Skip to main content

Dysphagia - Symptoms and Treatment

dysphagia

The danger of swallowing disorders is that they can lead to aspiration pneumonia and poor nutrition. Both conditions contribute to declining health and increased length of hospital stays. Symptoms of difficulty swallowing include:

  • coughing
  • choking
  • food "sticking in the throat"
  • drooling
  • nasal drainage while eating
  • weight loss
  • fever from pneumonia

The Diagnosis of Dysphagia

When the above symptoms are noted by physicians, nurses or therapy staff, a speech-language pathologist (SLP) is consulted. Patients hospitalized for neurological disorders such as stroke, brain injury, Parkinsonism, or ALS likely are on the SLP caseload.
Swallowing requires timely and effective coordination of many muscles. When these do not operate efficiently, ingested substances can enter the airway and endanger patient health.

After the referral, an evaluation takes place. The SLP offers different food textures to assess difficulty swallowing them separately. Liquids, pudding, crumbling foods such as crackers and sometimes more complex foods containing mixed textures are introduced. The SLP assesses the patient's ability to:

  • chew (masticate) food thoroughly
  • clear food from pockets in the mouth
  • form a bolus (food ball)
  • use the tongue to project the bolus toward the pharynx
  • maintain timeliness and coordination of oral and pharyngeal movements to keep food on track
  • maintain timeliness of elevation of the larynx (Adam's apple area)
  • clear residual food from pockets around the airway (valecula)
  • move the epiglottis to cover the airway
  • effect travel of the ingested material down the esophagus

Assessments begin at bedside with behavioral observations. In addition to bedside evaluation, the SLP can perform tests such as a modified barium swallow study (MBSS) or a fiberoptic endoscopy study (FEES). The MBSS uses barium, a white substance that shows up on X-ray, indicating the path of ingested material. The FEES uses a camera above the vocal cords and color-tinted food, so the SLP can assess efficiency of food transfer.

These tests also help determine whether there is "silent aspiration." Liquids especially can penetrate into the airway, without coughing, in serious cases of impairment. When patients say they have no trouble at all with liquids, there can still be a dangerous problem.

Treatment of Swallowing Disorders

After determining the nature of the problem, several approaches may come into play. With silent aspiration, or in very severe cases of dysphagia where management is not immediately possible, feeding tubes may be necessary. A nasogastric tube (from the nose to the stomach) or a PEG (percutaneous endoscopic gastrostomy) tube may be placed to provide nutrition until the patient's condition improves.

The following treatments may be appropriate for specific patients:

  • Diet: easy to chew if oral problems occur
  • Thickened liquids when thin consistencies are difficult to manage
  • Sit upright for at least 20 minutes after ingesting anything
  • Small bites and sips to make it easier to manage
  • Slowed intake
  • Provide assistance when needed, especially if the patient is fatigued
  • Oral exercises to increase strength and range of motion (ROM) of the tongue
  • Lip strengthening exercises to improve lip seal and avoid leakage
  • Exercises to increase laryngeal strength

Swallowing Improvement

The good news is that swallowing often improves with therapy. This depends on the nature and severity of impairment. It is important to report these symptoms to one's physician and to follow recommendations. Avoiding aspiration pneumonia also means avoiding severe health complications.

steroids online direct usa

Popular posts from this blog

Safeguard the Achilles

One of the most painful tendon injuries is Achilles. But there are also ways to avoid these injuries. Here are some of them: You’ll feel a burning and piercing in the tendon above your heel and it can even make a crackling sound when you move it. Any higher up your calf and it’s more likely that you’ve strained or pulled a muscle. Rupturing your Achilles tendon is a exceptionally painful experience and you’ll know when you’ve done it. Your Achilles tendon connects your calf muscles to your heel bone and is made of thousands of individual fibers of collagen. Restricted blood flow to this area slows repair and pain will worsen if you keep training . Four important factors in healing the Achilles are: rest, ice, compression and elevation. If your tendon is harmed take a break from all weight bearing sport (except swimming) for at least 2 weeks. You can recover from mild injury in a couple of weeks but a severe one can take 5 months. In order to prevent Achilles injury in

Diabetes Food Pyramid

This diabetic food pyramid functions in a similar way to the regular food pyramid. One of the main differences is that the diabetic food pyramid focuses on limiting sugar intake . Diabetes is a disease that prohibits people from eating sugar at the same levels that they used to. This does not mean that all diabetics have to avoid sugar like vampires avoid the sun! Some people have mild cases that enable them to eat sugar once in a while. Others have to avoid it at all costs. The diabetic food pyramid is a lifesaver to many people. Just by looking at the pyramid they can tell which foods to eat and which ones not to. It also suggests serving sizes and suggestions for planning whole meals. The diabetic food pyramid has six categories of food groups. At the bottom the main group is grains, starchy vegetables, and beans. The second grouping on the diabetic food pyramid includes vegetables and fruits . The third includes diary products, meats and other sources of protein. At the t

Causes of Easy Bruising: Reasons Why People Bruise Easily

Bruising , a reddish or purple discoloration under the skin, most often results from trauma to the small blood vessels, called capillaries, but can also occur spontaneously. How and Why Bruises Occur Blood leaks out of the capillaries and accumulates under the skin, gradually absorbing over several days. Bruising most often occurs because people run into objects or experience other trauma. Most bruising is easily explained, but frequent bruising that occurs without obvious cause needs prompt investigation, since several serious diseases can cause bruising. In general, women bruise more easily than men. How Aging Increases the Risk of Easy Bruising Bruising increases as people age for several reasons. Skin thins as people age and the capillaries become more fragile. The layer of fat that cushions blood vessels and protects them from injury becomes thinner as well. Older people often take medications and supplements that thin the blood and contribute to easy bruising. Visi