Having Trouble Swallowing? An FAQ On Dysphagia
When you or someone you love has trouble with swallowing, it can be a very challenging experience. The ability to swallow food and drink with ease is often taken for granted, so when this ability is impacted it can cause a lot of discomfort and stress.
Difficulty swallowing is clinically referred to as Dysphagia. We’ve put together this comprehensive guide to answer the questions we are frequently asked about Dysphagia, including the symptoms, diagnosis methods, and treatment options.
What is Dysphagia?
Dysphagia (pronounced dis-FAY-juh) is a swallowing disorder that often includes difficulty with chewing, manipulating, and moving food, medications and drinks through the mouth, throat, and oesophagus into the stomach.
Some people with Dysphagia may be completely unable to swallow or have trouble safely swallowing liquids, foods, or saliva. As you can imagine, when this happens eating and drinking becomes a challenge.
How do we swallow?
As Speech Pathologists we’ll be the first to tell you how fascinating the swallowing process is. Sure, it may not sound too glamorous, but swallowing is a complex process that involves the coordination of approximately 40 muscles and many nerves. The process of swallowing is often described as taking place in three stages.
In the first stage of swallowing, called the oral phase, the tongue collects the food or liquid being consumed and makes it ready for swallowing. The tongue and jaw move solid food around the mouth so it can be chewed. Chewing turns solid food into the right size and texture for swallowing by mixing the food with saliva.
You might be surprised to learn that normally the only solid we swallow without chewing is in the form of a pill or caplet. Everything else that we swallow has been turned into the form of a puree through the oral phase of the swallowing process.
The second stage begins when the tongue pushes the food or liquid to the back of the mouth. This triggers a swallowing response that passes the food through the pharynx (or throat). This is referred to as the pharyngeal phase, where the larynx (voice box) closes tightly and breathing briefly stops to prevent food or liquid from entering the airways or lungs.
The third swallowing stage begins when food enters the oesophagus, the tube that carries food and liquid to the stomach. This is called the oesophageal phase and it’s a speedy process – usually taking about three seconds depending on the texture or consistency of the food.
What causes Dysphagia?
Dysphagia can occur for a variety of reasons, most often due to a condition that causes weakness in the muscles and nerves used for swallowing.
As an example, people with diseases that affect the nervous system, such as Parkinson’s disease, often develop problems with swallowing. On the other hand, there are people who experience head injury or stroke that can affect the coordination of the swallowing muscles and/or limit sensation in the mouth and throat.
What are the common signs and symptoms of a swallowing problem?
The common signs and symptoms of Dysphagia include:
- Coughing or choking when eating or drinking
- Difficulty with chewing food
- Food/fluids often ‘going down the wrong way’
- Reoccurring upper respiratory infections
- A ‘wet sounding’ voice
- Unplanned weight loss
- Food sticking in the mouth or throat
- Pneumonia or other respiratory disorders
- Experiencing a ‘bit of a tickle in the throat’ while eating/drinking
What can happen if Dysphagia is left untreated?
Dysphagia can cause a lot of stress and discomfort if left untreated. When swallowing is painful or difficult it can cause individuals to eat less food and drink less fluids, leading to malnutrition, dehydration, weight loss, and decreased quality of life.
If left undiagnosed and untreated Dysphagia can also lead to aspiration, meaning the entry of food/liquid into the airway. Aspiration increases the risk of developing pneumonia.
With this in mind, it’s important to note that Pneumonia is the leading cause of death in children under 5 and is the 5th leading cause of death in adults over 65 with progressive neurological disorders (eg Parkinsons, Motor Neuron Disease, Huntingtons Disease).
How is a swallowing problem diagnosed?
A qualified Speech Pathologist with experience in diagnosing and supporting individuals with swallowing disorders can help those experiencing Dysphagia symptoms.
When meeting with a Speech Pathologist to evaluate swallowing you’ll have a history of medical conditions and symptoms taken, and the clinician will look at the strength and movement of the muscles involved in swallowing.
A Speech Pathologist will also observe posture, behaviour and oral movements during eating and drinking and may perform special tests to evaluate swallowing ability.
Specialised tests for diagnosing Dysphagia include:
- Videofluroscopic swallowing evaluation
- Endoscopic assessment
If I suspect my family member or friend has a swallowing problem, what should I do?
If after reading through our guide you think you or a loved one may need an assessment to determine whether your swallowing challenges may be related to Dysphagia, we’d recommend getting in touch with your General Practitioner who will be able to provide a referral to a Speech Pathologist who specialises in the diagnosis and treatment of Dysphagia.
All information is general in nature.