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Difficulty swallowing, or dysphagia, can occur
as a result of a variety of medical conditions. Swallowing disorders occur
in all age groups from newborns to the elderly and may be mild, or so
severe that the patient cannot take nourishment by mouth and must be fed
by other means. Normal swallowing involves a complex sequence of movements
requiring precise muscle control. These movements occur rapidly, with
food or liquid only taking two or three seconds to pass from the back
of the mouth to the stomach. When a patient has a swallowing disorder,
there is always the danger that food or liquid will go into the lungs
rather than into the stomach. This is known as aspiration. Aspiration
in turn can cause pneumonia.
Swallowing disorders may be present in a variety
of diseases especially any diseases or injury that directly affects the
oral mechanism, or damage to the brain that causes neurological impairment
of swallowing.
This list includes, but is not limited to:
- Traumatic brain injury
- Stroke
- Neurogenic degenerative diseases such as Amyotrophic lateral sclerosis,
Parkinson’s disease, Multiple sclerosis, Huntington’s disease
- Surgical revision of the head and neck as the result of diseases such
as cancer, including patients that have undergone radiation treatment
to the neck
- Newborn feeding and swallowing disorders
- Difficulty starting a swallow
- Coughing or choking during a meal
- Sensation of food sticking in the throat
- Needing to swallow two or three times
- Pocketing of food on one side of the mouth
- A wet or gurgly-sounding voice after drinking
- Increased body temperature of unknown cause
- Pneumonia
The onset of a swallowing problem may occur suddenly
as with a stroke or may worsen slowly over time as in a progressive
neurological disease. If you notice symptoms of a swallowing disorder
seek a physician’s advice. You may be referred to a speech language
pathologist who will complete a clinical dysphagia exam or may recommend
a Videofluoroscopic modified barium swallowing study (VMBSS) to further
investigate the cause of dysphagia and to recommend treatment or diet
modifications. The VMBSS allows the speech pathologist and the radiologist
to actually see the material being swallowed and to asses the degree
of difficulty and determine how changes in positioning and/or food consistency
may affect swallowing safety.
You can help the person with swallowing problems
by following these tips:
- Allow sufficient time for eating
- Be sure the patient has swallowed completely before taking more food.
- Encourage the patient to take small amounts of food
- Offer only food and liquids that are the consistency recommended by
the speech language pathologist
- Stop feeding immediately if the patient chokes
- Leave the patient sitting upright for 20 to 30 minutes after eating.
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