We don’t need to think about most of the essential actions that our bodies undertake to keep us alive and well. You don’t need to remember to breathe in and out. You don’t need to think about how often you should blink to keep your eyes moist. And for most people, you don’t need to focus on how you’re going to swallow. 

But for some, the vital throat-closing action that moves food and liquid out of the mouth and into the body is a minefield of complications. 

At Digg, writer Bryn Nelson tells the story of an Australian woman who, at 39 years old, woke up one day suddenly unable to swallow her toast: 

She tries again, pressing her lips together and pushing the food back further in her mouth where her throat can take over. But it doesn’t, and now she’s choking.

It’s called dysphagia, and it affects an estimated 13 percent of the population, particularly people with neurological conditions, Parkinson’s disease, or acid reflux disease, or who’ve had strokes or undergone chemotherapy focused on the head and neck. 

Swallowing is the result of a complex interaction between nerves and muscles—as many as 22 muscle pairs and seven cranial nerves, according to Nelson. Yes, you can choose to swallow consciously, as you do when you eat, but you also swallow all the time to keep your mouth and airway from filling up with spit and mucus. When your body stops swallowing on its own, it can feel like drowning.

“It’s like being constantly waterboarded,” one doctor told Digg.

When you can’t swallow, eating becomes fraught with danger. Dysphagia can lead to choking, but it can also cause patients to breathe in food and water, resulting in pneumonia. Without the normal cycle of saliva moving debris out of the mouth, tooth decay is common. And of course, if you can’t swallow, it’s really hard to eat. Patients lose weight and become dehydrated. 

But researchers are working on better treatments, both to help patients swallow and to deal with the psychological blow of not being able to join in on that most common of communal experiences—sharing a meal. Taste strips that stimulate salivation and evoke the taste of doughnuts or turkey can simulate the joys of actually eating. A new type of bread that is engineered not to absorb saliva is easier to swallow. Some companies have started 3D-printing foods in easy-to-swallow gels. And some researchers are experimenting with nerve aids and mechanical devices that can help patients regain control over their throats, though these are still in the experimental phases. 

Read more about the struggles of people with dysphagia (and some incredible descriptions of how the throat works) from Digg