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    Glossary of Feeding Terms

    Here are two glossaries of medical and behavioral terms frequently associated with feeding disorders.

    Medical and Gastroenterology Terminology

    Aerophagia

    The swallowing of air. This may be done voluntarily to stimulate belching, accidentally during rapid eating or drinking, or as a habit. It is a common cause of gas in the stomach and belching. Everyone swallows small amounts of air when eating or drinking. However, rapid eating or drinking, reflux or crying may cause a significant increase in swallowed air in children.

    Aspiration

    Inhalation of residual bolus particles or refluxed stomach contents into the airway after the swallow.

    Barium Swallow Study and Upper GI Series

    Diagnostic studies performed in the workup of dysphagia. The patient is asked to swallow liquid barium or food dipped in barium. The movement of the bolus is then observed fluoroscopically and recorded on X-ray film or videotape. The process of swallowing is recorded from initiation to completion, which provides visual information about the pre-esophageal swallowing function, the nature of peristaltic activity and the presence of gastroesophageal reflux, and information about the anatomy of the esophagus and pharynx. Since the entire upper gastrointestinal tract can be examined during this test, the procedure is sometimes called esophagogastroduodenoscopy (EGD).

    Cerebral Palsy

    A developmental abnormality of the brain resulting in weakness and uncoordination of the limbs, and delayed development. The brain abnormality may be caused by injury during birth, hemorrhage, delayed development, lack of oxygen before birth, meningitis or viral infection.

    Cystic Fibrosis

    A hereditary disease affecting the exocrine glands, including mucus-secreting glands, sweat glands, etc. The abnormality results in the production of thick mucus, which obstructs the intestinal glands, pancreas and bronchi. Respiratory infections, which may be severe, are a common complication. Also, children with CF are likely to have difficulties with malabsorption and need to consume many more calories a day than is typical.

    Dysphagia

    Refers to the feeling of difficulty passing food or liquid from the mouth to the stomach. It is a condition in which the act of swallowing is difficult or painful. It includes the inability to initiate swallowing and/or the sensation that the swallowed solids or liquids are stuck in the esophagus. It is caused by painful conditions of the mouth and throat, obstruction of the pharynx or esophagus, or by abnormalities of pharyngeal/esophageal muscles that typically facilitate swallowing.

    Emesis

    Vomited stomach contents.

    Epiglottis – A flap of cartilage located in the throat behind the tongue and in front of the larynx. The epiglottis is usually upright at rest allowing air to pass into the larynx and lungs. When a person swallows, the epiglottis folds backward to cover the entrance of the larynx so food and liquid do not enter the windpipe and lungs. After swallowing, the epiglottis returns to its original upright position.

    Esophagitis

    Esophageal inflammation of the mucosal lining caused by refluxed material from the stomach. It may result in destruction of the mucosal lining of the esophagus. When stomach acid and digestive enzymes repeatedly reflux into the esophagus, the tissues become inflamed and ulcerated. This inflammation is known as esophagitis. When the inflammation is severe, esophageal ulcers can develop.

    Esophagus

    A muscular tube that extends from the pharynx to the stomach. It is lined with mucous membrane, whose secretions lubricate food as it passes from the mouth to the stomach. Waves of peristalsis (contraction of muscle) assist the food in passing along the esophagus. The esophagus begins as an extension of the pharynx in the back of the oral cavity. It then courses down the neck next to the trachea, through the thoracic cavity and penetrates the diaphragm to connect with the stomach in the abdominal cavity.

    Failure to Thrive

    Describes a condition rather than a specific disease. Children who fail to thrive don't receive or are unable to take in, retain or utilize the calories needed to gain weight and grow as expected. Most diagnoses of failure to thrive are made in infants and toddlers in the first few years of life, a crucial period of physical and mental development. Poor nutrition during this period can have significant effects on a child's development. Failure to thrive can result from a wide variety of underlying causes. Some children fail to thrive due to social factors, conditions involving the gastrointestinal system, malabsorptive disorders, a chronic illness or medical disorder, an intolerance of milk protein, infections and metabolic disorders. Doctors diagnose failure to thrive by using standard growth charts to plot the child's weight, length and head circumference, which are measured at each well- baby exam. Children who fall below a certain weight range for their age or who are failing to gain weight at the expected rate will likely be evaluated further to determine if there's a problem.

    Gastric Emptying Study

    A procedure done by nuclear medicine physicians that measures the emptying of food from the stomach. It is used to diagnose abnormal emptying of food from the stomach. The study usually is done when a patient has continued nausea and vomiting, signs that the stomach is not emptying normally.

    Gastritis

    Inflamation of the stomach. It means that white blood cells move into the wall of the stomach as a response to some type of injury. Gastritis does not mean there is an ulcer or cancer. It is simply inflammation, either acute or chronic. The symptoms of gastritis depend on how acute it is and how long it has been present. In the acute phase, there may be pain or gnawing in the upper abdomen, nausea and vomiting. In the chronic phase, the pain may be dull and there may be loss of appetite with a feeling of fullness after several bites of food. Very often, there are no symptoms at all. If the pain is severe, there may be an ulcer as well as gastritis.

    Gastroenterology

    The study of gastrointestinal disorders and diseases, which may involve any part of the digestive tract and the liver, biliary tract and pancreas.

