Causes of swallowing disorders or "dysphagia" are innumerable. They may affect everyone from birth through geriatric years. The main culprit usually tends to be a weak swallowing reflex or weak muscles in the mouth or throat. Frequently neurological complications adversely affect one's ability to swallow such as stroke, however, physical changes or malformations can contribute to their cause, also. It is a disorder associated with aging, as well. Even lack of saliva production when eating or dentistry problems can affect one's ability to swallow food.
Diagnosis needs to be made by a licensed speech/language therapist who works with the patient's primary physician. Frequently diagnosis is made after numerous tests are completed and may include but are not limited to 1) manipulation of the outside of the throat during swallowing, 2) mouth, face and throat musculature assessment, 3) videoflouroscopic swallow examination (x-rays of one eating morsels of food of various consistencies from solids to liquids) to determine if food or liquid is going into the lungs rather than into the stomach, 4) observation of eating/swallowing at meal times.
A swallowing disorder can usually be diagnosed when one takes 10% total or 1/3 of one teaspoon of food/liquid into their trachea rather than their esophagus consistently. This is referred to as "aspiration of food or liquid" and is not healthy. Usually a therapist also determines which consistency of food (solid, semi-solid, gravy-like or thin liquid type) is the most difficult for a patient. Residue or food particles which remain in one's mouth after swallowing food or a paralysis on one side of the face/throat are a few of several factors which can also contribute to a dysphagia diagnosis.
If swallowing difficulties continue without professional diagnosis and treatment real complications may occur. These range from aspiration pneumonia to possible death if left untreated. Professionally, I have seen severe complications for those who already suffer some breathing or pulmonary problems such as congestive heart failure because the lungs have difficulty clearing fluid which pool in the lungs in the first place. Any aspiration of food/liquid only exacerbates this!
Treatments range from medical to surgical to intervention by a speech therapist. We have all heard of someone who could only eat pureed food, for instance, which probably was recommended following a swallowing evaluation. Some may not have liquids at all, or if they do, must add a thickening agent, which is not an appealing choice for most. Others have to be ordered to receive their food via a tube (N-G tube through the nose to the stomach, G-tube which is placed through the abdomen into the stomach/small intestines region surgically), as oral eating has been deemed extremely dangerous for them. Speech therapy can involve direct treatment such as hot/cold stimuli applied to various throat structures internally before attempting swallowing to promote a strong reflex. Some other dysphagia treatments even require as little intervention as holding the chin down to the chest as swallowing occurs to reduce the chance of food spilling over the base of the tongue and into the trachea before the person or swallowing reflex is ready. I have even seen people need to recline when eating so gravity helps move the food to the back of the throat because their tongue was to weak to move it itself.
Go To Page: 1 2
