What is Epiglottis?
Epiglottis is a elastic flap of tissue that is shaped like a thin leaf and situated at the root of the tongue. It protects the opening between the vocal cords, known as the entrance of the glottis. Epiglottis is covered with mucous membrane, which is a yellow elastic cartilage structure.
When we swallow our food, the epiglottis provides a folding over the glottis. This helps to stop the food and liquid from reaching the windpipe, called as trachea.
One cannot breathe and swallow at the same time. It is rather not possible to do so since our body is designed in a way wherein both the tasks cannot be performed simultaneously. However, infants are capable of doing both the functions together because of the anatomical position of both the larynx and epiglottis.
In the infancy stage, the larynx is situated very high up the baby’s throat. It is so high that the epiglottis can actually touch the soft palate in the baby's mouth. Due to this, the nasal cavity has room for unlimited patency towards the larynx. Hence babies can feed on milk and breathe at the same time. Both the activities are not disturbed since the milk goes directly into the esophagus. By the time they attain the age of two, the tongue enlarges thus pushing the larynx deeper inside the throat. Hence now, they cannot perform both the activities together.
Functions of Epiglottis
Epiglottis has a few other important functions like providing aid in digestion and speech, apart from protecting the opening between the vocal cords:
Digestion of food - While swallowing food, epiglottis plays an important role. One would want the foods and liquids which we intake to go directly in our stomach rather than going elsewhere to create an unpleasant experience. Here the epiglottis comes into picture as it makes sure that the food enters the esophagus rather than obstructing the windpipe or the airways to the lungs, thereby also preventing choking each time one eats or drinks. Once the person finishes eating, the epiglottis opens up once again and allows for normal breathing.
The movement of the larynx is governed by two sets of muscles called as extrinsic and intrinsic muscles. The main function of the extrinsic muscles is to control the folding of the epiglottis along with controlling the laryngeal structure.
Once the person starts chewing the food, a trigger movement is sent to the extrinsic muscles which allow the larynx to move slowly upward. The extrinsic muscles relax the moment the food reaches the epiglottis. It then returns the epiglottis to the upright position. Normal breathing resumes wherein the air again passes through the larynx into the trachea and from there into the lungs.
Speech functioning – Epiglottis also plays a pivotal role in speech and production of sound in a certain language. The space between the vocal folds and arytenoid cartilages situated in the larynx is called the glottis. The intrinsic muscles control speech and the vocal cords. Glottis is basically the opening of the larynx; it is a place where vocal tones are produced.
The consonants and vowels are produced by the epiglottis which acts as an articulator. Speech is generated when the epiglottis articulates words against the posterior wall in the pharyngeal area. The opening between the epiglottis and pharynx opens up when one pronounces vowels and when one pronounces consonants, it becomes smaller. When one starts whispering, the epiglottis retracts as compared to normal speech.
Problems related to the Epiglottis
Like any other organ of the body, the epiglottis also has its own set of problems which can lead to various medical conditions:
- Aspiration is one of the medical conditions which happens because of the food going down the wrong pipe. If the condition worsens, the person can have pneumonia or it can even lead to a stroke.
- Epiglottitis is another medical condition which is caused due to swelling or inflammation of the epiglottis. This condition also known as supraglottis leads to the blockage of airways. Though this condition is quite rare now, it can affect anyone especially small children aged between two to six years of age.
- Infection of the epiglottis is also another medical issue, which though rare now is a very serious condition. Infection is mostly seen in adults. This infection can lead to difficulty in breathing and if still left untreated, it can possibly cause death. One should not overlook this condition since its life threatening.
- Ulcers in the epiglottis is another major issue. The person suffering with this condition finds it difficult to swallow liquids and food. This ulcer can also lead to blockage in ears and sore throat.
Causes of Epiglottitis Infection
Haemophilus Influenza Type B bacteria are one of the main causes for Epiglottitis. This bacterium is also called as Hib. Epiglottitis can also be caused by fungus, virus or any other bacteria which are capable of producing upper respiratory infection. Few of these would include:
- Shingles virus, also called as Varicella zoster virus
- Streptococcus pneumonia
- Haemophilus parainfluenzae
- Herpes simplex virus
Environment also proves to be a point of concern when it comes to causes of epiglottitis. One such example would be heat damage, it leads to inflammation in the epiglottis or else it can cause injury to the thermal epiglottis. Drinking very hot liquids, use of drugs, eating solid foods are also few of the causes for inflammation or injury.