    Gastroesophageal Reflux Disease (GERD)

    A backflow of acid from the stomach into the swallowing tube or esophagus. This acid can irritate and sometimes damage the delicate lining on the inside of the esophagus. Almost everyone experiences gastroesophageal reflux at some time. The usual symptom is heartburn, an uncomfortable burning sensation behind the breastbone, most commonly occurring after a meal. In some individuals, this reflux is frequent or severe enough to cause more significant problems. Gastroesophageal reflux disease is a clinical condition that occurs when reflux of stomach acid into the esophagus is severe enough to impact the patient's life or damage the esophagus.

    Gastrostomy Tube (G Tube)

    A surgical incision in the wall of the stomach so a tube can pass from it to the abdominal wall. Nutritional and fluid needs are provided through the tube when swallowing is impossible, oral intake would cause medical complications or there is esophageal disease or obstruction. There are different types of gastrostomy tubes such as a Mickey, a button or a percutaneous endoscopic gastrostomy. They all serve the same function but differ structurally.

    Larynx

    The organ responsible for the production of vocal sounds, also serving as an air passage conveying air from the pharynx to the lungs. It is situated in the front of the neck above the trachea; is made of a framework of nine cartilages; is bound together by ligaments and muscles and is lined with mucous membrane. The larynx, or voice box, is an organ in the neck that plays a crucial role in speech and breathing. The larynx is the point where the aerodigestive tract splits into two separate pathways. The inspired air travels through the trachea, or windpipe, into the lungs, and the food enters the esophagus and passes into the stomach.

    Malabsorption

    Difficulty digesting or absorbing nutrients from food substances. Absorption of specific sugars, proteins, fats and vitamins by the small intestine is reduced and may cause symptoms such as weight loss, diarrhea, anemia, swelling and vitamin deficiencies. Common causes of malabsorption are celiac disease, chronic pancreatitis, cystic fibrosis, blind-loop syndrome or surgical removal of a portion of the small intestine.

    Malrotation

    A type of mechanical obstruction caused by abnormal development of the intestines while a fetus is in the mother's womb. It is due to abnormal rotation of the intestine around the superior mesenteric artery during embryologic development. It may result in a twisting of the intestine, obstruction or inadequate blood supply. Some people who have malrotation never experience complications and are never diagnosed. But most children with this condition develop symptoms during infancy, often during the first month of life, and the majority is diagnosed by the time they reach 1 year of age.

    Motility Disorders

    Disorders where peristalsis is absent, weak, too strong and sustained or uncoordinated, and results in dysphagia of solids and liquids. The function of the lower esophageal sphincter may be abnormal, resulting in pressure that is too high or too low that does not relax upon swallowing.

    Nasogastric Tube (NG Tube)

    - A flexible tube passed from the nasal cavity through the esophagus to the stomach. Nutrition and fluids are then passed through the tube to the stomach to provide adequate caloric intake. Nasogastric feedings may be necessary when there is severe malnutrition or failure to thrive.

    Nissen Fundoplication

    - A surgical procedure that alleviates chronic heartburn in reflux and vomiting in patients whose condition cannot be controlled by either lifestyle changes or medication. The symptoms are caused by severe gastroesophageal reflux due to a weak valve muscle between the stomach and the esophagus. Patients experience a burning sensation from the chest to the throat whenever stomach acids are forced back up into the esophagus. Nissen fundoplication offers a good chance of overcoming a condition that affects many areas of life.

    Pharynx

    - A muscular tube lined with mucous membrane that extends from the beginning of the esophagus to the base of the skull. It acts as a passageway for food from the mouth to the esophagus and as an air passage from the nasal cavity and mouth to the larynx.

    Pyloroplasty

    - A surgical operation in which the outlet of the stomach (pylorus) is widened by a form of reconstruction to relax the muscle and widen the opening into the intestine. It is done to allow the contents of the stomach to pass more easily into the duodenum so there is no delay in gastric emptying.

    Swallowing

    - A process that begins when a liquid or solid bolus (ball of chewed food) is propelled to the back of the mouth into the pharynx by the tongue. The upper esophageal sphincter relaxes, allowing the bolus to pass into the upper esophagus. In response to swallowing, an orderly, progressive contraction of the esophageal body occurs (primary peristalsis), propelling the bolus down the esophagus. The lower esophageal sphincter relaxes as the food reaches the lower esophagus, allowing the passage of the food to the stomach. Peristalsis and relaxation of esophageal muscles are controlled by the brain stem, several cranial nerves and the vagus nerve.

    Trachea

    - The windpipe; the part of the air passage between the larynx and the main bronchi. It is in the front of the neck and is very hard with tough rings around it. Only air goes into the trachea.

    Tracheostomy

    - A surgical operation in which a hole is made into the trachea through the neck to relieve obstruction to breathing. It is a surgical procedure that is usually done in the operating room under general anesthesia. A tube is inserted through the opening to allow passage of air and removal of secretions. Instead of breathing through the nose and mouth, the child will breathe through the tracheostomy tube.

    Upper Gastrointestinal Endoscopy

    - Viewing the interior of the upper gastrointestinal tract using an instrument such as an endoscope or a gastroscope. These instruments typically consist of a tube with a light at the end and an optical system for transmitting an image to an examiner's eye. The entire esophagus, stomach and proximal duodenum are examined. The upper GI endoscopy allows evaluation of digestive complaints.
    Here are two glossaries of medical and behavioral terms frequently associated with feeding disorders.


    This program is accredited by The Joint Commission as part of an ambulatory survey process.




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