HYDERABAD: Dysphagia is commonly described as swallowing difficulty. It is a problem in which the patient has difficulty in moving food/liquid from the mouth to the stomach. Sometimes, it may associated with pain while swallowing. The occasional difficulty in swallowing, which may occur when the patient eats too fast or doesn’t chew the food well enough, usually isn’t cause for concern. But persistent dysphagia may indicate a serious medical condition and require treatment.
Dysphagia can occur at any age, but it’s more common in older people. The causes of swallowing problems vary, and treatment depends on the cause. The muscles of the head and neck move intricately for many functions. Beyond articulating words with the tongue and lips, the muscles of the mouth and throat must work in synchrony in the essential process of swallowing.
Any difficulty in this process of swallowing is called dysphagia. Persistent difficulty in the process of swallowing can have a deep impact on a person mentally and physically. Malnutrition, dehydration, and unexpected weight loss can occur when it is difficult ingest the proper nutrients. It is very important to note that after a stroke, sensation in the throat may be reduced; food or liquid may enter the lungs without the person’s knowledge and silent aspiration can occur.
Psychologically, dysphagia can result in a lack of interest in eating, embarrassment when dining in a restaurant or around others, or isolation in social situations that involve eating. Modified-texture food and beverages may be difficult to obtain, expensive to purchase, or generally unappetizing.
Diagnosis
If you know someone who is undergoing this situation, consult a doctor for a referral to a speech pathologist /dysphagiologist. A dysphagiologist with expertise in swallowing disorders can determine if a patient is suffering from dysphagia by:
■ Taking a thorough history of the signs, symptoms, and medical condition he/she is experiencing. Also noting any medications one is taking.
■ Performing an oral mechanism exam to evaluate the strength, sensation, and movement of the lips, tongue, cheeks, and larynx.
■ Observing patient during a meal or while swallowing liquids to note aspiration signs ,behaviour, posture, and oral actions.
■ If silent aspiration / micro-aspiration was suspected then the dysphagiologist will plan for an Objective Evaluation like Modified Barium Swallow Study to observe the swallowing process under an X-ray called video fluoroscopy. An endoscopic assessment (called FEES) which inserts a a lighted tube with a camera through the nose might also be performed to examine the swallowing process.
Treatment
Managing dysphagia with the expertise of a speech-language therapist can only help people improve the impairments responsible for the dysphagia or utilise techniques to help compensate for lost function.
— Dr Govathi Nikhila Karpuram,
dysphagiologist - speech pathologist, Medanta