The children we see in the Aerodigestive Program have been referred to us because they have several health issues that are linked with each other. In order to solve one problem, the other problems must be treated as well.
These linked health issues happen because the tube-like parts of our body that we use for breathing and swallowing share physical space. There is an opening in the voice box (larynx) between the vocal cords. This opening connects to the windpipe (trachea), which connects to the lungs. This area is known as the body’s airway. Just in front of the larynx is the opening to the food tube (esophagus), which leads to the stomach and intestines. When everything is working well, food and air take different paths:
- Food travels from the mouth to the throat to the esophagus to the stomach.
- Air travels from the mouth to the throat to the larynx to the trachea to the lungs.
Each child we treat has a unique mix of digestive, respiratory and/or pulmonary issues causing them distress. For example, we might see a child who has severe reflux (where food and stomach acid back up into the esophagus) and has recurring pneumonia (a lung infection) as a result of inhaling (breathing in) their reflux. Through talking to you and your child and through diagnostic tests, we might learn that:
- Stomach acid from the severe reflux is causing damage to your child’s swallowing reflexes.
- Swallowing trouble is causing food or stomach content to accidently get into the lungs (aspiration).
- More frequent aspiration is leading to more bouts of pneumonia.
You’ve probably had the experience of food “going down the wrong pipe.” This can happen in children when they have trouble swallowing (called dysphagia). Instead of food staying in the esophagus, some of it takes a detour through the larynx and into the lungs (aspiration). Many of the children we see in the Aerodigestive Program have dysphagia and aspiration, and as well as frequent lung infections from chronic aspiration.
There are many aerodigestive problems other than dysphagia and aspiration that we manage. Some children we see have conditions that develop because they have a narrowing of the airway (subglottic stenosis) and might need reconstructive surgery. Some children are born with subglottic stenosis, and some develop it from having a breathing tube (ventilator) for a long period of time. Other children we see are having trouble with the transition from breathing through a tracheotomy tube to breathing on their own, and we have been asked to investigate the causes.
Because our mission is to treat complex, linked aerodigestive conditions, we don’t have a “typical” patient. Most of our patients have been referred to us by other specialists because of the complex nature of their conditions.
After identifying the problems and how they are connected, we create a care plan that spans your child’s respiratory, digestive and pulmonary systems. The care plan includes the caregivers who are experts in those systems.