Aphagia is the inability or refusal to swallow. The word is derived from the Ancient Greek prefix α, meaning "not" or "without," and the suffix φαγία, derived from the verb φαγεῖν, meaning "to eat." It is related to dysphagia which is difficulty swallowing (Greek prefix δυσ, dys, meaning difficult, or defective), and odynophagia, painful swallowing (from ὀδύνη, odyn(o), meaning "pain"). Aphagia may be temporary or long term, depending on the affected organ. It is an extreme, life-threatening case of dysphagia. Depending on the cause, untreated dysphagia may develop into aphagia. Behavioural classification
The following behavioural classifications result from studies performed on rats, in which lesions were made on the lateral hypothalamus region in the brain. Passive aphagia: An animal with passive aphagia will not respond to food if it is presented. However, if food is inserted into the mouth, the animal will chew. Active aphagia: Active aphagia is a complete rejection of food. The animal will physically push food away or move its head from it. One might first sample the food by smelling or tasting, then spit out anything in the mouth. Afterwards the animal will show a complete repulsion to the food. The animal reacts to food as if it is bitter or foul. Mixed aphagia: When presented with food, the animal initially does not react positively or negatively. However, when food is placed in the mouth, the animal demonstrates active aphagia, spitting out the food and refusing to eat thereafter.These studies point to the function of the hypothalamus in regulating food intake.
The tumour in thymoma associated disease is typically epithelial in nature. Facioscapulohumeral muscular dystrophy – even though there is not a clear correlation between the facioscapulohumeral muscular dystrophy and the pharyngeal and upper aesophageal striated muscle. Minor, and nonspecific, primary aesophageal dysmotility was present as seen in the 2008 study by Joerg-patrick Stübgen. Multiple sclerosis – may lead to aesophageal dysmotility Chemotherapy – radiation from cancer therapy may cause a stricture of the throat leading to the inability to swallow. Stroke – swallowing problems can cause stroke victims to aspirate food or liquid into the lungs and cause pneumonia mostly in elderly people. Parkinsons disease – the mechanism of swallowing disorders in Parkinsons disease may be related to extrapyramidal and autonomic system disorders. The cardinal symptoms of Parkinsons disease: tremor, bradykinesia, and rigidity are initially responsible for swallowing, which is mainly observed in the advanced stages of the disease
Damage to the lateral hypothalamus can also lead to aphagia, as seen in the 1978 study by Timothy Schallert and Ian Whishaw. Other causes might be due to depression, cervical spine disease and conversion disorders.It is important to note that all these causes (except due to the damage of the lateral hypothalamus) are indirect. Diagnosis
Modified barium swallow – videofluoroscopic swallow (fluoroscopy). A lateral video X-ray that provides objective information on bolus transport, safest consistency of bolus, and possible head positioning and maneuvers that may facilitate swallow function depending on each individuals anatomy and physiology.