in an attempt to push back the acid into the stomach. This is a reflex action.
The salivary glands also secrete large amounts of saliva in response to the rising stomach acid. Since saliva is alkaline, this is an attempt to neutralize some of the acid in the esophagus. This excess saliva is known as water brash. Swallowing occurs as a result as explained under hypersalivation.
Read more on chest pain when swallowing.
- Globus pharyngeus is the sensation of a lump or object in the throat despite the absence of any mass or substance. Constant swallowing may occur as the body attempts to clear the throat.
- Dysphagia (difficulty swallowing) occurs for several reasons and may trigger repetitive swallowing partly in an attempt to facilitate the movement of food and fluid down the throat or esophagus.
- Nerve disorders involving the nerves that control swallowing can also lead to constant swallowing despite not eating or drinking.
- Muscle disorders that involve the muscles of the throat or esophagus can also lead to repetitive swallowing. This may also involve spasms of the muscles in conditions like cricopharyngeal spasms or esophageal spasms.
- Pain can also trigger premature and sometimes repetitive swallowing. This may be linked to excessive salivation that can occur with pain but is also an unconscious response to pain, similar to clenching the teeth.
- Anxiety, agitation or psychological stress may also lead to constant swallowing. It may also arise with excessive salivation which in turn contributes to constant swallowing. However, it may be a secondary response to an altered mental state similar to the way it may occur in pain.