An abbreviation of Glycosaminoglycans is GAGs. They are long unbranched polysaccharides consisting of a repeating disaccharide unit and it is an abnormality. A gag reflex is basically a protective mechanism that protects the aspiration of food, fluid and vomitus. This is normally done by touching the posterior wall of the oropharynx with a tongue depressor or by suctioning the throat. Gag is indicated when there is prompt elevation of the palate, constriction of the pharyngeal musculature and a queer sensation of gagging. The basic symptom of an abnormal gag is the inability to swallow anything, which further increases susceptibility to life-threatening aspirations.
When an over-reactive gag reflect occurs, it hinders the daily based activities like eating out, wearing dentures or dental appliances, hinders swallowing necessary pills and medicines and fear of going to the dentist.
There are numerous causes of Gags (Glycosaminoglycans), some of which are:
1. Basilar artery occlusion
2. Brain stem glioma
3. Bulbar palsy
4. Wallenberg’s syndrome
5. Anesthesia
Whenever an abnormal gag reflex occurs, the patient’s oral intake should be stopped in order to cease aspiration. His level of consciousness (LOC) should be evaluated instantly. If the LOC is found decreased, the patient should be placed in a side-lying position in order to prevent aspiration or should be placed in Fowler’s position. The suction equipment must be kept in hand.
The patient or any family member of the patient should be interrogated if the patient finds it difficult to communicate. The swallowing and other difficulties should also be looked upon. The patient should be asked if he finds it difficult to swallow solid but easy to swallow liquid. Or if the swallowing becomes difficult at certain times of the day, as in case of bulbar palsy which is associated with myasthenia gravis. Neurologic should be suspected if the patient finds it difficult to chew his food as chewing action involves the use of different cranial nerves.
When a physical examination is taken, the patient’s medical history for vascular and degenerated should be explored. Also, his respiratory status for evidence of aspiration should be checked and a neurologic examination should be performed.