Swallowing Difficulties Dysphagia

Swallowing Difficulties (Dysphagia)

Eating and drinking are among life’s greatest pleasures. They’re also vital for staying alive! But when swallowing becomes difficult, it’s downright frightening.

The occasional catch in your throat when you eat too fast or don’t chew your food enough is not usually the cause for concern (although you might want to slow down!). If this happens frequently, then it can be a sign of a serious and possibly life-threatening condition, called dysphagia.

Ongoing dysphagia is a sign something’s not right with your throat or oesophagus. Although far more common in people with a brain injury or nervous system disorder (such as multiple sclerosis or Parkinson’s disease), swallowing difficulties can happen to anyone.

If you sometimes find yourself coughing, gagging, or dribbling when eating or drinking, or if your dinner often goes down the wrong way, it’s best to get checked out.

Even if it doesn’t seem like a big deal, random bits of food or drink getting into your lungs can cause nasty problems like pneumonia (which can knock you off your feet for weeks!)

Other signs to look out for:

  • Not getting food or drink down on the first try
  • Gagging or coughing when you swallow
  • Having food or drink come back up after you swallow
  • Feeling like what you’ve swallowed is stuck in your throat
  • Stomach acid in your throat or chest including heartburn
  • Trouble controlling saliva in your mouth
  • Needing to cough or clear your throat during or after eating
  • Getting recurring chest infections

Although dysphagia usually affects older people, babies can get it too – make sure you watch out for signs of difficulty sucking during feeding.

What can cause difficulties with swallowing?

Swallowing is one of those bodily processes we don’t think about. We chew, we swallow – simple right? But eating is actually quite complex and involves muscle control in your mouth, throat, and oesophagus to move food down into our stomach.

Swallowing difficulties can be caused due to the following concerns:

Muscle weakness and/or uncoordinated movements

The muscles in your mouth and throat aren’t moving food through properly.

Reflux

Stomach acid is leaking from the stomach and travelling up the oesophagus.

Nervous system changes

Conditions that affect the brain and nerves, such as stroke, Parkinson’s disease, dementia, cerebral palsy, and multiple sclerosis.

Structural damage

Tongue, palate, and lip damage can all make eating difficult. Radiation therapy can also lead to inflammation and scarring of the oesophagus.

Complications of dysphagia

Eating and drinking is how we nourish and hydrate our bodies. So logically the less we eat, the closer we get to malnutrition. Equally, dehydration is also a serious health issue with potentially devastating consequences.

Another danger is an infection, which occurs when bits of food or drink “go the wrong way” and down into the lungs. People with dysphagia are more likely to get recurring chest infections and even pneumonia. This is particularly dangerous in the elderly, and people with impaired physical health.

Even more dangerously, getting food stuck in our oesophagus can block our airway. This danger can manifest into a bigger psychological issue too, making people frightened of eating because they’re afraid they might choke. So they eat less and become malnourished. A vicious cycle!

How is dysphagia diagnosed?

A speech pathologist will try to determine where the problem is being caused – mouth, throat, or oesophagus.

After a consultation where we talk about your symptoms, how long they’ve been happening, and the exact nature of your difficulty, your speech pathologist will observe your eating and drinking a variety of textures to further determine the core issues.

If required, the following tests can also be completed:

Videofluroscopy Swallow Study (VFSS) – Using video x-ray to watch different consistencies of food and liquid to see what part of the swallowing process is causing the difficulty and if different consistencies make the swallow easier or harder.

Fibreoptic Endoscopic Evaluation of Swallowing (FEES) – Using a small camera down the back of the nose to assess swallow function and determine if there are any structural changes impacting on swallow ability.

Treatment for dysphagia

Your speech therapist will work with your medical team to help create a course of treatment.

Depending on where your problem is caused (mouth, throat or oesophagus), treatment can involve a combination of therapies, including:

  • Changing the textures of your foods and drinks
  • Learning new ways to perform swallowing functions
  • Doing exercises to help your muscles work better
  • Taking medication to reduce stomach acid or reflux
  • Positioning your body differently to help you swallow better
  • Changing the types of equipment you use to eat and drink (different cups, plates, cutlery, etc)

What to do next

Do you cough or choke when you swallow? Or feel like something is stuck in your throat after eating?

Get in touch with our family-focused team at SpeechEase. Our services are eligible for a rebate from Medicare with a referral and health insurance. Our therapists are also registered with NDIS and DVA.  Call us on 0423 334 144 to book an appointment.

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