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What Is Dysphagia?

Dysphagia (dis-FAY-juh) is the medical term for difficulty swallowing. Swallowing problems can happen in your mouth, throat, or esophagus (tube from your throat to your stomach). Dysphagia can be related to difficulty moving and coordinating your muscles as well as sensation, or the ability to feel where food is in your mouth and throat. Swallowing problems can cause dehydration, malnutrition, weight loss, and pneumonia.

 

 

There are many causes of dysphagia, but the some of the most common are stroke, brain injury, cancer, and progressive neurologic diseases like Alzheimer’s, Parkinson’s, ALS, or multiple sclerosis (ASHA.org). Some people have dysphagia for a short time because of sudden weakness from a flare up of an unrelated problem, such as the flu or kidney disease. Others may have more long-term swallowing problems. Because many conditions cause swallowing problems, it is hard to tell how many people are affected. It is thought that one in 25 adults experience a swallowing problem every year (Bhattacharyya, 2014).

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There Are Two Ways Dysphagia Affects Your Ability To Swallow:

 

Safety - Choking and aspiration (when foods or liquids pass the vocal folds into your lungs) can cause a serious lung infection called aspiration pneumonia. When food goes down the wrong way without making a person cough or react, it is called silent aspiration. About one third of people with dysphagia develop pneumonia (AHCPR 1999). Aspiration can be a serious medical condition.

 

Efficiency - It may take you extra time, effort, and swallows to swallow food or liquids. For example, if your throat muscles are weak, you might have residue in your throat after you swallow, and need to swallow two or three additional times or use a liquid wash to clear it.

What Can I Do If I Have Dysphagia?

 

Your speech-language pathologist can recommend a specialized swallowing test to better understand the problem. It can be an X-ray or a small camera that goes in the nose. Both tests are used to determine what may be causing the swallowing problem, and strategies that can be used to address it during therapy.

 

Managing dysphagia may include: 

 

  • Swallowing exercises to improve strength and coordination

  • Special strategies or head positions to make swallowing safer and easier

  • Diet texture changes, such as thickening liquids or pureeing food

Diagnosis And Treatment Of Swallowing Disorders

Swallowing Specialists of Central Ga, LLC uses advanced equipment to determine what is causing your swallowing difficulties and how they can be treated. Specific assessment and treatment modalities may include:

  • Clinical Swallowing Assessment evaluating the oral stage, cranial nerves, and neuromuscular physiology

  • Modified Barium Swallow (MBS) study or Fiberoptic Endoscopic Evaluation of Swallowing (FEES)

  • Neuromuscular electrical stimulation to enhance use of traditional swallowing exercises for increased strength and range of motion

  • Referrals to ear, nose and throat specialists for assessment of vocal cord functioning or to a gastro-intestinal physician for dilatation or endoscopy to assess esophageal motility

  • Referrals for Nutritional consult and diet education

  • Specialized Seating and Positioning

  • Written report to include interpretation of completed assessments, treatment plan and appropriate referrals

  • Development of a treatment plan of care that are specialized for each patient’s needs.

  • Swallowing exercises to improve strength and coordination

  • Special strategies or head positions to make swallowing safer and easier

  • Diet texture changes, such as thickening liquids or pureeing food

Symptoms of Dysphagia

  • Drooling saliva, food or fluid

  • Effortful or prolonged chewing

  • Pocketing of food in cheeks

  • Pooling of fluid in mouth

  • Spitting out food

  • Nasal regurgitation

  • Fatigue

  • Coughing when drinking or eating

  • Wet or gurgly voice

  • Food getting stuck in the throat or neck region

  • Pain or discomfort with swallowing

  • Unexplained weight loss

  • Chest infections or aspiration pneumonias.

Associated Conditions That May Cause Swallowing Issues

Patients who may be appropriate for the program could be experiencing swallowing problems secondary to:

  • Spinal Cord Injury

  • Brain Injury/Stroke

  • Multiple Sclerosis

  • Transverse Myelitis

  • Head/Neck Surgery

  • Parkinson's Disease

  • Amyotrophic Lateral Sclerosis (ALS)

  • Guillain-Barré Syndrome

  • Mechanical Ventilation or Tracheostomy

  • GERD or Reflux

  • Inflammatory myopathies such as dermatomyositis and polymyositis

  • Esophageal strictures, achalasia, diffuse esophageal spasm, scleroderma

  • Head, Neck and Oral Cancer

At Swallowing Specialists of Central Ga, LLC our speech-language pathologists offer expert advice on diet modification, positioning and strategies to help with safe swallowing.  They also make sure that eating and drinking is as pleasurable as possible for their patients.

 

If you’re caring for someone with dementia who has swallowing issues, please contact us.  

References

 

Adult Dysphagia: Causes. (n.d.). Retrieved from https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589942550§ion=Causes

 

Agency for Health Care Policy and Research (AHCPR). (1999). Diagnosis and treatment of swallowing disorders (dysphagia) in acute-care stroke patients [Evidence Report/Technology Assessment No. 8, AHCPR Publication No. 99-E024]. Rockville, MD.

 

Bhattacharyya, N. (2014). The prevalence of dysphagia among adults in the United States. Otolaryngology–Head and Neck Surgery, 151, 765–769.

 

Layne, K., Losinski, D., Zenner, P., & Ament, J. (1989). Using the Fleming Index of Dysphagia to establish prevalence. Dysphagia, 4, 39–42.

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