A swallowing disorder, known as dysphagia, may occur as a result of various medical conditions and can affect people of all ages, from infancy to geriatrics. Dysphagia is defined as problems involving the oral cavity, pharynx/throat, esophagus, or gastroesophageal junction.
Malnutrition and dehydration, aspiration pneumonia, compromised general health, chronic lung disease, choking, and even death may be a consequence of dysphagia. Individuals with dysphagia may also experience (a) disinterest and/or less enjoyment of eating or drinking and/or (b) embarrassment or isolation in social situations involving eating. Dysphagia may increase caregiver burden and may require significant lifestyle alterations for the patient and the patient’s family.
Speech-language pathologists (SLPs) with appropriate training and competence are involved in the diagnosis and management of dysphagia along with other healthcare providers, i.e., otolaryngologists, gastroenterologists, dentists and primary care providers. They are all integral members of an interprofessional team.
Signs of dysphagia may include drooling, poor oral management, food/liquid leaking from the oral cavity or the nasal cavity, food “sticking” in the throat/esophagus, coughing during or right after eating/drinking or weight loss/dehydration from not eating/drinking properly. Other issues resulting in dysphagia include oral aversion or food aversion. Recurring aspiration pneumonia or respiratory infection can indicate there is a swallowing issue as well.
Dysphagia may result from numerous medical conditions. Some of these could be stroke, traumatic brain injury, spinal cord injury, dementia, Parkinson’s disease, multiple sclerosis, developmental disabilities or myasthenia gravis. Dysphagia can also occur due to problems affecting the neck and head including cancer in the oral cavity, pharynx/throat, nosopharynx or esophagus, chemo/radiation for head-neck cancer treatment, trauma or surgery involving the head-neck, or decayed or missing teeth.
Treatment for swallowing dysfunction or dysphagia is different for each individual, based on the underlying impairment. Treatment may include oral motor/pharyngeal exercises to address muscle strength and function, diet/texture modification for foods and/or liquids, as well as use of compensatory strategies or maneuvers.
The overall goal of dysphagia therapy is airway protection and adequate nutrition/hydration. However, eating is not only a necessity for life, but it is also a very social aspect of life for pleasure and interacting with friends and family. When swallowing function works properly, it is taken for granted but when it does not work properly, it can lead to not only health issues but depression and isolation.
At Eastern New Mexico Medical Center, assessment and treatment of dysphagia can be addressed while a person is hospitalized (inpatient) or on an outpatient basis upon referral from a physician.
Please contact Kim Perez, speech-language pathologist at 575-627-4053 if you have any questions or concerns regarding swallowing/dysphagia. The advice offered in this column is that of the author.