Signs and symptoms of Epiglottitis
There are several symptoms which show up when one is suffering from epiglottitis. This medical condition begins very quickly, but sometimes takes a few hours to few days in adults or older children. Below mentioned are few symptoms associated with this condition:
- Irregular or fast heart rate
- Continuous drooling
- Having trouble swallowing
- Sudden rise in temperature
- Chill feeling
- Having trouble while speaking
- Sore throat which gets severe with passing time
- Voice starts sounding hoarse
- Skin discoloration
- While breathing, it sounds like a high pitched whistling sound
- Having trouble while breathing and at times, the person would need to lean ahead to breathe properly
- The muscles are being pulled inward from in between the ribs while breathing
Apart from the ones mentioned above, there are certain other symptoms which can be seen in children such as anxiety, getting irritated, sitting in a sniffing posture wherein the body is leaning ahead with the head and the nose upwards or tilted forward. When it comes to infants, they would also show similar signs of epiglottitis, but in addition infants would also catch cough and infection in the upper respiratory system.
When to visit the doctor
One should not take the epiglottitis symptoms lightly since it can later prove to be fatal if the person starts having trouble while breathing. Don’t hesitate to reach out to the doctor or look for immediate help in case of an emergency. Remain calm during such an emergency medical condition and ensure that the person sits upright so he/she doesn’t have further trouble while breathing. Do not go in to examine the throat of the person since it can worsen the situation for the person who is suffering from the epiglottis attack. Let it be done by an expert.
Symptoms such as drooling, severe sore throat, fast or irregular heartbeats, having trouble while breathing or rapid and shallow breathing should not be taken lightly and the person should be immediately admitted to the hospital.
Treatments for Epiglottitis
Since epiglottitis gets very serious and may turn severe if ignored, it is best to get it treated as early as possible by consulting the doctor. Avoid taking medications on your own without consultation. Since epiglottitis is directly associated with breathing issues, the best practice would be to get hospitalized if a person experiences difficulty in breathing.
The doctor would then perform certain procedures so that the person can start breathing without any issues. This is done by inserting a breathing tube, also called as intubation, along with the use of humidified oxygen. Once this is done, the hospital staff would keep a tab on the airways along with starting intravenous therapy of antibiotics. These antibiotics will help the body to get rid of the bacteria which is causing the infection of epiglottitis.
The doctor would also go in for steroid medications which would reduce the swelling in the airways. The patient would also be given fluids via IV so they can start to swallow again. To minimize the symptoms caused due to epiglottitis, the doctor can also give corticosteroids and epinephrine.
Some people go through the problem of chronic aspiration wherein the food particles which are taken in are inhaled into the lungs from the mouth. This medical condition can cause coughs, sore throat, infection in the respiratory tract. During such situations, the only option the doctors would go in for would be the modification of the epiglottis surgically.
The main aim of the surgery would be to only change or modify the structure of the epiglottis without removing the epiglottis completely. One needs to note that complete removal of the epiglottis would result in other serious medical conditions.
In such cases, the air which is breathed would enter the stomach and the food would travel in the trachea. The surgery would mainly aim at putting an end to chronic aspirations without touching or removing any important organs.
Natural Remedies to prevent or reduce Epiglottitis
One can also go in for natural remedies to prevent or reduce the condition of epiglottitis:
- Sensitivity to certain type of food – One of the concern for the epiglottitis condition is food allergies or being sensitive to certain kind of food items. In such instances, it is always best to avoid any such foods which trigger epiglottitis. Few of the common food allergies found in people are shell fish, peanuts, wheat, milk, soy, tree nuts and eggs. This is just a generalised list, there can be many other food items which can lead to allergies. One can go in for enzyme linked immunosorbent assay or the food elimination diet which can check for food allergies. Bio-meridian test or meridian stress assessment test can be conducted to check for food sensitivities.
- Essential Oils – To ease down troubles related to breathing which is one of the major symptoms when it comes to epiglottitis and at the same time to fight off the bacteria which is causing the infection, one can go in for essential oils. This would also provide a soothing effect in the respiratory tract. Few of the essential oils which promote the function of epiglottis and respiration are lavender, bergamot, eucalyptus, lemon, tea-tree and peppermint.
- Vitamin C – Vitamin C can naturally boost the immune system and provide relief from a number of symptoms which are related to epiglottitis, food allergies, shingles and sore throat. Vitamin C if included in the daily diet can fight off the infection causing bacteria. Apart from vitamin C, the other nutrients which help with promoting the good health of the immune system are vitamin E, vitamin A and zinc.
- Homeopathy – Severe sore throat conditions can also be cured with the help of homeopathic medicines. Few of the homeopathy medicines would include mercurius solubilis, hepar sulphuris, Lachesis muta, sulfur, kali bicromicum etc.
Preventing the Infection causing Epiglottitis
Epiglottitis has now reduced considerably due to various Hib vaccinations which are widely available. This HiB vaccination is provided to children so they can be immune to these medical conditions. One should ensure that the vaccinations are administered to the children properly and regularly at the stipulated period.
Adult Hib vaccinations are still not recommended, unless the person is suffering from some serious medical condition such as cancer and sickle cell anemia. Avoid having hot beverages such as tea or coffee, avoid too much hot and spicy food such as pepper or chilli which can increase the inflammation in the epiglottis.
It is always advisable to check with your doctor if there is a history of epiglottitis in the family or if the person has suffered injury in the neck or throat to avoid any further complications.