Dysphagia: The Difficult Swallowing Dilemma
Many of us experience difficulty swallowing if we eat too fast or don't chew our food well. But, for more than 9-million Americans, this is more than an occasional annoyance. If you continually have difficulty swallowing, or if it's painful to swallow, it could be a medical condition known as Dysphagia.
Dysphagia can be severe and requires treatment. June is Dysphagia Awareness Month, so let's take a look at the symptoms, causes, and treatment of this condition. First, we will begin with the definition of Dysphagia.
What is Dysphagia?
Dysphagia is a condition that causes people to have difficulty swallowing. Those with dysphagia may have difficulties in several aspects of the process of swallowing. These difficulties could occur anywhere in the pathway from the mouth to the stomach. In some cases, those with dysphagia are unaware that their unpleasant symptoms actually stem from a swallowing problem. Next, we will explore the symptoms patients with Dysphagia often report.
Symptoms resulting from a swallowing issue can vary. Some of the most common symptoms may include:
- Coughing before, during, and/or after swallowing
- Persistent throat clearing during meals
- Pain or discomfort when swallowing
- Feeling of food being "stuck in the throat"
- Tension in the throat while trying to swallow
- Heartburn or food/liquid coming back up after being swallowed
- Food or liquid spilling from mouth, lips, and/or nose
- Difficulty and/or excessive chewing
- Food that remains on the tongue after swallowing
- Food that remains in cheeks after swallowing
- Shortness of breath while chewing or swallowing
- Avoidance of food, poor appetite, and/or unexplained weight loss
Now, let's talk about common causes of Dysphagia.
The causes for Dysphagia may differ, depending on the type you experience. Some common causes are:
- Neurological- weakening from an event such as stroke or brain injury. It could also be a result of the progression of neurodegenerative disease processes like Parkinson's disease, ALS, or dementia
- Gastrointestinal- conditions such as acid reflux disease, scleroderma, esophageal strictures or obstructions
- Respiratory diseases- some conditions make it difficult to coordinate breathing and swallowing cycles during meals, such as pneumonia or COPD
- Cancer- as a result of cancerous tumors or cancer treatments like chemotherapy, radiation, and surgical procedures to the head and neck. These treatments could cause changes in swallowing anatomy and function
- Acute infections- some infections can cause changes in thinking which, in turn, may affect swallowing. Examples include sepsis, encephalopathy, or urinary tract infections
- The process of aging- some changes in swallowing occur as we age. Some of these changes are normal with little importance and others require attention
If you or a loved one has experienced difficulty with swallowing or if you are at risk of developing Dysphagia, don't panic. There is hope for recovery for patients with Dysphagia, but you must first consult with an expert for proper diagnosis and care.
Next, let's examine the beginning of the recovery journey: diagnosis.
If you experience difficulty when swallowing, first check with your doctor. They will likely refer you to see a Speech Pathologist who specializes in the evaluation and treatment of swallowing disorders. Evaluation will begin with a clinical swallowing assessment. Your speech pathologist will interview you to better understand how your swallowing is impacting you. The speech pathologist may also examine your mouth and throat, and assess you while you attempt trials of various foods and liquids.
Results of this assessment may require more formal swallowing tests using radiographic testing or fiberoptic endoscopic testing by the speech pathologist. Referral to a GI doctor may also be needed. Your initial assessment will be used to determine which formal tests fit your swallowing profile best.
Once all of the results from the assessments are available, your care team will use the results to build your treatment program.
Treatment and Recovery
Treatment options could require any or all of the following:
- Individualized exercise plan developed by your speech pathologist to target the weakened or under-performing muscle groups
- Least restrictive diet modification recommendations by your speech pathologist based on the findings of your swallow tests
- Behavior/environmental modifications recommended by your speech pathologist. These modifications could include how, when, or where you eat to promote the best function
- Medical interventions recommended by your physician, which could include medication changes, procedures, or surgical interventions
Help is Available
In conclusion, Dysphagia is a serious medical condition that requires treatment. The primary symptom is difficulty swallowing, but there is a combination of symptoms you may experience. A doctor's referral for speech therapy is the first step to gain more information. Your speech pathologist will perform tests and examinations to determine if you have Dysphagia. Then, the speech pathologist will determine to what extent treatment is necessary, and which treatment approaches may benefit you most.
In many cases, a speech pathologist may be the best course of treatment. Several things can help alleviate symptoms and ensure patients get the nutrition and hydration they need. Identification of the cause and type of Dysphagia, implementation of strengthening exercises to promote the highest level of function, and learning new techniques while swallowing are often involved in best treatment practices.
If you or a loved one is experiencing dysphagia, contact one of our speech therapists today for a full assessment.