Dysphagia

Dysphagia refers to difficulty in eating as a result of disruption in the swallowing process. Dysphagia can be a serious threat to an individual and may result in one or all of the conditions like Aspiration Pneumonia, Malnutrition, Dehydration, Weight Loss or Airway Obstruction. Hence, it is important to identify and deal with the underlying reasons of feeding difficulties. Dysphagia can affect people in varying degrees; some individuals may experience a mild discomfort while others experience a complete inability to swallow. The problem can arise anywhere from the mouth to the stomach.


Adults

Dysphagia widely occurs in older adults. It is estimated that as many as 45% of people aged over 75 show symptoms of Dysphagia but it can affect people of all ages. By failing to realize how widespread Dysphagia is in elderly population and the extent to which it can affect both mentally and physically, we are depriving them a good healthy meal to satisfy their appetite. Not only that, we may be unwittingly exposing this already vulnerable group of people to malnutrition, which may have long term adverse effects on their health and well-being.

Causes:

Any condition that weakens or damages the muscles and nerves used for swallowing may cause Dysphagia.

The most common causes are:

  • Stroke
  • Traumatic Brain Injury (TBI)
  • Tumors
  • Muscular weakness in aging population.
  • Infectious diseases like Herpes, Candida, HIV
  • Barrett’s Esophagus

Associated Medical Conditions:

In individuals with a diagnosis of any of the following medical conditions; swallowing difficulties may occur:
Parkinson’s Disease, Amyotrophic Lateral Sclerosis (ALS), Motor Neuron Disease, Alzheimer’s Disease, Multiple Sclerosis, Dementia, Myasthenia Gravis, and Cerebral Palsy.

It has been suggested that as many as 30% of all stroke patients experience Dysphagia to some degree. In younger patients, causes of Dysphagia often involve accident-related head and neck injuries, as well as cancers of the throat and mouth.

In adults, the general signs and symptoms of Dysphagia may include:

  • Loss of appetite
  • Weight Loss
  • Choking, coughing or throat clearing while or after swallowing
  • Experiencing pain while swallowing
  • "Lump in throat" feeling
  • Heartburn, discomfort in throat or chest
  • Eye tearing, redness of face, increase in pulse rate

Children

In infants and children, feeding and swallowing disorders are usually caused by multiple factors. It can result from congenital or acquired neurologic damage, anatomic and structural problems, genetic conditions, systemic illness, psychosocial & behavioral issues or developmental disorders like Autism or Down’s syndrome.

Family or friends may say your child will “grow out of it” but not treating Dysphagia as early as possible is potentially costly to your child’s health. Children with Dysphagia are at high risk for choking, aspiration pneumonia, upper respiratory infections, failure to thrive, dehydration, malnutrition and delays in learning.

Children with feeding difficulties may include one or more of the following symptoms:

  • Failure to accept age-appropriate food textures or quantities.
  • Gagging, coughing or choking on food or liquid.
  • Vomiting during or after meals.
  • Inadequate weight gain or poor nutritional status.
  • Failure to accept varying food textures or consistencies.
  • Fussiness, crying or tantrums at meal time.
  • Longer meal times (is "work" rather than a social time for the parent and child).
  • Inability to drink from a cup.
  • Inability to breast or bottle feed.
  • Significant loss of food or liquid from the mouth.

Evaluation and Treatment:

At Let’s Talk Speech Therapy, Ms. Kothari may examine the strength and movement of the muscles involved in swallowing, observe oral movements during eating and drinking along with the individual's medical history and conditions. Ms. Kothari will then recommend specific swallowing treatment to help the individual swallow more effectively. It may include exercises, sensory activities, diet modification and diet upgrades. The length of the therapy program is dependent upon the severity of the Dysphagia, his/her individual rate of progress and any co-existing medical conditions.